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Ulcerative Colitis vs. Crohn's Disease?

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Ulcerative Colitis
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Posted 3/23/2016 1:45 AM (GMT 0)
I just shared our story here on another post earlier.

But I hope you guys can share some thoughts on how doctors can correctly identify between UC or Crohn's- aside from knowing the location of the ulcers/inflammation/sore spots?
We have very limited knowledge of IBD, here where we live, so we must do our own research.

We read that there's such thing as Crohn's Colitis- Crohn's that appear as if it's UC; but what makes a reliable diagnosis of either? How can a doctor specifically distinguish between them- what must be seen or not seen in the tests?

Thank you!
Posted 3/23/2016 2:05 AM (GMT 0)
That's a good question. My aunt who was diagnosed at one of the most reputable GI groups in the country was initially diagnosed with Ulcerative Colitis (after many a colonoscopy, and many a biopsy). She had colectomy as she wasn't responding to many of the medications. It wasn't until a year or so after Crohn's reared it's ugly head confirming that she was misdiagnosed.

...the doctors don't even really know

Having many a biopsy as well as prometheus blood work should theoretically help get a more conclusive diagnosis. Also how your disease appears to your GI during a colonoscopy should help make an educated guess. Also if you're having inflammatory issues sometimes they'll make you drink a barium dye to look at your small intestine under xray to see if there's inflammation, capsule pill endoscopy can also show inflammation in the small or large intestine when you're having a flare. There's a lot of pieces to the puzzle that goes with a specific IBD diagnosis
Posted 3/23/2016 2:59 AM (GMT 0)
A few cases may never be certain. It is becoming clear both CD and UC may each have several distinct types.

But two main things. 1) continuious vs splotchy inflammation, 2) CD ulcers penetrate deeper into the lining of the intestine.

There is also the obvious, if in small intestine.

Also, while there are many genes in common, there are a few susceptibility genes unique to each. But, I do not think a commercial gene test has been developed.
Posted 3/23/2016 4:58 PM (GMT 0)
Chrons disease and chrons colitis are the same thing. Chrons affects the digestive system anywhere from mouth to rectum, colitis is only in the large intestine
Posted 3/23/2016 5:07 PM (GMT 0)
There are 5 subtypes of Crohn's disease and crohn's colitis is one of them...like mentioned above, it's still CD but it's based on the location since CD can affect any part of the GI tract from mouth to anus where UC is limited to the rectum/colon, often starting in the rectum and CD often starting in the small intestine (of course nothing is written in stone on either of those but it's the general "norm") CD inflammation can go through the surface of the GI tract lining, UC stays on the surface of the lining only. With CD, the inflammation is patchy where as with UC it's continuous and not patchy or cobblestone effect like with CD.

Definitely google the 5 subtypes of CD.
Posted 3/23/2016 5:34 PM (GMT 0)
I heard different stories but does anyone know if Crohn's Colitis remains confined to the colon, or can it eventually spread to the small intestine? And if it does remain in the colon then can Crohn's Colitis be one form of CD that can be “cured” through surgery?
Posted 3/23/2016 6:14 PM (GMT 0)
A storybook perfect case of uc starts at the anus, moves up the large intestine in a continuous, unbroken pattern of inflammation. Ulcers are often present, and obvious red, swollen inflammation and bleeding signs are also present to the naked eye during the colonoscopy. Biopsies will confirm that finding by noting shallow tissue damage (limited to the mucusal layer), showing a irregular pattern of blood vessels (caused by repeat cycles of inflammation and healing permanently alter the vessel pattern), and the cells will have often have unusual deformities caused by the ongoing chronic disease.

A story book perfect case of Crohn's disease starts at the terminal ileum (where the small intestine and large intestine join). Crohn's patients usually have small intestinal involvement (wheras uc is limited to the large intestine). Crohn's has skip lesions (repeated areas of active disease followed by normal tissue). Under biopsy, the tissue damage is deep, extending well beyond the mucosa deep into the tissue beneath. Crohns disease can include fistulas, strictures, and abscesses that necessitate surgical procedures.

A small percentage of cases (around 5 percent) don't neatly fit into the above two categories. A patient may have a Crohn's like feature within the large intestine (like skip lesions) but everything else looks like uc. And that's when terms like Crohn's-colitis or indeterminate-colitis are used.

Generally, the treatment of both diseases is very similar, do I wouldn't worry which disease you have. Repeat diagnostics will likely determine which type of IBD you have, over time.
Posted 3/23/2016 6:51 PM (GMT 0)

Coffeemate said...
I heard different stories but does anyone know if Crohn's Colitis remains confined to the colon, or can it eventually spread to the small intestine? And if it does remain in the colon then can Crohn's Colitis be one form of CD that can be “cured” through surgery?

I have crohn's colitis and it has stayed confined to my colon, on and off in the rectum...when I first became sick it was affecting the TI as well as colon and rectum and anus (perianal crohn's skin tags which have also stayed constant since getting them mistakenly banded, they thought it was hemmies) if you check out the 5 sub-types of crohn's disease you'll get a great explanation to your question as well. It's individual like anything with IBD (both UC and CD) so nothing's written in stone but it definitely is a good outline of CD and how it can affect different parts of the GI tract from mouth to anus.

CD in the colon cannot be "cured" through surgery the way UC can...commonly if the affected colon is removed, there's always a good chance CD will attack what isn't removed, so any part of what's left of the GI tract from mouth to anus....the nature of the CD beast.
Posted 3/23/2016 10:01 PM (GMT 0)

DutchessCountyJim said...
Initially I was diagnosed with ulcerative colitis.My latest biopsies in November show submucosal involvement and granulomas which I believe indicates Crohn's, but my diagnosis is now called indeterminate colitis. --- I've been feeling good for the past 5 months, so at this point I don't really want to pursue my diagnosis any further.

I have also been diagnosed with indeterminate colitis. To be honest it does not bother me at all - what's the point in getting hung up on labels, I definitely have IBD and it needs to be dealt with, that's the important thing.
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