The Difference Between Crohn’s Disease & Ulcerative Colitis

Crohn’s Disease and Ulcerative Colitis (UC) are both gastrointestinal diseases, and while they have some commonalities, they require different treatment. One of the most common complaints patients present with to their general practitioner are “tummy troubles”. While many gastrointestinal problems are usually not serious, in some cases, they can be, especially when accompanied by severe pain that comes on suddenly, an inability to have bowel movements, bloody stool, vomiting blood, abdominal rigidity, or breathing difficulties.

Crohn’s disease and UC are two of the most common types of IBDs caused by chronic inflammation of the digestive tract.

Although there are no accurate statistics that reflect the true number of South Africans who suffer Crohn’s or UC, experts suggest combining the numbers could be seven in every 100 000.

Crohn’s disease and UC present with very similar symptoms, but there are key differences between them. Understanding these differences is essential in diagnosis and treatment.

Both diseases most commonly develop in teenage and young adult years but can occur at any age. Both affect men and women. Both have no definite cause (although factors may include environmental aspects, genetic makeup, and hyper-immune responses from the body). And both can be detected through a colonoscopy and blood tests.

With so many similarities, what then are the key difference between Crohn’s disease and ulcerative colitis?

Crohn’s symptoms include nausea, weight loss, and vomiting, with only occasional rectal bleeding and diarrhoea. In contrast, symptoms of UC are blood in the stool with mucus, frequent diarrhoea, loss of appetite, and a strong urge to use the bathroom without necessarily having a bowel movement.

Crohn’s disease affects the entire gastrointestinal tract, from the mouth to the anus, whereas UC affects only the colon.

People with Crohn’s disease typically have healthy stretches of intestine between inflamed areas, whereas people with UC have continuous colon inflammation.

Crohn’s disease produces granulomas, which are groupings of immune cells, whereas UC does not.

How is crohn’s and ulcerative colitis diagnosed?

A colonoscopy, a technique that allows a gastroenterologist to observe the whole colon and collect a biopsy of inflamed tissue, is the gold standard for diagnosing both IBDs.

If there are patches of healthy tissue interspersed with patches of inflamed tissue, it could suggest Crohn’s. If inflammation starts at the rectum and moves continuously up the colon and then stops, this could be a sign of UC.

According to the Crohn’s & Colitis Foundation, 10 to 15% of persons with IBD have “indeterminate colitis,” which has symptoms similar to both Crohn’s and UC, which can lead to a misdiagnosis.

Treatment options

While there is no cure for Crohn’s nor UC, symptoms can be managed with medication to reduce inflammation, pain, and discomfort that worsens during flare-ups (IBDs often follow a cycle of remission and relapse, where symptoms are controlled at times and flare at other times).

Diet has a vital role in treating both diseases’ flare-ups. Working with a dietitian can help you determine which foods you should avoid and which foods assist in fighting inflammation.

In severe cases, surgery may be needed. About half of Crohn’s patients will require surgery within ten years of diagnosis, compared with 10 to 30 percent of adults with UC.

“Only your doctor can tell you if you have an IBD and, if so, which one,” says Murray Hewlett, CEO of Affinity Health. “If you think you could have Crohn’s disease or ulcerative colitis, it’s important that you consult with a healthcare provider to confirm the diagnosis and put you on the right course of treatment.”

For more information on the Chronic Disease Benefit and the full Affinity Chronic Disease List, click here.