People often confuse Crohn’s disease with ulcerative colitis (UC). There are similarities between these conditions, but there are also some major differences that help doctors determine whether a patient is suffering from UC or Crohn’s. In this post, I’m going to talk about both these conditions.
Introduction: Irritable Bowel Disease
Irritable bowel disease is the catch-all category for chronic inflammatory diseases affecting the digestive tract. Crohn’s disease and ulcerative colitis are forms of irritable bowel disease.
In people with IBD, the immune system mistakes normal things like food and “friendly” bacteria in the digestive tract for invaders and responds by sending infection-fighting white blood cells, which then cause chronic inflammation. This inflammation can be seen during diagnostic imaging such as colonoscopy or CT scan.
There is no cure for IBD, but treatment to improve symptoms and enhance quality of life are available. Diet changes and medications can help reduce inflammation in the digestive tract and allow patients to live a pretty normal life.
Crohn’s Disease
Crohn’s disease can affect any part of the gastrointestinal tract, from the mouth to the anus, although it’s mostly found at the end of the small intestine and the beginning of the colon. Symptoms of Crohn’s disease include frequent diarrhea, occasional constipation, abdominal pain, weight loss, blood in the stool, and even skin conditions or joint pain. Crohn’s disease can cause blockages of the intestine due to scarring and swelling. The inflammation in Crohn’s disease involves the entire depth of the intestinal wall, leading to ulcers and potentially fistulas between the bowel and other organs.
Symptoms of Crohn’s disease vary from person to person, but some of the more common symptoms include abdominal pain and cramps, persistent diarrhea, rectal bleeding, constipation, an urgent need to move your bowels, loss of appetite and resulting weight loss, fatigue, night sweats, and, in women of childbearing age, loss of the normal menstrual cycle.
The most common way to treat Crohn’s disease is through medications that include steroids; antibiotics if infections or fistulas cause abscesses; immune modifiers such as azathioprine and 6-MP; aminosalicylates such as 5-ASA; and biologic therapy. Some people with especially severe Crohn’s disease that doesn’t respond to these treatments may have to have surgery to remove portions of the intestinal tract.
Crohn’s disease symptoms can change in severity over time. They could become very severe or they could go into remission, and the symptoms might change over the years. Crohn’s symptoms can also come on suddenly and without warning. It’s very important for Crohn’s patients to work closely with their doctors and advocate for themselves to ensure the best possible quality of life. One thing to know about Crohn’s disease is that it increases the risk of colon cancer, so patients should follow their doctor’s advice and get regular colonoscopies.
Ulcerative Colitis
Unlike Crohn’s disease, ulcerative colitis is largely limited to the large intestine and the rectum. Inflammation in UC only affects the top layers of the large intestine, whereas Crohn’s inflammation can go through the intestinal wall and cause fistulas and ulcers.
According to the Crohn’s and Colitis Foundation, more than 900,000 people in the United States are affected by ulcerative colitis. The disease can appear at any time, but it most often starts between the ages of 15 and 35.
Symptoms of UC include abdominal pain, loose stools, bloody stools, weight loss, malnutrition from loss of appetite, fatigue, and urgent need to have a bowel movement. The symptoms can vary depending on the type of UC. Acute severe UC is a rare form of the disease that affects the entire colon and causes eating problems. Left-sided colitis affects the descending colon and rectum, pancolitis affects the whole colon and causes persistent bloody diarrhea. Proctosigmoiditis affects only the lower colon and rectum, and ulcerative proctitis affects only the rectum and is the mildest form of UC.
Treatment for UC is similar to that of Crohn’s disease. It includes aminosalicylates, antibiotics to control infections or treat complications of UC; biologic therapy, steroids to treat UC flare-ups, and immune modifiers, which are commonly used to maintain remission or for people who have only responded to steroids.
UC patients should have regular colonoscopies because UC can increase the risk of colon cancer.
Conclusion: Similar, But Not the Same
Although the symptoms and treatment programs for Crohn’s disease and ulcerative colitis are similar, the diseases themselves have some important differences. Whichever disease you have, it’s important to do research on the disease and work with your doctor to manage the condition. It’s important for both Crohn’s and UC patients to advocate for themselves with their doctors and to understand which treatments your doctor wants to use, and why.
With treatment, people with Crohn’s disease and ulcerative colitis can manage their conditions and live a good life. By being careful what they eat, following doctor’s orders for treatment, and getting recommended screening tests, it’s possible to manage Crohn’s or UC—and maybe even achieve remission.