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Carene's Wellness Corner
Crohn's and ulcerative colitis: What's the difference?

While Crohn's disease and ulcerative colitis are both chronic, inflammatory bowel diseases, they do have some significant differences.

Crohn's can involve any portion of the gastrointestinal (GI) tract - from the mouth to the anus - and can affect any layer of the bowel wall.Ulcerative colitis is confined to the large intestine and only concerns its lining. The lining can become inflamed and develop small open sores or ulcers that make mucous and pus.

"Both conditionscan affect a person's quality of life, impairing their ability to work as well as putting stress on personal relationships," says Nancy Botelho, NP, a nurse practitioner with the Women & Infants Hospital Center for Women's Gastrointestinal Services.Gastrointestinal Health

The causes of these diseases are unknown. However, it is believed that environment, genetics, and perhaps an inappropriate reaction by the body's immune system may play a role.

According to the Crohn's and Colitis Foundation of America (CCFA) as many as 700,000 Americans may have ulcerative colitis and another 700,000 suffer from Crohn's. Most are diagnosed with ulcerative colitis in their mid-30s, while those with Crohn's are diagnosed between the ages of 15 and 35. Both diseases affect men and women equally.

Signs and symptoms

Crohn's and ulcerative colitis have some similar symptoms.

Approximately 50 percent of people with ulcerative colitis will have mild symptoms that come and go in an unpredictable way. These can include:

  • Looser bowel movements
  • Persistent diarrhea
  • Abdominal pain
  • Bloody stools
  • Lack of appetite
  • Fatigue
  • Weight loss

People with Crohn's disease may also experience:

  • Abnormal weight loss, with or without bleeding
  • Fever
  • Anal fissures
  • An urgent need to have a bowel movement
  • Constipation
  • Inflammation in the small bowel

Anxiety and depression may be secondary symptoms of both conditions.

Each condition also carries the potential of severe, although rare, complications. With ulcerative colitis, they can include bleeding, fulminant colitis, acute colon distension, and tears in the colon. In Crohn's disease, complications may include bleeding, fistulas, abscesses, anal diseases, and improper absorption of nutrients, adds Virginia Liberto, a student intern with the Center for Women's Gastrointestinal Services.


If you're experiencing any of the described symptoms, you should see a gastroenterologist. Mostly likely, this physician will perform some type of test to view the interior of your GI tract with a lighted camera, such as a sigmoidoscopy or a colonoscopy. This is called an endoscopic examination. A tissue sample, called a biopsy, may be taken during the exam for further evaluation.

"Stool tests may also be done to rule out infection, and blood work may be used to detect inflammation," adds Liberto.


A variety of treatment options exist for both diseases, including medications that treat inflammation. By suppressing inflammation, some symptoms such as fever, diarrhea, and pain, can be controlled while intestinal tissues heal, according to the CCFA.

While neither disease may be due to a negative reaction to a specific food, eating bland foods rather than spicy or high-fiber foods can cause less discomfort. Because symptoms such as diarrhea can cause the body to not properly absorb vitamins and minerals, it's important to pay attention to optimal nutrition.

For people with Crohn's, surgery may be performed to remove diseased areas of the colon. The person is not cured, however, as Crohn's may reoccur after surgery. With ulcerative colitis, the entire colon may be removed and the individual is cured of the disease.

What else you should know

People with irritable bowel diseases are at a greater risk for colon cancer, osteoporosis, blood clots, and hemolytic anemia. Certain medications can also increase the risk of other medical conditions. For example, azathioprine can increase risk for non-melanoma skin cancer while patients taking corticosteroids and immune suppressants are more likely to have an abnormal PAP smear, Botelho says.

Inflammatory bowel disease in pregnancy is best cared for by a team that specializes in gastroenterology and women's health. "Often, medications may be continued in pregnancy and lead to better outcomes for mother and baby," Botelho reports.

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