Crohn’s disease and ulcerative colitis (UC) are both types of inflammatory bowel disease (IBD) that share similar symptoms but differ in their affected areas, disease progression, and treatment approaches.
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 two other conditions. So, Crohn’s disease and UC are two types of IBD. But there’s 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 regarding 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.
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 attacks its own gastrointestinal tract by mistake.
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 causes of inflammation in the GI tract include:
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 the 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:
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 also increase the risk of colon cancer if one-third of the colon or more is affected by Crohn’s. If less than one-third is affected, or it does not affect the colon at all (only the small intestine), then there’s no increased risk of colon cancer.
Medication is the most common way to treat Crohn’s disease. The four types of drugs are:
Some cases may also require surgery, although surgery won’t cure Crohn’s disease.
Unlike Crohn’s, UC is confined to the colon (large bowel) and only affects the mucosa and submucosa (top layers) in an even distribution. Symptoms of UC include:
Surgery is much more common in Crohn’s than UC, with 50% to 80% of Crohn’s patients having surgery versus 10% to 30% of UC patients.
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:
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.
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