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Crohn’s vs. Ulcerative Colitis: How Are They Different?
Millions of people in the United States live with Crohn’s disease or ulcerative colitis.1 There are many people who have one of these conditions and have not yet been properly diagnosed because they are unaware of the symptoms or only have occasional flare ups.
Both Crohn’s and ulcerative colitis are inflammatory bowel diseases that affect the digestive system. While they are both incurable, there are treatments available to help alleviate the symptoms.
December 1st through December 7th is Crohn’s & Colitis Awareness Week. This week is meant to spread awareness and educate people about these two similar diseases. Here are some facts about Crohn’s and ulcerative colitis and what makes them different, as well as the symptoms and treatment options available.
What is Crohn’s Disease?
Crohn’s disease is an inflammatory bowel disease that causes inflammation in the digestive tract.2 The areas of inflammation, as well as the severity, can vary from person to person. This means inflammation can be anywhere throughout the large and small intestine.
Symptoms of Crohn’s Disease
Some of the symptoms of Crohn’s disease include:
- Cramping or abdominal pain
- Weight loss
- Loss of appetite3
In some cases, the symptoms of Crohn’s disease can worsen depending on certain triggers that cause flare ups such as specific foods or stress.
What is Ulcerative Colitis?
Ulcerative colitis is an inflammatory bowel disease that causes inflammation and ulcers on the lining of the large intestine, also known as the colon.4 The inflammation due to ulcerative colitis typically starts at the rectum and spreads to other parts of the colon.
Symptoms of Ulcerative Colitis
Some of the symptoms of ulcerative colitis are very similar to Crohn’s, which include:
- Abdominal cramping
- Weight loss
- Joint pain5
Crohn’s vs. Ulcerative Colitis
Crohn’s and ulcerative colitis both have many of the same symptoms, which oftentimes gets them mistaken for the same disease. However, there are a few things that differ between these two inflammatory bowel diseases.6
- Location. Ulcerative colitis only affects the large intestine. Crohn’s can be anywhere in the digestive tract, from the mouth to the anus.
- Inflammation. People with Crohn’s will have healthy spots between spots of inflammation. People with ulcerative colitis will not.
- Areas affected. Crohn’s disease affects more areas throughout the whole digestive tract, which can cause other problems such as mouth sores and anal ulcers. These issues are not present in those with ulcerative colitis because only the large intestine is affected.
Causes & Diagnosis
- Genes. About 20% of people with an inflammatory bowel disease also have a parent, sibling, or child who also has an IBD.8 The genetic risk for Crohn’s is higher than ulcerative colitis.
- Autoimmune reaction. If your immune system mistakenly attacks healthy cells in the body, such as bacteria mistakenly triggering the immune system, this can cause inflammation and lead to symptoms of Crohn’s disease.9 Ulcerative colitis is also caused by an overactive immune response that causes the immune system to attack healthy tissue.10
Diagnosing Crohn’s disease or ulcerative colitis will oftentimes call for numerous medical tests. Some of these tests include:
- Physical examination. The doctor may give you a physical evaluation and ask you questions about your symptoms.
- Blood test. This can check for intestinal inflammation.
- Stool test. This can also check for signs of intestinal inflammation.
- Colonoscopy. This will examine the small and large intestine.
- Endoscopic ultrasound. This will check the digestive tract for signs of swelling or any ulcers.
- Imaging scan. A CT or MRI may be used to check for inflammation or an abscess.11
Although Crohn’s disease and ulcerative colitis may have some slight differences, they are typically treated with the same medications. Neither disease can be cured, but there are medications and options available to help mitigate the effects.
There are different medications for these two diseases, and each person can react differently to the medications. The main goal of these treatments is to reduce inflammation which would in turn reduce the symptoms that come with the diseases.
Some of the anti-inflammatory medicines used include corticosteroids, which help to reduce inflammation. There are also immune system suppressors designed to suppress the abnormal response from the immune system that is causing the symptoms.12
Diet is another form of treatment for those with Crohn’s diseases and ulcerative colitis. Although there is not a specific diet to completely get rid of the symptoms, there are certain foods may cause flare ups and increase the symptoms and discomfort. Here are some foods that individuals with Crohn’s or ulcerative colitis are advised to limit their intake of:
- Spicy foods
- Greasy foods
- Whole grains
- High-fiber fruits and vegetables
There are a few different surgical options for individuals with Crohn’s disease or ulcerative colitis.
Surgery is usually only suggested if other forms of treatment are not effective or if there is an emergency situation. If you have a severe form of Crohn’s or ulcerative colitis, consult with your doctor before considering surgery. Individuals may also consider surgery if they’re at higher risk for colorectal cancer.
Here are some emergency instances in which surgery for Crohn’s disease would need to be performed:
- Intestinal blockage. Chronic inflammation in the intestine can cause scar tissue to form within the digestive organs. This will cause a stricture, which is a narrow section within the walls of the organs, and can lead to blockage.
- Bleeding in the intestine. This is a rare symptom of Crohn’s disease, however, if the bleeding cannot be controlled with other treatments, surgery is needed.
- Perforation of the bowel. Chronic inflammation can weaken the walls of the intestine, which can lead to a hole, otherwise known as a perforation. This will cause contents of the intestine to spill over into the abdomen and cause an infection.
