George Krucik, MD, MBA
The term colitis refers to conditions that cause inflammation of the large intestine or colon. The most common types of chronic colitis are ulcerative colitis and Crohn’s disease, which are collectively known as inflammatory bowel diseases. The symptoms of these conditions can be very similar and it can be hard to differentiate between them.
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The main difference between Crohn’s disease and ulcerative colitis is that Crohn’s disease can cause inflammation anywhere in the gastrointestinal tract, while the inflammation of ulcerative colitis is localized in the large intestine. But according to the Merck Manuals, the large intestine is one of the most common areas affected by Crohn’s and the segment of intestine affected by ulcerative colitis, making the distinction between them even harder.
The symptoms of chronic colitis include diarrhea that can be bloody, abdominal cramps, fever, weight loss or loss of appetite. Patients with inflammatory bowel disease undergo flareups, or periods when their symptoms become worse. These flareups can be relatively mild, or can be severe and even life-threatening. Symptoms during the flareups include significant abdominal pain, dehydration, and anemia or blood loss.
Patients with Crohn’s can have symptoms in other areas of their body during their flareups. These include inflammation of the joints, or arthritis; mouth sores; inflamed nodules in the arms and legs, a condition called erythema nodosum; and inflammation inside the eye, or uveitis. The inflammation of ulcerative colitis is limited to the colon.
The complications for each of these conditions vary. For Crohn’s disease, the inflammation can cause localized scarring of a segment of intestine, resulting in intestinal obstruction. Also, patients with Crohn’s disease can have abscesses, or pus-filled pockets of infection, within the intestines. Crohn’s patients have a higher risk of developing colon cancer than patients with ulcerative colitis. Patients with ulcerative colitis can have severe flareups with paralysis of the colon, or ileus, and perforation of a segment of intestine, resulting in peritonitis, an infection of the tissue lining the abdominal wall.
According to the Mayo Clinic, the treatment for both Crohn’s and ulcerative colitis involves anti-inflammatory medicines, to reduce the chronic inflammation of the intestines; steroids, which have an anti-inflammatory effect; and immune system suppressors, on the theory that by suppressing the immune system you decrease the level of inflammation in the whole body. Patients with Crohn’s may benefit from antibiotics if there is abscess formation. Patients with ulcerative colitis can be cured with surgery if their disease is limited to a small segment of colon. Patients with either condition benefit from nutritional management to avoid severe weight loss and malnourishment.