ULCERATIVE COLITIS VS. CROHNS DISEASE
LOCATION
Ulcerative Colitis only affects the large intestine.
Crohns Disease can affect any part of the GI tract from the mouth to the anus.
PATTERN
Ulcerative Colitis – Inflammation is continuous, so it is usually in one patch in the colon. Inflammation generally appears smoother than in Crohns.
Crohns Disease – Crohns has “skip lesions” inflammation can be patchy and in several places in the GI tract. Crohns inflammation has a bumpy “cobblestone” appearance.
TYPES
Ulcerative Colitis – Phenotypes, or different observable types of disease, are rare in Ulcerative Colitis.
Crohns Disease – Crohns 3 main phenotypes are, Inflammatory, Fistulizing and Obstructing. These phenotypes are what create such different experiences in patients of the same disease
INFLAMMATION
Ulcerative Colitis – Inflammation is “Superficial” meaning it’s on the surface lining of the large intestine.
Crohns Disease – Inflammation is “transmural” meaning it can occur throughout all layers of the bowel wall.
LESIONS
Ulcerative Colitis – Lesions, which are damaged, diseased spots, are uncommon in Ulcerative Colitis. UC patients are lacking in granulomas, a cluster of inflammatory cells.
Crohns Disease – Focal lesions and Granulomas are more common in Crohns patients. Granulomas are one criteria that doctors use to determine diagnosis.
SYMPTOMS
Ulcerative Colitis – UC patients more commonly experience pain in the lower left abdomen, which is often the site of inflammation. Patients may also experience more bleeding during bowel movements.
Crohns Disease – Crohns patients often experience pain in the lower right abdomen. Crohns patients may experience more complications such as fistulas and obstructions.
SURGERY
Ulcerative Colitis – Up to 45% of UC patients will have surgery. Often, just one, or one series of surgeries. Many UC patients find relief after surgery, but this is not widely considered a cure for Ulcerative Colitis.
Crohns Disease – Up to 75% of Crohns Patients will require surgery. Often multiple, separate surgeries are needed, such as resections and fistula repairs.
OSTOMY
Ulcerative Colitis – Many UC surgery patients have a Total Abdominal Colectomy ( TAC ). This results either in a permanent ostomy, or a temporary ileostomy, followed by a takedown surgery and pouch construction.
Crohns Disease – Crohns patients are less likely to have a permanent ostomy, but Temporary ileostomies are used to divert digestion and give the bowel a rest for a period of time, and then reversed.
TOBACCO EFFECT
Ulcerative Colitis – While we NEVER recommend tobacco use as a treatment, some studies show opposite effects or tobacco in Crohns and UC – for Colitis patients, it may have a preventative effect.
Crohns Disease – In Crohns Patients, tobacco can worsen symptoms, so we DEFINITELY don’t recommend it. But this difference is a strong indicator that while Crohns and UC can be similar, they are still different.
REMISSION
Ulcerative Colitis – Once in remission, UC patients report having higher rates of remaining in remission. However, just like surgery, this differs in each patient.
Crohns Disease – Many studies show that Crohns patients have a less predictive pattern of flaring and remission, and flares can occur at nearly any time.
WHAT DO WE ALL HAVE IN COMMON ?
Both Crohns and Colitis are considered inflammatory bowel diseases ( IBD ) and are Autoimmune in nature. They often develop in teenagers and young adults, and affect men and women equally. Symptoms can be specific to each individual, but generally the symptoms are very similiar.
SYMPTOMS AND EXPERIENCES FOR BOTH UC AND CROHNS VARY BY PERSON, BUT THIS WE ALL KNOW FOR SURE… WE ARE ALL ON THE SAME TEAM AND MOVING TOWARDS THE SAME GOALS.
GO TEAM IBD !
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