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Differences for Ulcerative Colitis vs Crohn’s Disease

Updated on October 9, 2019
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After 22 years as an RN, I now write about medical issues and new medical advances. Diet, exercise, treatment, and lifestyle are important.

Abdominal Pain

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Inflammatory Bowel Disease (IBD) Statistics

Inflammatory bowel disease (IBD) includes Crohn’s Disease and Ulcerative Colitis. Worldwide there approximately 33,000 new cases diagnosed annually, but many cases are never reported. People that are 45 years or older are more likely to report this disease. In the U.S. as of 2015, an estimated 3 million people have been diagnosed with IBD.

Gluten disease is not an IBD. It is a chronic digestive disorder affecting 1 in 141 Americans. It results from an immune reaction to a gluten protein that is found in wheat, rye, barley and sometimes oats.

IBDs can be very debilitating and even life-threatening. Hospitals in the U.S. experienced 500,000 visits last year and 46,000 hospitalizations for Ulcerative Colitis.

Differences Between Crohn’s Disease and Ulcerative Colitis

Ulcerative colitis is a disease that causes long-lasting inflammation, plus sores (ulcers) in the innermost large intestinal lining and in the rectum.

Crohn’s disease causes inflammation in the digestive tract lining that typically spreads deeper into surrounding tissues. It can appear anywhere in the digestive system.

The cause of IBDs is not known, but it may be an autoimmune disease. Heredity may be another factor.

The colon normally contains good bacteria, but with ulcerative colitis the white blood cells attack rather than protect the colon. Both of these diseases cause inflammation in the digestive tract.

Some of the symptoms are the same for both IBDs, such as:

  • Diarrhea
  • Abdominal pain and cramping
  • Urgency
  • Fatigue
  • Rectal bleeding
  • Unintended weight loss
  • Canker sores
  • Dehydration
  • Anemia

Ulcerative colitis is found in the colon (large intestine), and it causes ulcers along the lining of the intestine. Crohn’s Disease can cause inflammation anywhere in the digestive tract, starting with the mouth and ending with the anus. The symptoms of these diseases may be mild or severe, depending on the amount of inflammation and where the inflammation occurs.

What is Crohn's Disease?

Diagnosing IBDs

Ulcerative colitis is diagnosed by one or more of the following:

  • Blood tests
  • Stool sample
  • Colonoscopy
  • Flexible sigmoidoscopy
  • CT scan (looks at the entire bowel as well as at tissues outside the bowel)
  • MRI (detailed images of organs and tissues)

Crohn’s Disease is diagnosed by one or more of the following:

  • Colonoscopy
  • CT scan (looks at the entire bowel as well as at tissues outside the bowel)
  • MRI (detailed images of organs and tissues)
  • Capsule endoscopy
  • Balloon-enteroscopy (scope is used in conjunction with a device called an overtube)

Digestive Tract

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Risk Factors for IBD

While most people are diagnosed by age 30, some people do not get this disease until the are 50 or 60. White people are at a higher risk, but people of Ashkenazi Jewish descent are at the highest risk. If someone in your family has one of these diseases, you are at a higher risk.

Cigarette smoking puts you at a higher risk for Crohn’s Disease. Nonsteroidal anti-inflammatory medications (Advil, Aleve, Motrin) can worsen the symptoms of IBDs and also increase the risk for developing the disease. People who live in industrialized countries are also more likely to develop IBD also. Stress and diet may aggravate these diseases.

Ulcerative Colitis Diet, Treatment, Symptoms Flare Ups

IBD Treatments

A fiber supplement such as psyllium powder (Metamucil) or methylcellulose (Citrucel) may help with loose stools or diarrhea. Intestinal bleeding may require an iron supplement. Vitamins such as fish oil, probiotics and turmeric may help.

The patient’s diet may also help alleviate the symptoms. There is no diet that is good for everyone, but depending on the symptoms there may be a diet that helps.

The recommended diet information includes:

  1. Ulcerative colitis patients tend to lose weight so a high calorie diet may prevent unintended weight loss.
  2. A lactose-free diet is also advised for patients with ulcerative colitis. Ulcerative colitis may cause problems with fat absorption
  3. A low-fat diet is recommended for some patients during a flare-up of the disease.
  4. Drinking plenty of fluids is important and eating small meals may help.
  5. A low-fiber diet may help some patients reduce the frequency of bowel movements and abdominal cramping.
  6. Patients that are taking corticosteroids may be on a low-salt diet to prevent water-retention.

Sometimes surgery may be warranted for both diseases where a portion of the colon is removed, but this does not cure the disease. At times a patient’s whole colon and anus is removed for ulcerative colitis. This means a colostomy bag is necessary for the balance of the patient’s life. A portion of the diseased colon may be removed for Crohn’s disease, but this does not cure the disease.

A support group or talking to a therapist may help patients reduce their stress, thus their symptoms. It can be difficult to reach out to anyone when a patient is running to the bathroom every few minutes.

In Summary

Both of the IBDs are difficult to cope with, especially when the symptoms become severe. It is good to be fully informed about your disease, knowing the possible causes and treatments. Having a support system in place is especially important as it is stressful to be ill each day. There is a large amount of clinical research in progress so hopefully a cure will happen in the near future.

This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.

© 2019 Pamela Oglesby

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