Difference Between Crohn’s Disease and Ulcerative Colitis

Written and medically reviewed by Dorcas Morak, Pharm.D

If you’ve been experiencing persistent stomach cramps, fatigue, weight loss, or frequent bathroom trips, you could be dealing with inflammatory bowel disease (IBD). There are two main types of IBD—Crohn’s disease and ulcerative colitis (UC)—and while both can have a serious impact on your digestive health, it’s essential to understand their key differences. With Crohn’s and Colitis Awareness Week taking place from December 1-7, now is the perfect time to learn more about these conditions.

Shared Symptoms: Why is it Easy to Confuse Them?

Crohn’s and Ulcerative Colitis share many symptoms, making them hard to tell apart. Common symptoms include:

• Belly cramps and pain
• Chronic diarrhea or constipation
• A feeling of incomplete bowel movements
• Rectal bleeding
• Fatigue, weight loss, and loss of appetite
• Fever and night sweats
• Irregular menstrual periods (for women) Both conditions can come and go in waves of flares (worsening symptoms) and remissions (when symptoms subside). While they can appear at any age, they are often diagnosed in teenagers and young adults and may run in families.

Key Differences Between Crohn’s and Ulcerative Colitis Despite their similarities, Crohn’s and ulcerative colitis have three key distinctions:

1. Location

• Ulcerative colitis only affects the large intestine (colon). Inflammation occurs in the innermost lining of the colon.
• Crohn’s disease can show up anywhere along the digestive tract, from the mouth to the anus. This means inflammation isn’t just limited to one spot.

2. Pattern of Inflammation

• In ulcerative colitis, the inflammation is continuous, meaning there are no healthy patches between inflamed areas of the colon.
• With Crohn’s, you might have “skip lesions”—inflamed areas mixed with sections of healthy tissue.

3. Depth of Inflammation

• Ulcerative colitis typically affects only the innermost lining of the colon.
• Crohn’s disease can affect all layers of the bowel walls, leading to complications like fistulas (abnormal connections between tissues), narrowing of the intestine, and even ulcers in areas like the mouth.

Diagnosis Options for Ulcerative Colitis and Crohn's Disease

Diagnosing these conditions involves a variety of tests, including colonoscopies, endoscopies, imaging scans, and even blood tests. The goal is to pinpoint the exact location and severity of inflammation. Since Crohn's and ulcerative colitis differ in how they affect your digestive system, getting an accurate diagnosis is crucial to finding the right treatment plan.

Are Crohn’s and Ulcerative Colitis Treatable?

There are many treatment options available to help manage symptoms and reduce inflammation. These include:

Lifestyle Changes

Managing Crohn’s disease or ulcerative colitis often requires adjustments to daily habits to help reduce symptoms and improve overall well-being. Here are some lifestyle changes that can make a difference:

• Regular Exercise: Physical activity can reduce inflammation, improve immune function, and enhance mood through the release of endorphins. Low-impact exercises, such as walking, swimming, or yoga, are often easier on the body and can be particularly beneficial during flare-ups.
• Stress Management: Stress can trigger or worsen symptoms, so finding ways to manage it is crucial. Techniques like deep breathing, meditation, and mindfulness practices can help keep stress levels in check. Some people also benefit from therapy or support groups to help manage the emotional challenges of living with IBD.
• Avoiding Trigger Foods: Certain foods can aggravate symptoms and trigger flare-ups. While triggers vary by individual, common culprits include high-fiber foods, dairy products, caffeine, alcohol, and fatty or fried foods. Keeping a food diary can help you identify and avoid specific foods that worsen your symptoms. Consulting a dietitian can also be helpful to ensure a balanced diet that meets your nutritional needs.

Medications

Medication plays a crucial role in managing symptoms and reducing inflammation in both Crohn’s disease and ulcerative colitis. Treatment plans vary, and doctors may adjust them over time based on symptom severity and how well the patient responds to each medication. Here’s a breakdown of common medication types:

• Anti-Inflammatory Drugs (5-ASAs): Medications like sulfasalazine and mesalamine help reduce inflammation in the digestive tract and are often used for mild to moderate cases of ulcerative colitis. They’re generally less effective for Crohn’s disease affecting areas beyond the colon.
• Corticosteroids (Steroids): Drugs like prednisolone can quickly reduce inflammation and are used for short-term treatment during flares. While effective, they are not ideal for long-term use due to potential side effects like weight gain, mood changes, and a weakened immune system.
• Immune System Suppressants: These medications, such as azathioprine and methotrexate, work by targeting the immune system to prevent it from attacking the digestive tract. They are often prescribed when other treatments haven’t been effective or for long-term management, though they may take a few months to start working.
• Biologics: Biologics are newer medications, such as infliximab and adalimumab, that specifically target proteins involved in the inflammatory process. These drugs are typically prescribed for moderate to severe cases of Crohn’s or ulcerative colitis, especially when other treatments have not been effective. Biologics can help maintain remission and prevent complications, but they may increase susceptibility to infections due to their effect on the immune system.

Each person’s response to medication can vary, so it may take time to find the right combination of treatments to achieve symptom control and maintain remission. Regular follow-up appointments with healthcare providers are important for monitoring side effects and adjusting the treatment plan as needed.

Surgery

Sometimes, it is necessary for severe cases, mainly when medications aren’t enough. While remission is possible for many people, it’s essential to maintain regular checkups and monitoring. Consider tracking symptoms and potential triggers to help manage your condition effectively.

Why Crohn’s and Colitis Awareness Week Matters

Crohn’s and Colitis Awareness Week, held each year from December 1-7, is a time to shine a light on these chronic conditions that often go unnoticed. This week is about educating the public, reducing stigma, and supporting patients and families dealing with the daily challenges of IBD. If you or someone you know is affected, this is a chance to connect with a supportive community and access resources to help you navigate life with Crohn’s or ulcerative colitis.

For those managing Crohn's disease or ulcerative colitis, access to affordable medications is essential. RxLess is here to support you with discounts of up to 88% on prescriptions at over 70,000 pharmacies, including CVS, Rite Aid, and Walgreens. By joining the RxLess Assurance Plan through our free app, you can get the best and most accurate discounts tailored to your needs. Take control of your health with confidence—download the app and start saving today.