Gut Trouble: Ulcerative Colitis vs. Crohn’s Disease

Imagine your digestive system is unhappy and inflamed. This is what happens with ulcerative colitis and Crohn’s disease, two chronic conditions that cause long-term gut problems. These can make everyday activities challenging. Imagine needing to use the bathroom a lot, having bad diarrhea, and feeling tummy aches all the time. This can mess with work, school, and fun stuff with friends.

On top of that, constant belly pain, fatigue, and the worry of flare-ups can also make you feel anxious and isolated. Even though these diseases can be challenging, there’s hope! With the proper inflammatory bowel disease treatment and some adjustments to your routine, you can absolutely manage them and live a whole, active life.

Let’s take a closer look and see what makes these two gut troubles different from each other.

What is Inflammatory Bowel Disease?

IBD, also known as Inflammatory bowel disease, refers to a group of conditions that can cause inflammation of the digestive system. Thus making it swollen, red and painful. It includes two main chronic conditions: Crohn’s disease and ulcerative colitis. Both of these conditions result in inflammation of the intestines.

Usually, when we eat food, it travels from the mouth to the anus. When the body’s digestive system is in healthy condition, it absorbs all the nutrients it needs from the food you eat, and the rest of the food passes through the body and is eliminated as urine or stool. However, if you have Inflammatory bowel disease, then your digestive system gets inflamed. With time, this inflammation can cause diarrhea, pain and sometimes blood in the stool.

What is ulcerative Colitis?

It is a type of IBD that can cause swelling and ulcer formation in the large intestine, thus affecting both the parts of the large intestine, such as the rectum and colon. This inflammation causes redness, swelling, and pain as the body responds to injury or irritation. These ulcers, or sores, mostly form on the inner lining of the intestines, thus causing bleeding and mucus production. Typically, this inflammation starts in the rectum and may travel throughout the large intestine, either initially or gradually, over a period of time.

What is Chron’s Disease?

It is a form of IBD that can cause inflammation throughout the digestive system, starting from the mouth to the anus. This inflammation can cause redness, swelling, and abdominal pain, as it’s the body’s response to injury or irritation. Sometimes, symptoms are minimal or absent, and they can alternate with flare-ups when symptoms become more active.

What are the Common Symptoms of Both?

The symptoms of both Crohn’s disease and ulcerative colitis differ for each person. They depend on two things. For chron’s disease, it depends on where inflammation occurs in the gut. Furthermore, symptoms of ulcerative colitis depend upon how much the large intestine is inflamed.

Following are the common symptoms shared by both:

1. Abdominal cramps and pain
2. Diarrhea
3. An urgent need to have a bowel movement
4. Feeling like bowel movement wasn’t complete
5. Rectal bleeding
6. Fever or feeling tired
7. Smaller appetite or weight loss
8. Night sweats

You might not have all of those symptoms all the time. Both conditions can come and go, with symptoms switching between worsening and easing up or stopping.

Doctors commonly diagnose both Crohn’s disease and ulcerative colitis in teenagers and young adults, although they can occur at any age.They often run in families, too.

What is the Difference between Ulcerative Colitis and Chron’s Disease?

There are three key differences that set them apart

1. Site of Inflammation

Ulcerative colitis mainly targets the colon and rectum, the part of the large intestine. Whereas on the other hand Crohn’s disease, inflammation can occur anywhere in the digestive system, from the mouth to the anus.

2. Continuous inflammation

In ulcerative colitis, inflammation typically occurs continuously along the innermost lining of the rectum and colon, with no healthy areas in between. Whereas in Crohn’s disease, inflammation may have healthy tissue between inflamed areas.

3. Which layers are affected?

Crohn’s disease affects more parts of the GI tract and can cause some complications that are less common in ulcerative colitis. These complications include the formation of mouth sores between the gums and lower lip or on the bottom side of the tongue. Furthermore, anal tears (fissures), ulcers, infections, or narrowing.

Can you have both Ulcerative colitis and Chron’s disease?

While it’s rare, some people are diagnosed with both ulcerative colitis and Crohn’s disease. This condition is called “indeterminate colitis.” It occurs when the symptoms and characteristics of the bowel disease don’t fit into either the ulcerative colitis or Crohn’s disease categories.

