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What's the Difference Between Crohn's Disease and Ulcerative Colitis?

December 13, 2023

Elderly man clutching his stomach.

Crohn’s disease and ulcerative colitis are the two most common forms of inflammatory bowel disease (IBD), a condition that affects millions of people. While the two diseases have many similar characteristics, including pain, diarrhea, bleeding and inflammation, understanding the difference between the two can help you manage your symptoms effectively and get the relief you need.

“People with IBD can struggle with their symptoms for months or even years,” says Ravish Parekh, MD, a gastroenterologist at Atlantic Health System. “With the help of a specialist physician you can control the condition well, minimize complications and live a normal, healthy life.”

IBD can strike at any age and both men and women are equally likely to develop the condition. While the disease most often affects people between the ages of 15 and 30 and 50 to 80, Dr. Parekh explains that children also have a high risk for developing the condition. Because IBD is an autoimmune disease, the condition is triggered by your body’s misdirected immune response, and it tends to run in families.

Ulcerative Colitis

Ulcerative colitis can cause painful inflammation and ulcers. The condition affects only the inner lining of your lower intestines. Symptoms may include:

  • Diarrhea or frequent loose stools
  • Rectal bleeding
  • Urgent bowel movements
  • Weight loss
  • Abdominal pain
  • Anal leakage
  • Anemia

Crohn’s Disease

Crohn’s disease can affect any portion of your digestive tract, from your esophagus to your small intestines. A Crohn’s disease flare or attack can involve any layer of tissue lining your gastrointestinal walls. People with Crohn’s disease may have sections of healthy tissue surrounded by areas of inflammation. In addition to the symptoms outlined above, people with Crohn’s disease might also experience the following:

  • Abdominal pain
  • Diarrhea
  • Bowel obstruction
  • Rectal bleeding
  • Fistulas

“Diagnosing IBD can take some time and it involves both blood work, a colonoscopy and endoscopy, but there’s no reason to suffer with painful and bothersome symptoms,” says Dr. Parekh. “The sooner you are diagnosed, the sooner you can begin a course of treatment that will have you feeling better.”

Treatments and Outlook

Unfortunately, there is currently no cure for Crohn’s disease or ulcerative colitis and treatments for IBD are designed to reduce inflammation and send the disease into remission. A host of new treatments means that many people will find their disease stays in remission for a long time. Newer medications range from IV infusions, injections or pills to keep the disease in check. People with IBD also often take steroids for short periods of time to control inflammation.

“We are fortunate to have so many medications available to help manage IBD symptoms,” says Dr. Parekh. “If we start one type of therapy and it’s not controlling your symptoms, we have several options to keep the disease in remission.”

While diet cannot eliminate the disease, what you eat may play a role in how you manage IBD depending on the stage of your condition. Your gastroenterologist may suggest that you limit your fiber intake, limit processed foods or try an elimination diet to see if specific foods or ingredients aggravate your symptoms. Dr. Parekh says there is some evidence that supplements such as turmeric and vitamin D might have benefits for people with Crohn’s disease or ulcerative colitis.

Because IBD can lead to other gastrointestinal complications, Dr. Parekh stresses that it’s important for people diagnosed with IBD to manage their condition with a gastroenterologist, even when the disease isn’t causing any issues.

“With all of the resources we have to treat and manage IBD, the outlook is very positive for people with this condition, whether it’s Crohn’s disease or ulcerative colitis,” says Dr. Parekh. “We’ve come a long way with treatment options and it’s a rapidly growing field of research, so I’m very optimistic.”

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To stay safe and healthy, it's good to have a primary care provider who knows and understands your health history and wellness goals.

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