Ulcerative Colitis vs Crohn's Disease

What is the difference between ulcerative colitis and Crohn's disease? Ulcerative colitis and Crohn's disease are the two most common types of infammatory bowel disease, or IBD. The symptoms for both generally tend to be the same, with a few small differences.

First, ulcerative colitis affects only the large intestine, or colon, whereas Crohn's disease has the capability to affect the entire intestinal tract. To that degree, ulcerative colitis presents itself as continuous inflamed bowel, where there are no healthy areas of intestine in between. Crohn's disease can appear patchy, and diseased sections of the bowels may 'skip', leaving healthy segments of intestine between diseased areas.

Ulcerative colitis only affects the inner lining of the intestines, while Crohn's disease possesses the ability to affect all layers of the intestines. This simply means that in ulcerative colitis, the mucus lining of the colon, or large intestine, becomes inflamed, but does not penetrate deeper than that. In Crohn's disease, the ulcerations can penetrate all layers of the bowel wall.

Fissures, Fistulas, and Strictures

Fissures, fistulas, and strictures are all common complications seen in Crohn's disease, but are less frequent in people with ulcerative colitis.

• Fissure - An ulcer, or tear, in the lining of the rectum.
• Fistula - An abnormal tube, or tunnel, connecting two body cavities. In Crohn's, this presents as pockets of stool, which can prevent healing. Fistulas can eventually break, leaking its contents into other areas of the body.
• Stricture - Abnormal narrowing of a body opening.

Surgical Treatment

The surgical treatments for both ulcerative colitis and Crohn's disease differ in that what is done to 'cure' ulcerative colitis, cannot be done for Crohn's. In ulcerative colitis, a colectomy is done, which is removing the entire section of large intestine. It is uncommon to remove only affected areas of the colon, because people with ulcerative colitis risk further flare-ups of the disease in the remaining healthy section. After a colectomy, an ileostomy may be done, or a procedure to make a pouch out of healthy small intestine can be performed as well.

In Crohn's disease, diseased sections of the bowel may be surciacally removed. In the instances where a colectomy must be performed, pouches are not created, as in ulcerative colitis, due to the risk of Crohn's affecting the pouch itself, ptentially requiring further surgery.