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Crohn's Disease vs. Ulcerative Colitis (UC)

What are Crohn's disease and ulcerative colitis (UC)?

Picture of Crohn's disease and ulcerative colitis.
Both Crohn's disease and ulcerative (UC) cause abdominal pain.

What are the differences and similarities between the signs and symptoms of Crohn's and ulcerative colitis?

Picture of the areas affected by Crohn's disease and ulcerative colitis.
Picture of the areas affected by Crohn's disease and ulcerative colitis.
Picture of the areas affected by ulcerative coilitis.
Picture of the areas affected by ulcerative coilitis.

Differences between symptoms and signs of Crohn's disease and ulcerative colitis

There are a few differences in the symptoms between ulcerative colitis and Crohn's disease. Frequently, doctors cannot diagnose the cause of either disease by symptoms alone. However, for people with ulcerative colitis, the abdominal pain is often confined to the left side of the abdomen, while Crohn’s disease may have abdominal pain anywhere in the abdomen.

Similarities between symptoms and signs of Crohn's disease and ulcerative colitis

Both Crohn’s disease and ulcerative colitis have many similar symptoms.

  1. Abdominal pain
  2. Diarrhea (sometimes bloody and/or containing mucus)
  3. Bloating
  4. Abdominal cramps
  5. Urgency to have a bowel movement (defecate)
  6. Anorexia
  7. Nausea/vomiting
  8. Constipation
  9. Weight loss

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What are the causes and triggers of Crohn's disease vs. ulcerative colitis?

Doctors and researchers don not know what causes both diseases, but they speculate that a number of factors such as genetics, heredity, mucosal immunity, gut microbes, diet, environmental factors, vascular problems, psychosocial problems, and certain drugs may be triggers that may participate in causing these diseases.

Because the diseases have unknown causes, it is difficult to know what triggers their development. However, if you carefully note in a diary when symptoms reappear in Crohn’s disease or worsen in ulcerative colitis, you may be able to identify triggers that affect your disease.

Can you drink alcohol with Crohn's disease?

  • Drinking alcohol is not recommended for most people with Crohn's disease.
  • Alcohol may irritate the lining of the intestinal wall, causing or worsening symptoms such as vomiting, diarrhea, and bleeding.
  • It also may contribute to malabsorption, further complicating nutritional deficiencies.
  • Alcohol interacts with many medications, causing side effects that may be serious.
  • Alcohol disrupts sleep cycles and can leave you feeling tired, and irritable the next day. However, if alcohol is well tolerated and not causing any complications, it can be consumed in moderation.
  • Chronic diarrhea can lead to dehydration very easily.
  • Dehydration makes you feel weak, tired, light-headed, or just "blah."
  • Alcohol can cause headaches, abdominal pain, and other symptoms. It also can place dangerous strain on your kidneys.
  • Dehydration can be avoided by making a special effort to take in plenty of nonalcoholic fluids.
  • You should take at least 8 full glasses of fluid every day.
  • Try to stick to water, diluted fruit juice, sports drinks, decaffeinated beverages, and fruit and vegetable drinks.
  • Avoid caffeinated beverages and sodas.

What procedures and tests diagnose Crohn's disease and ulcerative colitis?

Doctor’s diagnose ulcerative colitis by endoscopy (sometimes with biopsy). During this procedure the doctor can see and take pictures of the patient’s abnormal gut mucosa (often with ulcers), and the presence of continuous disease (there are no areas of normal mucosa). Other blood tests and imaging tests like CT scan or MRI are used, but these tests are not definitive.

Doctors use the same procedures and tests to diagnose Crohn’s disease. However, they also use small bowel studies, colonoscopy, and upper GI endoscopy to identify the abnormal gut mucosa that usually occur in multiple areas anywhere in the intestinal tract. These areas are not continuous, but are separated by normal areas of intestinal mucosa that distinguish them from ulcerative colitis lesions.

QUESTION

What is Crohn's disease? See Answer

Are there special diet plans or supplements for Crohn's disease vs. ulcerative colitis?

  • There is no evidence that diet has anything to do with causing inflammation or Crohn's disease.
  • There is no evidence linking food allergies, inflammation, with Crohn's disease.
  • There is no specific diet that is recommended for everyone with Crohn's disease. However, many people with Crohn's disease can reduce their symptoms by changing their eating habits or avoiding certain foods.
  • Nutritional deficiencies are a problem for almost everyone with Crohn's disease, but they are most serious in children and teens who are still growing.
  • Growth can be stunted permanently and sexual development (puberty) delayed in children and teens with Crohn's disease.
  • Girls and women can develop hormone imbalances and stop menstruating.
  • Nutritional deficiencies also can prevent medications from working as well as they should in healthy people.
  • In general, nutritional deficiencies can lead to overall poor health. If you have enough nutritional deficiencies they can make you feel
    • weak, 
    • tired,
    • depressed, or
    • just "blah."
  • Crohn's disease can leave you vulnerable to infections and other diseases.
  • They can stop anyone from looking, feeling, or performing at his or her best.

As with Crohn’s disease, nutrition is important if you have ulcerative colitis because symptoms of diarrhea and bleeding can lead to dehydration, electrolyte imbalance, and loss of nutrients. It may be necessary to take nutritional supplements if your symptoms do not allow you to eat a nutritionally balanced diet. Talk to your health-care professional about what supplements to take. 

What supplements should you take for Crohn's disease vs. ulcerative colitis?

Crohn's disease nutritional diet deficiencies

Ulcerative colitis nutritional deficiencies

As with Crohn’s disease, nutrition is important if you have ulcerative colitis because symptoms of diarrhea and bleeding can lead to dehydration, electrolyte imbalance, and loss of nutrients. It may be necessary to take nutritional supplements if your symptoms do not allow you to eat a nutritionally balanced diet. Talk to your health-care professional about what supplements to take. 

What foods can you eat on a ulcerative colitis diet?

If you have ulcerative colitis you may need to modify your diet to help manage their symptoms. There is not a single diet or meal plan that fits everyone with ulcerative colitis, and diets are individualized for each patient. Depending on symptoms different types of diets may be recommended, such as:

What are the treatments for Crohn's vs. ulcerative colitis?

  • Ulcerative colitis and Crohn’s disease treatments may include corticosteroids, anti-inflammatory agents, tumor necrosis factor inhibitors, immunosuppressants, antibiotics, Alpha 4 Integrin inhibitors and anti-diarrheal agents.
  • Crohn’s disease treatments also may include anticholinergic agents and bile acid sequestrants, if there is no bowel obstruction.
  • Severe ulcerative colitis may require surgical removal of the large intestine.

Treatments are complex, and some drugs should not be used for long time spans. You and your team (primary care and gastroenterologist) should discuss what treatment protocol you should follow.

Can complications of Crohn's disease or ulcerative colitis be fatal?

The prognosis for both diseases is fair to good in individuals that respond to medical therapy and avoid known triggers that increase symptoms. Most people can have a normal lifespan. However, for people with severe ulcerative colitis that are 50 years of age or older and require surgery, their lifespan may be reduced due to colitis-associated postoperative complications.

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Reviewed on 4/2/2020
References
Ghazi, LJ, MD, et al. Crohn Disease. Medscape. Updated: Jul 06, 2019.
<http://emedicine.medscape.com/article/172940-overview>

Basson, MD, MD, et al. Ulcerative Colitis. Medscape. Jul 06, 2019.
<http://emedicine.medscape.com/article/183084-overview>
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