Crohn’s Dz. Vs.
Ulcerative Colitis
Characteristics Ulcerative Colitis Crohn’s Dz.
1. Location Ulcerative colitis is limited to the colon. There are Crohn's disease can occur anywhere between the mouth and the
five kinds of UC based on location: anus. Unlike with UC, Crohn’s isn’t limited to the GI tract. It may
Acute severe UC. This is a rare form of UC also affect the skin, eyes, joints, and liver. Since symptoms
that affects the entire colon and causes usually get worse after a meal, people with Crohn’s will often
eating difficulties. experience weight loss due to food avoidance.
Left-sided colitis. This type affects the
descending colon and rectum.
Pancolitis. Pancolitis affects the whole colon
and causes persistent bloody diarrhea.
Proctosigmoiditis. This affects the lower
colon and rectum.
Ulcerative proctitis. The mildest form of UC,
it affects the rectum only.
2. Nature Ulcerative colitis, is continuous inflammation of the In Crohn's disease, there are healthy parts of the intestine mixed
colon in between inflamed areas (Discontinuous) [Skipt].
3. Histological view Ulcerative colitis only affects the inner most lining of Crohn's disease can occur in all the layers of the bowel walls.
the colon. Gobelt cell loss & crypt abscess. Gobbestoning appearance
4. Immune mechanism TH2 activation results IL-5 & IL4 secretion TH1 activation leads to IL-17, IL-12 & IFN-γ liberation
5. Inflammatory process Superficial abscess due to humoral I.R. Crohn’s sometimes creates clusters of immune cells called
granulomas (i.e. C.M.I.)
6. Layers involvement Superficial shallow inflammation Transmural [deep in bowel wall] involved many layers
7. Intestinal Symptoms Telltale symptoms of ulcerative colitis are blood in Crohn’s, on the other hand, is often marked by nausea, weight
the stool with mucus, frequent diarrhea, loss of loss, and vomiting, with only occasional rectal bleeding, and
appetite, and tenesmus, or a strong urge to use the diarrhea.
bathroom without necessarily having a bowel Mouth sores between the gums and lower lip, or along the sides
movement. Fissures present. Bloody loose stool. or bottom of the tongue.
Fistula, abscesses and strictures are absent Anal tears (fissures), ulcers, infections, or narrowing. Fistula and
Stricture are common
8. Diagnostic Features can be detected Colonoscopy shows that the inflammation starts at Diagnosis of IBD is by colonoscopy — a small camera that’s
through a 1. colonoscopy; 2. Computer- the rectum and moves continuously up the colon attached to a thin tube that’s inserted into the colon. Enteroscopy
ized Tomography (CT) scans, which take and then stops, this could be a sign of ulcerative is better for illium or other parts of GIT.
images of cross-sections of the body; 3. colitis. Check the lining of the esophagus, stomach, and duodenum.
X-rays that can show whether or not By contrast, ulcerative colitis involves the endoscope This is an EGD (esophagogastroduodenoscopy).
there are narrowed spots in the insertion through the anus only. They are: For Crohn’s disease, there are two types of endoscopy, as
intestines; 4. an endoscopy that takes Sigmoidoscopy: This allows the doctor to follows:
images of the GI tract from inside the examine the rectum and lower colon for the Colonoscopy: The flexible tube, known as an endoscope, is
body; 5. or blood tests. extent and degree of inflammation in those inserted through the anus to allow for an examination of the
areas. colon.
Total colonoscopy: This occurs when the doctor Upper endoscopy: The flexible tube is inserted through the
examines the entire colon. mouth, down the esophagus, into the stomach, and into the
A chromo endoscopy, which is a test where blue first part of the small intestine.
dye is applied to the GI tract. This looks for
changes in the lining of the intestine, showing 2.Positive “ASCA” (anti-Saccharomyces Cerevisiae antibody)
precancerous changes known as dysplasia.
2. Positive for “pANCA” (perinuclear anti-neutrophil
antibodies)
9. Endoscopy evidence Pseudo-polyps positive Fissures present
10.Complications complications in severe, untreated, UC may lead to: Crohn’s disease can cause blockages of the intestine from
perforation (holes in the colon) scarring and swelling. Ulcers (sores) in the intestinal tract may
colon cancer develop into tracts of their own, known as fistulas. Crohn’s
liver disease disease can also increase the risk of colon cancer,
osteoporosis
anemi
