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Colitis vs Crohn's Disease: What's the Difference

Colitis vs Crohn's Disease: What's the Difference?noresize

Crohn’s Disease and Ulcerative Colitis are two gastrointestinal conditions that fall under the umbrella of Irritable Bowel Disease (IBD). It can be challenging to differentiate between the two conditions, but the main difference is area of the digestive system each condition affects. Additionally, there are also slight differences in their:

  • Diagnostic criteria
  • Symptoms
  • Treatment

Read more about the differences between Crohn’s Disease and Ulcerative Colitis below.

Physiological Location

  • Ulcerative Colitis (UC)
    • UC affects the large intestine, which is comprised of the colon and rectum. During a colitis flare, the innermost lining of your colon/rectum becomes inflamed and ulcers may form on the tissue surface. Ulcerative Colitis can also cause widespread inflammation in other parts of your body, including your eyes, skin, and joints.
  • Crohn’s Disease
    • Crohn’s disease can affect any part of the GI tract from the mouth to the anus, but most commonly affects the end of the small intestine (the Ileum). Crohn’s can also cause inflammation throughout other parts of the body such as the eyes, skin and joints. Unlike UC, Crohn’s inflammation can extend through the entire thickness of the bowel wall.

Symptoms

While there are many common symptoms of both Crohn’s and Ulcerative Colitis, there are also symptoms that are unique to each condition. As with all forms of IBD, symptoms vary from person to person. If you are experiencing 2 or more of these symptoms consistently, we recommend having an honest conversation with your doctor to begin diagnosis and treatment. The more common symptoms associated with each are listed below.

  • Ulcerative Colitis
    • Abdominal pain & discomfort
    • Blood or pus in stool
    • Fever
    • Weight loss
    • Rectal bleeding
    • Frequent, recurring diarrhea
    • Fatigue
    • Reduced appetite
    • Tenesmus: the feeling that you need to pass stools even though bowels are empty
    • Malnutrition
  • Crohn’s
    • Abdominal pain & cramping
    • Persistent Diarrhea
    • Fever
    • Rectal bleeding
    • Constipation
    • Urgent bowel habit
    • Loss of appetite
    • Weight loss
    • Fatigue
    • Night sweats
    • Changes in menstrual cycle
    • Skin conditions
    • Joint pain
    • Fistulas

Diagnosis

Diagnosing IBD involves eliminating all other possible causes of your symptoms. There is no single diagnostic, so your doctor will typically conduct multiple tests to confirm diagnoses. Your diagnostic tools will likely include:

  • Ulcerative Colitis
    • Blood tests
    • Stool tests
    • Colonoscopy
    • Flexible sigmoidoscopy
    • X-Ray
    • CT scan
  • Crohn’s
    • Blood tests
    • Stool tests
    • Colonoscopy
    • CT Scan
    • MRI
    • Endoscopy

 

Treatment

For both Crohn’s and Ulcerative Colitis, we recommend working with a team of professionals to help manage your condition. Your team should include your primary care doctor, GI doctor, dietitian, and therapist or psychiatrist (depending on your unique situation and needs). Having a clear treatment plan is key to helping keep Crohn’s and UC controlled. Your treatment plan should be built around your disease severity, disease location, current medication, possible side effects of medication, and co-morbidities. The goal of IBD treatment is to achieve and maintain remission… we define remission as the absence of symptoms. Although Crohn’s and UC have many differences, the methods of treatment are similar for each

Diet Therapy 

Dietary changes for IBD depend on the stage of your condition. When your symptoms are active, we recommend a low fiber diet. Once remission is achieved, high fiber foods can be reintroduced slowly to support a high-quality diet. When working with a dietitian, your treatment plan will focus on dietary changes.  Below, I describe our general approach to dietary management for both Ulcerative Colitis and Crohn’s Disease.

  • Diet therapy for an active flare
    • When symptoms are active, the main goal of diet therapy is to reduce inflammation in your gut. To do so, you need simple, easy-to-digest food. This is where a low fiber diet comes in. Low fiber diets allow your body to heal/reduce inflammation and ultimately do less work to break down and digest food.
  • Dietary recommendations during remission
    • Once your body has healed, your dietitian will recommend reintroducing specific high fiber foods. High fiber foods tend to be more nutritious, so whenever possible, it’s important to incorporate these back into your diet. The low fiber approach is intended to be a temporary solution to heal inflammation.
    • Most people will have to consistently adapt their eating habits to the current state of their condition throughout their lifetime.
Low Fiber (Active Flare) High Fiber (Remission)

Foods to Eat:

  • Low fiber fruit: bananas, cooked fruit, canned fruit
  • Non-cruciferous vegetables: asparagus, potatoes, cucumbers, carrots
  • Refined grain products: white pasta, white rice, white bread
  • Lean protein: fish, chicken, lean pork, eggs, tofu

Foods to Eat:

  • Whole grains: oats, brown rice, whole wheat pasta, whole wheat bread
  • Legumes/nuts: beans, nuts, seeds
  • Fruits and vegetables: Reach for colorful, fresh fruits and vegetables. It can be helpful to remove the skin and seeds to avoid symptoms

Foods to Avoid:

  • Fruits with seeds and skins
  • Beans and legumes
  • Nuts and seeds
  • Whole grains
  • Cruciferous vegetables
  • Dairy
  • Spicy food
  • Caffeine
  • Alcohol
  • High-fat foods: fried food, red meat, fast food

Foods to Avoid:

  • Dairy
  • Spicy food
  • Caffeine
  • Alcohol
  • High-fat foods: fried food, red meat, fast food

 

Medications

Medications for IBD include prescription and non-prescription treatment. Some prescription medications include Biologics, Aminosalicylates, Antibiotics, Steroids, and Immunomodulators- all of which aim to suppress inflammation. Over the counter medications include antidiarrheals, pain relievers, and vitamin and mineral supplements such as iron, vitamin B12, and calcium and vitamin D.

Surgery

Surgery is a last resort option for IBD treatment after medication and dietary intervention. Possible surgery options include removal of some or all of the small bowel, colon, and rectum.

Wrap Up

Although there are many overlapping characteristics of Ulcerative Colitis and Crohn’s disease, there are also many factors that make them unique. It is important to treat each person’s condition as its own unique case to ensure that your treatment plan is specific to you. If you suspect that you may have UC or Crohn’s, speak with your doctor to help with diagnosis, develop a treatment plan, and form a healthcare team.

Want to learn more about how to manage your Ulcerative Colitis or Crohn's Disease? Our team can help!

 

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