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What's the Difference between Crohn's and Ulcerative Colitis?

Crohn's disease and ulcerative colitis 

Crohn’s disease and ulcerative colitis are common, chronic types of irritable bowel disease (IBD). While they both cause similar symptoms, they are two distinct medical conditions. It is important to be able to identify the differences between the two conditions so that proper care and treatment can be maintained to control and modify the illness.

What is Crohn's disease? 

Crohn’s disease causes inflammation in the lining of the digestive tract. Inflammation can be located in different areas from person to person and commonly affects both the small and large intestines. However, any part of the digestive system may be affected, from the mouth to the anus. The inflammation is often spread deep into the layers of affected tissue. The cause of Crohn’s disease is unknown. It is theorized that it as an autoimmune disorder where the body’s immune system attacks healthy cells in the digestive tract. Crohn’s disease is also more common if you have a family member with the disease, suggesting that there may be a genetic factor involved. Crohn’s has also been heavily linked to smoking, as Crohn’s appears much more commonly in people who smoke.

Symptoms of Crohn’s disease include:

  • Diarrhea (possibly with blood present)
  • Fever
  • Fatigue
  • Abdominal pain or cramping
  • Unintentional weight loss
  • Mouth sores
  • Reduced appetite
  • Perianal disease (drainage or pain around the anus)

Treating Crohn's 

The most important part of treating Crohn’s disease is managing inflammation. There are different avenues to use, besides changes to diet and lifestyle, including:

  • Oral 5-aminosalicylates: These medications are useful if Crohn’s affects your colon, but is inadequate to treat the disease in the small intestine.
  • Corticosteroids: These can treat inflammation anywhere in the body, however they don’t help everyone with Crohn’s disease and have a long list of side effects.

Immunosuppressants are also helpful in reducing inflammation, however they do so by targeting and suppressing the immune system. Medications include:

  • Azathioprine (Imuran) and mercaptopurine (Purinethol)
  • TNF inhibitors (biologics): Neutralise the protein known as tumor necrosis factor (TNF)

What is ulcerative colitis? 

Ulcerative colitis causes long-lasting inflammation and ulcers (a type of sore) in the digestive tract. This disease commonly affects the large intestine (colon) and the rectum. Symptoms of ulcerative colitis usually develop slowly over time as opposed to sudden (acute) onset. Most people with this disease are diagnosed before the age of thirty. Similarly to Crohn’s disease, the cause of ulcerative colitis is unknown. It could be an autoimmune disorder where the body’s immune system attacks healthy cells in the digestive tract.

Symptoms of ulcerative colitis include:

  • Diarrhea
  • Rectal bleeding
  • Inability to defecate
  • Weight loss
  • Fatigue
  • Fever
  • Growth inhibition when seen in children

Treating ulcerative colitis 

Ulcerative colitis can be treated in a variety of ways. The first step is almost always anti-inflammatory medications along with diet and lifestyle changes. Some examples include:

  • Aminosalicylates
  • Corticosteroids: These can treat inflammation anywhere in the body, however they don’t help everyone with Crohn’s disease and have a long list of side effects.

Immunosuppressants are also helpful in reducing inflammation, however they do so by targeting and suppressing the immune system. Medications include:

  • Cyclosporine
  • Azathioprine and mercaptopurine
  • TNF inhibitors (biologics): Neutralise the protein known as tumor necrosis factor (TNF)
  • Vedolizumab: This medication is used for people who don’t respond to or don’t tolerate biologics or other treatments.