Crohn’s vs. Ulcerative Colitis

Both are forms of irritable bowel disease and even doctors sometimes struggle to discern which is which

Crohn’s vs. Ulcerative Colitis

By Danyelle White Published at March 13 Views 2,320

Crohn’s disease and ulcerative colitis are siblings in a family of dysfunctional digestive tracts. They can present themselves with similar symptoms, and as the two primary forms of irritable bowel disease, even doctors sometimes struggle to discern which is which. Here is a breakdown of the most important differences between the two conditions.

Symptoms

Both Crohn’s disease and ulcerative colitis patients experience common symptoms such as abdominal pain and cramping, diarrhea, bloody stool, unintended weight loss, and fever that tends to accompany inflammation. However, there are sometimes subtle differences in how these symptoms present themselves. For example, ulcerative colitis pain usually manifests on the left side of the abdomen while it’s more common for Crohn’s pain to be felt on the right side. And while bloody stools can be a symptom of either condition, because ulcerative colitis originates in the colon, bleeding is more common with that condition.

Diagnosis

Blood tests, stool samples and colonoscopies are the most typical screening processes your medical provider will request to help diagnose the bowel disorders. In both cases, a blood test would look for anemia — low iron levels — and certain types of antibodies that can accompany inflammatory diseases. A stool sample would test for blood and white blood cells or other signs of infection. Bacterial infections are particularly common in those who have ulcerative colitis.

The colonoscopy is usually the most determinant test in the diagnostic process because the patterns of inflammation in the two diseases differ vastly. With Crohn’s patients, pockets of inflammation appear intermittently throughout the digestive track amid patches of healthy intestinal tissue. Conversely, the damaged tissue in those with ulcerative colitis is continuous, starting from the colon and spreading inward as the disease progresses. In a colonoscopy, the appearance of these differences makes a Crohn’s patient’s colon appear thick and cobblestoned (because of the patches of healthy tissue), while an ulcerative colitis patient’s colon will appear thinner.

Treatment

Many of the treatments for both Crohn’s disease and ulcerative colitis are similar. The aim in both cases is to reduce the amount of inflammation present in the digestive tract to minimize pain and complications and to keep the patient in remission as long as possible.

Anti-inflammatory drugs are often the first stop in the journey of IBD treatment. The most effective of this family of medications are the corticosteroids, as they work to reduce inflammation throughout the body. However, oftentimes their use comes with several undesirable side effects, including weight gain, excessive facial hair, puffiness in the face or joints, and insomnia. More serious side effect include diabetes, high blood pressure, glaucoma, osteoporosis and more. Because these drugs can take such a toll on the body, they are meant to be short-term (three to four months) solutions to reduce the inflammation enough to put the patient in remission. Other oral medications to treat IBD can include immune suppressors, antibiotics and OTC anti-diarrheal drugs and pain relievers.

Surgery is also an option for both those with Crohn’s and those with ulcerative colitis, though with different results. Because the damaged areas within a Crohn’s patient’s digestive tract are interspersed, only small portions of the tissue can be removed. This type of surgery can provide the Crohn’s patient with some relief, but it’s usually temporary. Conversely, because the damage in an ulcerative colitis patient is continuous, the whole section of tissue can be removed, and the patient can be “cured” of the disorder.

To learn more about Crohn's disease:

10 Best Foods for Crohn’s Disease
Understanding Crohn’s Disease
What Is a Low-Residue Diet?

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