For the over 500,000 Americans who suffer from it in one form or another, it can be hard to distinguish between the two major types of inflammatory bowel disease (IBD): Crohn’s disease and ulcerative colitis. Most patients with either kind of IBD will follow the typical pattern of periodic flare-ups separated by occasionally long-term periods without symptoms, or remission.
But there are some key differences that IBD patients should be aware of. Both diseases involve some form of inflammation (hence the “I” in “IBD”), but the location of that inflammation differs. Crohn’s patients could see inflammation anywhere along the digestive system tract, while ulcerative colitis inflammation is usually limited to the large intestine.
While the symptoms of both diseases are similar, some differences do exist. In Crohn’s disease, the pain is frequently centered around the lower right abdominal area, contrasted with the lower left side pain common in ulcerative disease patients. Anal bleeding quite frequently occurs with ulcerative colitis, but is less frequently seen in Crohn’s patients.
A gastroenterologist can frequently diagnose the correct disease through common testing procedures. Scans such as colonoscopies can tell a physician which disease is most likely the culprit of the patient’s symptoms. For example, the appearance of the wall of the colon will be thicker and have a paving-stone-like appearance, while ulcerative colitis creates a thinner bowel wall with a more consistent area of inflammation. Additionally, a scan can show groupings of inflamed cells that create lesions in digestive organs (called granulomas). These lesion-like granulomas present in Crohn’s patients, but not in ulcerative colitis patients.
It is very important to get a correct diagnosis from an experienced physician (preferably a gastroenterologist, who is likely to have more experience and training in distinguishing between the two illnesses), because the treatment protocols for each illness can be quite different.