Crohn's colitis/UC differences.

[JamieG]

I was diagnosed with UC in Feb 2012, then diagnosis changed to Crohns colitis in May 2012. Good news is that I got offered some new treatment options. My symptoms at the moment are probably in general more similar to people with UC than Crohn's disease. What are the main differences between the CC and UC? Is it likely that I will experience inflammation in other areas other than my colon at some point? I guess it means that I wouldn't be considered cured if I ever have my colon removed.

 

[EDZEL]

Hi JamieG

I agree that it would be useful to have a 'sticky post' on here which defines the two! I'm new here and having read posts from sufferers of both conditions. I'm now wondering if my diagnosis of UC was in fact correct as I seem to have some of the symptoms which Chron's sufferers also have - but I have no idea if some symptoms are common to both! There seem to be way more Chron's than UC related posts on the forum... or maybe I'm looking in the wrong places, LOL.

 

[michaelearnest]

Hello there - I think the biggest difference is that Crohns inflammation can occur anywhere from the mouth to the anus and UC is mostly in the large intestine. Sometimes even a trained GI can only DX once an event has occurred.

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[pb]

I have crohn's colitis...when I first became sick 21 yrs ago, my CD was affecting my colon (crohn's colitis) small intestine, rectum (proctitis) and anus with perianal crohn's skin tags. It has stayed constant in my colon the entire 21 yrs, on and off in the rectum and constant on the anus with the perianal crohn's skin tags. UC is limited to the colon/rectum.

The symptoms between UC and crohn's colitis can basically be the same, blood, D, excess mucous, lower back pain, ab pain, etc...these symptoms can vary for each IBDer though (regardless if it's CC or UC).

The main difference between UC and CD is the pattern of inflammation and location generally....

With UC, the entire area will be inflammed, with CD (regardless of what part of the GI tract it's affecting) the pattern of inflammation will be patchy (healthy tissues amongst inflammed) that and the areas I mentioned above are the major differences in telling the 2 apart.

Often some GI's don't have a keen enough eye to note the difference in the pattern of inflammation...and also, they aren't thorough enough to check all IBD patiens entire GI tracts, they can be too quick to make assuptions (usually the arrogant GI's)...sometimes it's due to them being lazy.

Fistulas are also more common with CD rather than UC...a good GI will be suspicious if his/her patient has fistula issues when the DX is considered to be UC rather than CD.

The same meds used to treat UC are used to treat CC as well.

Surgery, like getting your colon removed if you have CC, is not going to guarantee that CD won't appear in other parts of the GI tract...if often will in time because that's the nature of crohn's. Just as it's the nature of UC to be "cured" with colon/rectum removal.

 

[Thermo]

I recommend reading this:

http://en.wikipedia.org/wiki/Crohn's_disease

About halfway down there is a section called 'Comparison with ulcerative colitis' it's not the best but some of the best information all in one place I have found. What new treatment options did they offer you?

 

[JamieG]

Hi thermo,

They offered me Humira or remicade. Just started on Humira a few weeks ago. I am also on Imuran (azathioprine), but started that when my diagnosis was still UC. So far improvement has been minimal and painfully slow. In February I was told that I had pan UC, but that seems odd now if crohns is normally more patchy. Going for a sigmoidoscopy next week so that might answer some questions. Just hoping that inflammation is less than it was in feb.

 

[EDZEL]

I recommend reading this:

http://en.wikipedia.org/wiki/Crohn's_disease

About halfway down there is a section called 'Comparison with ulcerative colitis' it's not the best but some of the best information all in one place I have found. What new treatment options did they offer you?

Thanks, those were great links, very informative!

I've never been offered any other treatment options - I think steroids were mentioned as a possibility at one point if the sulphasalzine became less effective, but both the consultant and I were of the opinion that it would be better to avoid them if at all possible. It will be interesting to see what is said about medication and dosage in 8 weeks time when I go for my biopsy results. I'm kind of hoping they won't want to reduce the dosage, but on the other hand by then I'm hoping to have made some progress in identifying problem foods and perhaps I will be able to tolerate less of the SSZ... certainly I had never realised that my skin rashes and thinning hair might be to do with the drug, since my late mother also had thin, fine hair so I've been assuming its a genetic thing...

Interestingly mum was diagnosed with diverticulitis in her later years... and three paternal direct relatives(grandfather, great-grandfather and great-great grandfather) all died of rectal cancer, so I guess my chances of the big C are higher than the norm... not a cheering thought and one which will probably stress me somewhat as results day draws near... :sign0085: But I'm going to try not to think about that too much...

 

[Thermo]

Hi thermo,

They offered me Humira or remicade. Just started on Humira a few weeks ago. I am also on Imuran (azathioprine), but started that when my diagnosis was still UC. So far improvement has been minimal and painfully slow. In February I was told that I had pan UC, but that seems odd now if crohns is normally more patchy. Going for a sigmoidoscopy next week so that might answer some questions. Just hoping that inflammation is less than it was in feb.

Where have they found your disease most active at and what type of inflammation have they found? Have you ever tried any mesalamine like Pentasa?

 

[Thermo]

Thanks, those were great links, very informative!

I've never been offered any other treatment options - I think steroids were mentioned as a possibility at one point if the sulphasalzine became less effective, but both the consultant and I were of the opinion that it would be better to avoid them if at all possible. It will be interesting to see what is said about medication and dosage in 8 weeks time when I go for my biopsy results. I'm kind of hoping they won't want to reduce the dosage, but on the other hand by then I'm hoping to have made some progress in identifying problem foods and perhaps I will be able to tolerate less of the SSZ... certainly I had never realised that my skin rashes and thinning hair might be to do with the drug, since my late mother also had thin, fine hair so I've been assuming its a genetic thing...

Interestingly mum was diagnosed with diverticulitis in her later years... and three paternal direct relatives(grandfather, great-grandfather and great-great grandfather) all died of rectal cancer, so I guess my chances of the big C are higher than the norm... not a cheering thought and one which will probably stress me somewhat as results day draws near... :sign0085: But I'm going to try not to think about that too much...

Yeah I had to stop taking mesalamine due to getting a really bad rash, which is an allergic reaction to it. It just depends on how bad it is for you if you can live with it, and since the mesalamine has been working so well for you I would not be in a hurry to replace it. I would not be worried about the increase rate of Cancer just keep up on getting your tests and scopes done. If you catch it quick enough there is a chance you wouldn't even have to do chemotherapy so don't get too worried. It is possible to greatly reduce your symptoms by changing your diet and getting on a good probiotic, it won't cure you but it will stop a good percentage of symptoms. Keep us updated on when the tests come back and you decide on a course of action with the medication.

 

[JamieG]

Where have they found your disease most active at and what type of inflammation have they found? Have you ever tried any mesalamine like Pentasa?

Yes they started me on prednisone and asacol which is apparently like pentasa. Asacol made me worse so I stopped.