
According to the journal BMJ, the prevalence of Inflammatory Bowel Disease (IBD) is substantially increasing in India. This condition is characterised by long-term inflammation in the intestine (small and large bowel). There are two main types of this condition, namely ulcerative colitis and Crohn's disease that affect the digestive tract. Although there are some similarities between the two illnesses, there are also significant distinctions.
On this World Inflammatory Bowel Disease (IBD) Day, we spoke to Dr Adi Rakesh Kumar, Consultant Gastroenterologist, Therapeutic Endoscopist and Endosonologist, Yashoda Hospitals, Hyderabad, to learn about the difference between ulcerative colitis and Crohn's disease.
Understanding Ulcerative Colitis
Dr Kumar said, "Ulcerative colitis mainly affects the lining of the large intestine and rectum. It is characterised by inflammation and ulcers that develop in a continuous pattern, usually starting from the rectum and spreading to the colon."
He said that the inflammation in ulcerative colitis remains confined to the large intestine only and does not typically involve other parts of the digestive tract.
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The key features of ulcerative colitis include:
- Inflammation: The large intestine's inner lining becomes inflamed and develops small ulcers.
- Continuous pattern: The inflammation in ulcerative colitis affects a continuous segment of the large intestine, starting from the rectum.
- Limited to colon and rectum: The disease is usually limited to the large intestine and does not extend beyond it to other parts of the digestive system
- According to research in the journal Intestinal Research, ulcerative colitis is more common than Crohn's disease.
- "Most ulcerative colitis patients respond well to medical treatment with mild disease course in them compared to Crohn's disease," said Dr Kumar.
Symptoms of Ulcerative Colitis
According to Dr Kumar, "Common symptoms of ulcerative colitis include diarrhoea with blood, abdominal pain, urgency to have bowel movements, and rectal bleeding."
Management of Ulcerative Colitis
Dr Kumar said that the medical option for ulcerative colitis includes early diagnosis and treatment which results in adequate control over the disease.
"In severe cases of ulcerative colitis, surgical removal of the colon and rectum (colectomy) may be necessary to alleviate symptoms but in the Indian scenario, the number of patients undergoing surgery is few," said Dr Kumar.
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Crohn's disease
Dr Kumar said, "Crohn's disease, on the other hand, can affect any part of the digestive tract, from the mouth to the anus." He said that it involves inflammation that can penetrate the entire thickness of the intestinal wall and can occur in various segments of the digestive tract, with healthy sections of the intestine in between the inflamed areas.
The key features of Crohn's disease include, according to the expert.
- The inflammation can occur in any part of the digestive tract, from the mouth to the anus.
- It can affect multiple layers of the intestinal wall.
- Anal fissures and fistulas are very common.
- Crohn's disease often affects multiple segments of the digestive tract with healthy areas in between the inflamed regions known as patchy pattern.
- Complications are more common in Crohn's disease than ulcerative colitis, leading to strictures (narrowing of the intestines), fistulas (abnormal connections between organs), abscesses and extra-intestinal manifestations, like joint pains, red eye, and low back ache.
Symptoms of Crohn's Disease
Dr Kumar said, "The common symptoms of Crohn's disease include abdominal pain, diarrhoea, weight loss, and fatigue." He said that in some rectal bleeding can occur but is rare.
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Management of Crohn's Disease
Dr Kumar said, "The medical therapy for Crohn's disease can include a combination of medications, such as anti-inflammatory drugs, immunosuppressive drugs, biological therapies, and antibiotics." He added that the choice of medication depends on the type and severity of the condition and the patient's response to treatment.
He said, "In some cases, surgery is required to remove the affected part of the intestine or to manage complications."
Conclusion
Dr Kumar said, "It is important to note that both ulcerative colitis and Crohn's disease are chronic conditions without a known cure. However, with proper treatment, you can manage the symptoms and reduce inflammation."
He concluded, "If you suspect you have any symptoms related to IBD, consult a healthcare professional who can provide a proper diagnosis and develop an appropriate treatment plan tailored to your specific condition."
[Disclaimer: The information in this article is provided by a registered medical practitioner. However, we recommend you consult your healthcare provider for accurate diagnosis and treatment.]