Ulcerative Colitis and Crohn’s Disease are two forms of the same disease, Inflammatory Bowel Disease, also called IBD. They are both chronic inflammatory diseases of the gastrointestinal tract. Both forms of the disease share many similarities in terms of symptoms such as diarrhea, bloody stools, abdominal pain, fatigue, and weight loss. Many of the treatment options are also similar. As a result, people sometimes wonder what the difference is between them.
The Location of the Disease in the Gastrointestinal Tract
The main difference between Ulcerative Colitis and Crohn’s Disease is where the disease is located.
Ulcerative Colitis is always restricted to the lower digestive tract in the large intestine and the rectum (the part of the large intestine next to the anus). It is usually a continuous inflammation that starts in the rectum and progresses up the large intestine, with most patients suffering from Ulcerative Proctitis involving only the rectum and the lowermost section of the colon.
Crohn’s Disease can affect anywhere from the mouth to the beginning of the large intestine. However, most patients have ileocolitis, which affects the ileum or lowermost section of the small intestine and the adjacent beginning of the large intestine. Their inflammation also tends to be patchy, with diseased sections found right next to healthy sections and often with multiple diseased sections in different locations in the gastrointestinal tract.
Which Layers of the Gastrointestinal Tract Become Inflamed
The other difference between the two forms of IBD is which layer of the gastrointestinal tract becomes inflamed. Your gastrointestinal tract or intestine is a tube made of three concentric layers of tissues. The outer layer is made of smooth muscles that help with peristalsis, the involuntary movement that pushes food down the digestive tract. Next is the submucosa, a layer of connective tissues, nerve cells, immune cells, blood, and lymph vessels. There is also another layer of muscles that some people classify as a separate layer, or others consider it part of the submucosa. Finally, the inner layer is the mucosa. The mucosa is what is in contact with our food. It is responsible for absorbing nutrients from our food, releasing enzymes to aid digestion, and secreting mucus to help the food move along the digestive tract. It is this layer that is affected in both forms of IBD.
The difference between Crohn’s Disease and Ulcerative Colitis is that patients with Crohn’s Disease can have inflammation in all three layers, while Ulcerative Colitis inflammation is restricted to the mucosa layer.
Which Form of Inflammatory Bowel Disease is Most Common?
Worldwide, Ulcerative Colitis affects more people than Crohn’s Disease. It is also less correlated with genetics and more strongly correlated with diet and stress.
Living with either form of IBD does not have to mean the end of life as you knew it. Many treatment options are available, including lifestyle changes like stress reduction and a healthy diet that can help patients with IBD live a long, healthy, and happy life.
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