- Toxic megacolon. This is caused by severe inflammation in the colon and causes pain, swelling of the abdomen, fever, and dehydration. This is a life-threatening issue that requires immediate surgery.14
There are also some situations in which those with ulcerative colitis may need surgery. Some of these include:
- Sudden and severe ulcerative colitis. This is the main reason that individuals with ulcerative colitis would need emergency surgery. This can lead to a toxic megacolon, bleeding from ulcers, or enlargement of the colon.
- Perforation of the colon. Chronic inflammation can weaken the walls of the colon until a hole, also known as perforation, forms and causes an infection.15
There are different options for these surgeries such as removing the colon or the rectum, or creating an internal pouch. The type of surgery that a doctor recommends will depend on an individual’s symptoms, personal preference, and medical suggestions.
Spread Awareness During Crohn’s & Colitis Awareness Week
Help spread awareness about these two diseases during Crohn’s & Colitis Awareness Week. Many people may know of these diseases, but may not be aware of the symptoms of Crohn’s disease, the symptoms of ulcerative colitis, and how they differ.
If you or a loved one have experience with an inflammatory bowel disease, share your story and help educate others.
To learn more about Saber Healthcare and our services, click here.
Saber Healthcare is an organization dedicated to providing consultant services to long term care providers. This article is for informational purposes and is not meant to be seen as professional advice. Please consult with a medical expert before relying on the information provided.
- “Crohn’s & Colitis Awareness Week.” Crohn’s & Colitis Foundation, crohnscolitisfoundation.org. Accessed December 1st, 2021. https://www.crohnscolitisfoundation.org/awarenessweek.
- “Crohn’s Disease.” Mayo Foundation for Medical Education and Research, Mayo Clinic. October 13th, 2020. Accessed December 1st, 2021. https://www.mayoclinic.org/diseases-conditions/crohns-disease/symptoms-causes/syc-20353304.
- “Crohn’s Disease.” National Library of Medicine, MedlinePlus. October 28th, 2021. Accessed December 1st, 2021. https://medlineplus.gov/crohnsdisease.html.
- “Ulcerative Colitis.” U.S. Department of Health & Human Services, National Institute of Diabetes and Digestive and Kidney Diseases. Accessed December 1st, 2021. https://www.niddk.nih.gov/health-information/digestive-diseases/ulcerative-colitis.
- “Ulcerative Colitis.” Cleveland Clinic, myclevelandclinic.org. April 23rd, 2020. Accessed December 1st, 2021. https://my.clevelandclinic.org/health/diseases/10351-ulcerative-colitis#symptoms-and-causes.
- Ratini, Melinda. “Crohn’s & Ulcerative Colitis: Know the Difference?” WebMD, webmd.com. September 4th, 2020. Accessed December 1st, 2021. https://www.webmd.com/ibd-crohns-disease/crohns-disease/crohns-colitis-difference.
- Holland, Kimberly. “Understanding Crohn’s Disease.” Healthline Media, healthline.com. April 16th, 2021. Accessed December 2nd, 2021. https://www.healthline.com/health/crohns-disease.
- “The Facts About Inflammatory Bowel Diseases.” Crohn’s & Colitis Foundation of America, crohnscolitisfoundation.org. Accessed December 1st, 2021. https://www.crohnscolitisfoundation.org/sites/default/files/2019-02/Updated%20IBD%20Factbook.pdf.
- “Symptoms & Causes of Crohn’s Disease.” U.S. Department of Health & Human Services, National Institute of Diabetes and Digestive and Kidney Diseases. Accessed December 1st, 2021. https://www.niddk.nih.gov/health-information/digestive-diseases/crohns-disease/symptoms-causes#:~:text=One%20cause%20of%20Crohn's%20disease,to%20symptoms%20of%20Crohn's%20disease.
- Sissons, Beth. “Is ulcerative colitis an autoimmune disease?” Healthline Media, Medical News Today. June 15th, 2021. Accessed December 2nd, 2021. https://www.medicalnewstoday.com/articles/is-ulcerative-colitis-an-autoimmune-disease.
- “Inflammatory Bowel Disease (Overview).” Cleveland Clinic, clevelandclinic.org. May 3rd, 2021. Accessed December 2nd, 2021. https://my.clevelandclinic.org/health/diseases/15587-inflammatory-bowel-disease-overview.
- “Crohn’s Disease Treatment Options.” Crohn’s & Colitis Foundation, crohnscolitisfoundation.org. Accessed December 2nd, 2021. https://www.crohnscolitisfoundation.org/What-is-crohns-disease/treatment.
- “Creating a Crohn’s Disease Diet Plan.” WebMD, webmd.com. May 12th, 2021. Accessed December 2nd, 2021. https://www.webmd.com/ibd-crohns-disease/crohns-disease/creating-a-crohns-disease-diet-plan.
- “Surgery for Crohn’s Disease.” Crohn’s & Colitis Foundation, crohnscolitisfoundation.org. Accessed December 2nd, 2021. https://www.crohnscolitisfoundation.org/what-is-crohns-disease/treatment/surgery.
- “Surgery for Ulcerative Colitis.” Crohn’s & Colitis Foundation, crohnscolitisfoundation.org. Accessed December 2nd, 2021. https://www.crohnscolitisfoundation.org/what-is-ulcerative-colitis/surgery.