Crohn’s Disease vs. Ulcerative colitis What's Difference?

Crohn’s Disease vs. Ulcerative colitis What's  Difference


 People can get confused when it comes to differentiating between inflammatory bowel disease (IBD), Crohn’s disease, and ulcerative colitis (UC).

The short explanation is that IBD is the umbrella term for the condition under which both Crohn’s disease and UC fall. But there is, of course, much more to the story.

Both Crohn’s and UC are marked by an abnormal response by the body’s immune system, and they may share some symptoms.

However, there are important differences as well, especially in regards to the location of the conditions in the gastrointestinal (GI) tract and the way each responds to treatment. Understanding these features is key to getting a proper diagnosis from a gastroenterologist.

This chart explains the similarities and differences between UC and Crohn’s, including types of treatment.

Crohn’s symptomsUC symptomsShared
symptoms
Crohn’s treatmentsUC treatments
Joint painUrgency of bowel movementsWeight lossSteroids (temporarily)
Biologic therapy
Antibiotics (if infections or fistulas cause abscesses)
Steroids (temporarily)
Biologic therapy
Antibiotics (if infections or fistulas cause abscesses)
FistulasLoss of appetiteFatigueImmunomodulators (e.g., azathioprine and 6-MP)
Aminosalicylates
(e.g., 5-ASA)
Immunomodulators (e.g., azathioprine and 6-MP)
Aminosalicylates
(e.g., 5-ASA)
Skin conditionsLoose stoolsAbdominal painSurgery is less commonSurgery

IBD was seldom seen before the rise of improved hygiene and urbanization at the beginning of the 20th century.

Today, it’s still found mainly in developed countries such as the United States. Like other autoimmune and allergic disorders, it’s believed that a loss of certain gut bacteria has partially contributed to diseases such as IBD.

In people with IBD, the immune system mistakes food, bacteria, or other materials in the GI tract for foreign substances and responds by sending white blood cells into the lining of the bowels.

The result of the immune system’s attack is chronic inflammation. The word “inflammation” itself comes from the Greek word for “flame.” It literally means “to be set on fire.”

Crohn’s and UC are the most common forms of IBD. Less common IBDs include:

  • microscopic colitis
  • diverticulosis-associated colitis
  • collagenous colitis
  • lymphocytic colitis
  • Behçet’s disease

IBD can develop at any age. Many with IBD receive a diagnosis before the age of 35, but it can be diagnosed later in life. Although the demographicsTrusted Source of IBD are changing, it can be more common in:

  • people in higher socioeconomic brackets
  • people who are white
  • people who eat high-fat diets

It’s also more common in the following environments:

  • industrialized countries
  • northern climates
  • urban areas

Aside from environmental factors, genetic factors are believed to play a strong role in the development of IBD. Therefore, it’s considered to be a “complex disorder.”

For many forms of IBD, there’s no cure. Treatment is centered around management of symptoms with remission as a goal. For most, it’s a lifelong disease, with alternating periods of remission and flare-up.

Modern treatments, however, allow people to live relatively normal and active lives.

IBD shouldn’t be confused with irritable bowel syndrome (IBS). While some symptoms may be similar at times, the source and course of the conditions differ quite significantly.

Crohn’s disease may affect any part of the GI tract from the mouth to the anus, although it’s most often found at the end of the small intestine (small bowel) and the beginning of the colon (large bowel).

Symptoms of Crohn’s disease can include:

  • frequent diarrhea
  • occasional constipation
  • abdominal pain
  • fever
  • blood in the stool
  • fatigue
  • skin conditions
  • joint pain
  • malnutrition
  • weight loss
  • fistulas

Crohn’s isn’t limited to the GI tract. It may also affect the skin, eyes, joints, and liver. Since symptoms usually get worse after a meal, people with Crohn’s will often experience weight loss due to food avoidance.

Crohn’s disease can cause blockages of the intestine from scarring and swelling. Ulcers (sores) in the intestinal tract may develop into tracts of their own, known as fistulas.

Crohn’s disease can also increase the risk of colon cancer, which is why people living with the condition must have regular colonoscopies.

Medication is the most common way to treat Crohn’s disease. The five types of drugs are:

  • steroids (on a temporary basis)
  • antibiotics (if infections or fistulas cause abscesses)
  • immunomodulators, such as azathioprine and 6-MP
  • aminosalicylates, such as 5-ASA
  • biologic therapy

Some cases may also require surgery, although surgery won’t cure Crohn’s disease.

Ulcerative colitis

Unlike Crohn’s, ulcerative colitis is confined to the colon (large bowel) and only affects the mucosa and submucosa (top layers) in an even distribution. Symptoms of UC include:

  • abdominal pain
  • loose stools
  • bloody stool
  • urgency of bowel movement
  • fatigue
  • loss of appetite
  • weight loss
  • malnutrition

The symptoms of UC can also vary by type. According to the Crohn’s & Colitis Foundation, there are three kinds of UC based on location:

  • Left-sided colitis: This type affects the descending colon and rectum.
  • Ulcerative proctitis: The mildest form of UC, it affects the rectum only.
  • Extensive colitis: This type of UC affects the entire colon.

All of the medications used for Crohn’s are often used for UC as well. Surgery, however, is used more frequently in UC and is considered to be a cure for the condition. This is because UC is only limited to the colon, and if the colon is removed, so is the disease.

The colon is very important though, so surgery is still considered a last resort. It’s typically only considered when remission is difficult to reach and other treatments have been unsuccessful.

When complications do occur, they can be severe. Left untreated, UC may lead to:

  • perforation (holes in the colon)
  • colon cancer
  • liver disease
  • osteoporosis
  • anemia
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There’s no doubt that IBD can significantly decrease quality of life, between uncomfortable symptoms and frequent bathroom visits. IBD can even lead to scar tissue and increase the risk of colon cancer.

If you experience any unusual symptoms, it’s important to call your doctor. You may be referred to a gastroenterologist for IBD testing, such as a colonoscopy, sigmoidoscopy, or a CT scan. Your doctor may also order blood and fecal testing. Diagnosing the specific form of IBD will lead to more effective therapies.

Commitment to daily treatment and lifestyle changes can help minimize symptoms, achieve remission, and avoid complications.

JPeei Clinic