Inflammatory bowel disease

Differentiating Crohn's and ulcerative colitis

 Gastroenterology  MRCP

Crohn's diseaseulcerative colitis
symptomssteatorrheoa, fistulae, weight loss, oral ulcersmucus and blood in diarrhoea, tenesmus
bowel areas involvedsmall intestine, terminal ileum, colon, anus, rectum (rarely)colon and rectum
pathologypatchy areas of inflammation (skip lesions), transmural, deep geographic / serpiginous ulcers on endoscopycontinuous areas of inflammation, continuous ulcers on endoscopy, shallow mucosal ulceration
risk factorshigher risk with smokerslower risk with smokers
managementbiological therapies, surgery, mesalazine sometimes useful to prevent relapse after surgerymesalazine, steroids, immunosuppresants, surgery in severe cases
less common clinical presentationsmay mimic ulcerative colitis as a "Crohn's colitis", may present as a malabsorption syndromemay present with acute, severe ulcerative colitis with anaemia and fever
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Cummings JRF, Keshav S, Travis SPL. Medical management of Crohn’s disease. BMJ 2008 May;336(7652):1062–1066. Available from:

Wikipedia: Crohn's vs UC.


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