Crohn’s and Ulcerative Colitis

What Are Crohn’s and Ulcerative Colitis?

Crohn’s disease and ulcerative colitis (UC) are known as inflammatory bowel disease (IBD). It’s estimated that up to three million Americans have some form of IBD. Collectively, IBD is a group of disorders that cause inflammation of the digestive tract. Patients can often get confused between Crohn’s disease, ulcerative colitis, and IBD. The simple answer is that both Crohn’s and UC fall under the umbrella of inflammatory bowel diseases. Patients typically have Crohn’s or ulcerative colitis, but not both. These disorders have differences and damage the colon in different ways. 

What Is the Difference Between Irritable Bowel Syndrome (IBS) and IBD?

Because of the similarity in acronyms, IBS and IBD often become confused with one another. Both diseases have similar symptoms, however, the level of severity and impact on the gastrointestinal tract differs greatly. While symptoms of IBS affect patients’ lives negatively and affect their quality of life, IBS irritates, but does not damage the gastrointestinal tract.  While it can cause uncomfortable symptoms such as gas, bloating, and stomach pains, it is not a serious disease, Further, symptoms of IBS can typically be alleviated and managed with medications and modifications in diet.

On the other hand, if left untreated, IBD can damage the gastrointestinal tract through an inflammatory process that can affect any organ in the gastrointestinal tract from the mouth to the anus, depending on what type of IBD you have (Crohn’s or Ulcerative Colitis).

What Is Crohn’s Disease?

Crohn’s disease is a type of IBD capable of inflaming any part of the digestive tract, which is considered from the mouth to the anus. However, Crohn’s usually takes aim at the large and small intestines. Crohn’s symptoms can include chronic (sometimes uncontrollable) diarrhea, loss of appetite, unexplained weight loss, abdominal pain, blood in the stool, mouth sores, fever, and fatigue.  

Researchers are still unsure what causes Crohn’s disease. However, there are risk factors that can contribute to the development of Crohn’s. These include:

• Having an autoimmune disease. Having an autoimmune disease diagnosis (such as lupus) heightens your chances of developing Crohn’s. 
• Smoking. Your chances of having Crohn’s disease are doubled if you smoke cigarettes.
• Genetics. Inflammatory bowel diseases run in families, so if a close family member has Crohn’s or UC, it can increase your chances of having it too.

How Is Crohn’s Disease Diagnosed?

If you are experiencing symptoms such as the ones listed above, you should consult your doctor to find out the cause of the problem. The physician will look for evidence of Crohn’s disease and may also rule out other diseases by performing diagnostics. A complete blood count (CBC) is typically ordered first to look for a high white blood cell count and a low red blood cell count. This is because one in three patients with Crohn’s also have anemia. Your gastroenterologist may also order a stool test to look for signs of intestinal inflammation and infection. 

To get a closer look, your healthcare provider may also order a colonoscopy, upper gastrointestinal endoscopy, or a computed tomography (CT) scan. Some of these tests are more invasive but allow your doctor to get a closer look at your colon and digestive tract. 

Patients with Crohn’s often have “flare-ups,” where inflammation can come on fairly quickly. To help manage symptoms and reduce inflammation, your doctor may suggest the following:

• Antibiotics. You may be prescribed antibiotics as a preventative measure or as a treatment for a current flare-up.
• Antidiarrheal medication. Over-the-counter medications may not be sufficient for a Crohn’s flare-up, so your physician may give you prescription-strength medicine. 
• Corticosteroids. These medications ease inflammation.
• Aminosalicylates. These are a certain class of drugs that can reduce inflammation in the small and large intestines and are used for mild forms of Crohn’s disease.
• Biologics. These are a group of medications, such as monoclonal antibodies, that can suppress the immune response. These are generally used for more moderate to severe levels of Crohn’s disease 
• Immunomodulators. These are a groups of medicines that can deter the immune response and tend to be stronger than the anti-inflammatory class of drugs. However, there are typically not as strong as Biologics in treating Crohn’s disease. 
• Surgery. This is an extreme measure and is only an option when there is significant damage to the intestines or there is bleeding or blockage.

If Crohn’s isn’t diagnosed and treated, this can lead to serious complications, such as ulcers, abscesses, bowel obstruction, and fistulas. Crohn’s disease also increases the risk of colon cancer and can cause malnutrition, both by damaging the digestive tract lining and decreasing the small and large intestine’s capacity to absorb nutrients, vitamins and minerals.

What Is Ulcerative Colitis?

Ulcerative colitis (UC) is another form of inflammatory bowel disease that is chronic and just affects the colon (large intestine) and rectum. This distinguishes it from Crohn’s disease as the latter can involve any part of the digestive tract from the mouth to the anus. UC is a type of colitis, which is a general term for inflammation of the colon. Other common forms of colitis tend to last for a short duration, are often due to viral or bacterial infections, and can be treated with antibiotics. In contrast, UC is a chronic condition that lasts for decades and requires long-term management. 

What Are the Symptoms of Ulcerative Colitis?

The symptoms between Crohn’s and UC are very similar, though patients with UC more commonly have blood in the stool. Patients with either condition can experience diarrhea, abdominal pain, unexplained fatigue, weight loss, diarrhea and urgent bowel movements, and abdominal pain.

How Is UC Diagnosed and What Are the Treatments?

Diagnostic tests for UC are very similar to Crohn’s disease.. Your physician will likely order a CBC and stool samples. Colonoscopy and sigmoidoscopy are routinely performed. A computerized tomography (CT) scan can sometimes be performed.  

The treatments for UC are very similar to that of Crohn’s disease. Medication is often used to both manage flare-ups and keep the disease under control. Your doctor may prescribe aminosalicylates, corticosteroids, immunomodulators, or  biologics. Surgery is reserved for those who couldn’t arrest and control their UC condition medicinally. 

What Are the Differences Between Crohn’s and Ulcerative Colitis?

While both Crohn’s and ulcerative colitis are IBD and have similar symptoms, there are a few differences to set them apart. Some of the main differences include:

• Crohn’s disease can affect the gastrointestinal tract from the mouth to the anus, while ulcerative colitis appears only in the colon (large intestine).
• Ulcerative colitis affects the colon’s innermost lining, while Crohn’s disease causes damage to all layers of the gastrointestinal tract, primarily the small and large intestine.
• Crohn’s disease may affect the entire GI tract, but it is patchy. The inflammation does not cover the whole area. With ulcerative colitis, the area of colon inflammation starts from the rectum and extends in a continuous fashion in part or all of the colon.

Am I At Risk for Crohn’s Disease or Ulcerative Colitis?

Researchers are not sure what causes Crohn’s disease and Ulcerative Colitis. However, some patterns have been studied over time. Both diseases tend to start in adolescents and young adults, with another group of patients in their 40s and 50s.