In this guide:
1. The Difference: UC vs Crohn's 2. Key Symptoms 3. How We Diagnose 4. Prognosis & CareTwo Major Disorders
Inflammatory Bowel Disease (IBD) is a term for two conditions (Crohn's disease and ulcerative colitis) that are characterized by chronic inflammation of the gastrointestinal (GI) tract. Prolonged inflammation results in damage to the GI tract.
Ulcerative Colitis (UC)
Affects only the colon (large intestine). It causes long-lasting inflammation and ulcers (sores) in the innermost lining (mucosal layer) of the large intestine.
Crohn’s Disease (CD)
Can affect any part of the digestive tract from the mouth to the anus. It involves "transmural inflammation," meaning it can affect the entire thickness of the bowel wall, not just the lining.
Clinical Features: What You Feel
Symptoms can vary from mild to severe. They may develop gradually or come on suddenly, without warning.
- Abdominal Pain: Often crampy, intermittent pain.
- Chronic Diarrhea: Diarrhea that comes and goes, sometimes with visible blood.
- Fatigue & Weight Loss: Feeling constantly tired or losing weight without trying.
Because Crohn's disease affects the deep layers of the bowel wall ("Transmural Inflammation"), it can lead to:
- Fistulas: Abnormal tunnels that connect the intestine to other organs or the skin.
- Abscesses: Pockets of infection.
Beyond the Gut (Extraintestinal Symptoms)
IBD is a whole-body disease. You might experience inflammatory symptoms elsewhere, such as:
- Arthritis or joint pain
- Eye redness or pain
- Skin rashes or sores
- Kidney stones or liver issues
Diagnostic Evaluation
Our goal is to confirm the diagnosis, rule out other causes (like infections), and determine how severe the disease is. A correct diagnosis is the first step to the right treatment.
1. The Initial Workup
If you have compatible symptoms (pain, diarrhea, weight loss), we typically order:
- Lab Tests: Blood tests to check for anemia (low blood count) and vitamin deficiencies (B12, D). Stool studies help rule out infections.
- Imaging (CT/MRI Enterography): Special scans to look at the small bowel, which connects the stomach and colon.
2. The Gold Standard: Colonoscopy
To confirm Crohn's or Colitis, we usually perform a Ileocolonoscopy. This allows us to look inside the entire colon and the end of the small intestine (terminal ileum).
During this procedure, we take small tissue samples (biopsies). The diagnosis is confirmed when we see specific signs of inflammation under the microscope.
Prognosis & Long-Term Care
IBD is a chronic condition, meaning it is long-term. However, the course of the disease varies for everyone.
Most patients experience times when symptoms flare up (active disease) followed by times when symptoms disappear (remission). About 20% of patients experience prolonged remission after their first treatment.
While medicines have reduced the need for surgery, it is sometimes required to fix blocked bowels, abscesses, or complications. Surgery is not a failure; it is sometimes the best way to restore quality of life.