{Crohn's Awareness} :: What's the Difference Between Crohn's and UC?

When people talk about IBD {Irritable Bowel Disease}, they are referring to the collective diseases of Crohn's {CD} and Ulcerative Colitis {UC}. The two diseases share similar symptoms, but there are very distinct differences. A trained GI can identify which disease you have, but the diagnosis can often be difficult and take some time.

In Crohn's Disease {what I have}, inflammation can occur anywhere along the digestive tract from the mouth to the anus. The type of CD you have is determined by where your inflammation occurs, and there can be overlap between these types:

• Crohn's Ileocolitis- affects the small intestines {ileum} and colon, most common type
• Crohn's Ileitis- affects the ileum {my diagnosis}
• Gastroduodenal Crohn's- affects the first part of the small intestines {stomach and duodenum}
• Crohn's Jejunoileitis- affects the upper half of the small intestines {jejunum}
• Crohn's {Granulomatous} Colitis- affects only the colon, not to be confused with ulcerative colitis*

The pattern of inflammation occurs in patches, meaning there can be a healthy section of the intestines between two diseased sections. The inflammation will extend through all layers of the intestines. Pain often {but not always} occurs on the lower right side of the abdomen. While bleeding from the rectum may occur, it is less common in CD than in UC. Strictures, fissures, and fistulas are common complications in CD.

Crohn's Disease is typically diagnosed in your teens or twenties. Medications for CD and UC are often similar, though some have been proven to work for one disease and not the other. About 70% of people with CD will require surgery. While the surgery to remove the diseased section of bowel can provide symptom relief, the disease often recurs.

*In a colon affected by CD, the colon wall is thickened and ulcerations are deeper, often extending into all layers of the bowel wall. Inflamed cells that lump together to form a lesion {granulomas} are present. In a colon affected by UC, the colon wall is thinner and ulcerations appear, though they do not extend beyond the inner lining. Granulomas are not present.

In contrast, the inflammation in Ulcerative Colitis is limited to the large intestines {colon and rectum}, though it can also affect the last section of the small intestines {ileum}. So there are no "types." The inflammation occurs only on the surface layer of the intestinal lining. The pattern of inflammation occurs continuously, but often spreads as the disease progresses. Pain often occurs on the lower left side of the abdomen. Bleeding from the rectum is more common in UC than in CD. Strictures, fissures, and fistulas are less common in UC.

Ulcerative Colitis is typically diagnosed in your thirties. About 30% of people with UC will require surgery, and surgery to remove the colon is often considered a "cure."

And just for fun, I thought this was a fun infographic :)

Some people ask if one is worse than the other. From a long-term perspective, Crohn's has the potential to cause more damage and is often more difficult to manage. But depending on the severity of your diagnosis, the symptoms of either disease can be mild to severe. So someone with a severe case of Ulcerative Colitis can have it "worse" than someone with a mild case of Crohn's. And it also depends on how you choose to manage your disease and work to achieve remission. While I can't imagine not doing everything possible to manage my Crohn's, I know some people who just endure without any specific treatment. I say either disease is horrible and no fun.

#themoreyouknow #youarewelcome

Sources:

- CCFA.org, various articles

- IBD Crohn's

- Livestrong