Can UC ever change into Crohn's?

My brother started having symptoms of IBD when he was seventeen. He was diagnosed with C Diff. It was very odd when flares of "C Diff" kept on coming back. When he was nineteen, he had his biggest flare up yet. He went to see many doctors about it. It was at about this time that I started getting symptoms of IBD, at seventeen years old. I brother was falsely diagnosed with UC, a few weeks later was diagnosed with Crohn's, then back to UC, and finally the doctors just stuck with Crohn's. In April earlier this year, I was diagnosed with Ulcerative Proctitis. It just seems strange that I have the exact same symptoms as my brother when he was seventeen, and my diagnoses is different. There are two people, excluding me, in my family who have Crohn's.

I was wondering if it was possible for Ulcerative Proctitis to develop into Crohn's? Seems kind of crazy, but I was just wondering.

Looks like I'll need to ask for my c-scope pathology results.

I've had two c-scopes, and one sig-scope. I was originally diagnosed with a c-scope.

Thanks quincy!

Your older brother sounds like my older brother. Similar story, except my brother has had his Crohn's/proctitis for nearly 20 years. I also had a cousin with Crohn's (she sadly died a few years ago). All of our cases have presented quite differently. My case has been far more severe than my brother's; he basically had Crohn's in Easy mode and I had mine in Hard mode. (Not his fault of course, but doesn't stop me from feeling gutted I got Crohn's at all, let alone the version of it that I did.)

If the biopsies don't show evidence of Crohn's, then you don't have it - at least not now. Biopsies aren't infallible and sometimes people can be diagnosed with UC for years then receive a Crohn's diagnosis. UC and Crohn's are normally treated as two discrete diseases, but they may not be as discrete as they seem, particularly Crohn's colitis and UC.

I for sure have IBD, that's no doubt. I was diagnosed with severe UC Proctitis because of how bad the inflammation was, it just didn't go up very far. I have severe pain, sometimes so bad that I can't even walk, or even stand up. Just two nights ago I woke up around 4:00 AM, rushed to the washroom, and went four times in a matter of half an hour. Every time I would try and go back to my room to sleep I would practically fall on the floor in pain, realizing I had to go back to the washroom. The amount of blood I lose every stool is astronomical as well. Well over half of the times I go, all of the water in the toilet turns deep red. Sometimes I can sit on the toilet for twenty minutes and still have blood come out in spurts. My brother was put on Influctra (10mg), a dose every six weeks, and it put him on remission when nothing else worked. The doctors are considering doing the same for me considering how bad my condition is getting.

You can be initially misdiagnosed. However it technically doesn't change from one to the other.

I don't get why you can't develop crohns. I never had UC until I had UC.

It's possible that UC could develop into Crohn's. It's not misdiagnosis if everything looked like UC at the time, but the person later develops Crohn's - how can you prove that's not UC 'turning into' Crohn's?

We don't know enough about either disease yet.

IBD as a continuum

No...one doesn't become the other.
q

Interesting article:

'Conversion' from ulcerative colitis to Crohn's disease associated with corticosteroid treatment.'
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1375072/

The link is interesting, however, I wouldn't take one study as fact.

Brucen's extract said...
Prolonged treatment with corticosteroids was associated with the development of numerous granulomata, stricturing, and perianal disease.

It is speculated that the immunosuppression associated with the corticosteroid treatment may have induced a change from ulcerative colitis to Crohn's disease of the colon.

Corticosteroids might not only change UC to Crohn's but there is research indicating that those who were prescribed steroids have dramatically lower rates of spontaneous remission. Almost all patients with IBD undergo standard medical care (drugs) but there are some patients in clinical trials who are in the placebo group, i.e. not on meds.

The National Cooperative Crohn's Disease Study (NCCDS) reviewed 77 patients who received placebo therapy. They all had active disease as defined by the CDAI index greater than 150. After 17 weeks of placebo therapy (no drugs) 49 percent were found to have a CDAI lower than 150. None of these patients' intestinal X-rays showed worsening of the disease. The majority (70 percent) remained in remission for one year and 45 percent remained in remission after two years.

However for those patients in the placebo group who had no history of steroid therapy 41 percent achieved remission after 17 weeks and 23 percent continued in remission after two years, compared with only a 4 percent of the group with a history of steroid use.

Similar results were found in the European Cooperative Crohn's Disease Study (ECCDS) in their study with 110 patients in the placebo group. Like the NCCDS, the ECCDS demonstrated that patients with no prior drug therapy have a greater likelihood of remission.

Although researchers did not advocate placebo therapy, they did carefully point that once remission is achieved, 75% of patients can continue in remission after one year and up to 63% for two years. Apparently the key is achieving remission which once attained, can be maintained by conservative nondrug therapy.