Getting the Right Diagnosis for Both

To diagnose inflammatory bowel disease (IBD), doctors will conduct a number of tests to assess your symptoms and determine the type of IBD you may have. Blood tests, including CBCs, are conducted initially to diagnose inflammatory bowel disease (IBD). Besides blood tests, stool samples play a crucial role in the diagnostic process. By examining a stool sample, healthcare providers can detect signs of inflammation, including the presence of blood, which helps in confirming the diagnosis of IBD.

Besides these tests, some special tests are also performed.

1. Colonoscopy or sigmoidoscopy

This procedure uses a flexible tube to which a camera is attached to visualize the lining of the colon and sometimes the small intestine by inserting it into the anus. They will look for inflammation, bleeding, or ulcers and may take tissue samples for further examination.

2. Upper endoscopy

This procedure is similar to a colonoscopy. During this, an endoscope is inserted through the mouth to visualize the stomach, esophagus and upper part of the small intestine.

3. Small bowel follow-through

This imaging test involves drinking a contrast solution that appears on X-rays as it moves through the digestive tract, thus helping to identify any abnormalities.

4. CT scan or MRI 

These imaging tests provide a detailed view of the digestive tract, thus helping to identify areas of inflammation or other complications associated with IBD.

5. Capsule endoscopy

In this diagnostic procedure, the patient swallows a small, pill-shaped camera that helps take pictures of the digestive tract as it passes through. This helps visualize the small intestine, which is not easily accessible with other procedures.

By conducting these tests and examinations, pediatric surgeons can accurately diagnose IBD and determine the most appropriate inflammatory bowel disease child treatment plan for managing these conditions.

Finding the Best Treatment Approach for You

Because ulcerative colitis and Crohn’s disease share many similarities, their treatments often overlap. Here’s what can help with both:

1. Lifestyle Modification

Lifestyle changes are essential in many ways, including managing symptoms, ensuring nutritional deficiency, and potentially treating active disease. These include adding high protein intake, oral vitamins and supplements, and a low or moderate FODMAP diet. Furthermore, staying active with regular exercise, quitting smoking if you smoke, and avoiding certain pain medications like ibuprofen can help manage both inflammatory problems.

Moreover, managing stress is also crucial. While stress doesn’t directly cause these conditions, it can cause flare-ups. Finding ways to relax and unwind, like exercising, enjoying hobbies, meditating, or spending time with loved ones, can make a difference.

2. Medications

Medicines can help control inflammation of both ulcerative colitis and chron’s disease

• 5-ASAs like sulfasalazine target inflammation in the lining of your digestive tract. Doctors commonly use them to treat flare-ups of ulcerative colitis or as maintenance therapy to prevent future episodes.
• Steroids like prednisone and budesonide work by calming down your immune system to reduce inflammation in ulcerative colitis. However, because of side effects, doctors usually not used it for long periods.
• Biologics are another option. Healthcare providers often administer these drugs via injections or IV to prevent inflammation, frequently combining them with other medications for moderate to severe cases.

3. Surgical Treatment

When other treatments fail to manage symptoms of inflammatory bowel disease (IBD), then surgical treatment comes in.

• Ulcerative Colitis

In ulcerative colitis, surgery usually involves removing the entire colon and rectum. The surgeon creates an internal pouch and attaches it to the anus, enabling bowel movements without requiring an external bag. If an internal pouch isn’t possible, the surgeon may create a permanent opening in the abdominal area (ileal stoma) to collect stool in an attached bag.

• Crohn’s Disease

During surgery, the surgeon removes damaged portions of the digestive tract and reconnects healthy sections. They also close fistulas and drain abscesses if present. Although surgery can temporarily relieve symptoms, Crohn’s disease frequently returns, especially near the reconnected tissue. Therefore, healthcare providers typically prescribe post-surgery medication to reduce the risk of recurrence.

Conclusion 

Ulcerative colitis and Crohn’s disease are both chronic inflammatory bowel diseases that significantly impact the quality of life of affected individuals. While they share some similarities, such as abdominal pain, diarrhea, and rectal bleeding, they also differ in terms of the site and pattern of inflammation, symptoms, and treatment approaches.

However, understanding these differences is essential for accurate diagnosis, personalized treatment planning, and improved outcomes for individuals living with these conditions.