Symptoms, Treatments, and Differences of Crohn's and Ulcerative Colitis
At 17, Angela was diagnosed with ulcerative colitis. At 20, her colon was removed. She has a passion to share her knowledge of the disease.
Is IBS an IBD? What's the Difference?
An IBD stands for inflammatory bowel disease, whereas IBS stands for irritable bowel syndrome. There are only two IBDs, ulcerative colitis and Crohn's disease. The basic difference between IBD and IBS is that Crohn's and ulcerative colitis usually result in ulcerations, whereas IBS does not.
One reason IBD is confused with IBS is that irritable bowel is often called spastic colitis, as well as colitis. Coincidentally, both IBDs can be referred to as just colitis since that merely means inflammation of the colon. Often times at the earlier phases of an IBD, a doctor may misdiagnose as irritable bowel syndrome. One of the biggest predictors that it might be something else is if you see blood in your stool. Keep in mind hemorrhoids can also cause blood in the stool. Hemorrhoids are often caused by frequent bowel movements, which is characteristic of both IBDs and IBS. Therefore, do not assume you have something more severe at the presence of blood, instead seek medical attention to rule out hemorrhoids.
Does Stress Cause Inflammatory Bowel Disease?
Contrary to popular belief, Inflammatory Bowel Diseases are not caused by emotional stress. That being said, stress can trigger a flare-up, the same way in which all diseases can flare during a time of stress. There are many myths surrounding IBD's as well.
Due to the similarities of the diseases, they are often confused in both diagnosis and symptoms. The main difference is ulcerative colitis affects the colon, whereas Crohn's can target any part of your digestive system from the mouth to the anus. This does not mean that Crohn's is a more serious disease. Someone with Crohn's may have a more mild case than someone with ulcerative colitis, it depends on the severity of the symptoms in the individual.
Unlike Crohn's disease, there is a "cure" for ulcerative colitis. I use quotes because I have been "cured" of ulcerative colitis. Unfortunately, there are lifelong ramifications to being cured since the only true cure is a full removal of your large intestine. This should not be a decision to be taken lightly, as I have met numerous people who have regretted their decision. Without my colon, I had five to eight bowel movements for the first five years after, and now have three to five bowel movements a day. Diarrhea is experienced differently without a colon than with. Also, there were many complications that I experienced afterward such as blockage, abscesses, and pulmonary embolism as a result of surgery. There are other complications as well. Yet, I am personally glad to be cured as I had nearly lost my life prior.
Both IBDs are inherited diseases. Twenty percent of people with UC have one other close relative with another IBD disorder, either Crohn's or UC itself. Since the diseases are so closely related, a person with ulcerative colitis may have a relative who has Crohn's. Both run in both sides of my family. At the current time, there has not been a gene that is identified as the IBD carrier; therefore, there is not a test to see if you will get the disease.
Not only can Crohn's affect a larger portion of the digestive tract, but it also affects more layers of the colon wall. Ulcerative colitis only inflames the innermost lining, whereas Crohn's affects several layers of the intestinal wall.
How is Ulcerative Colitis and Crohn's Diagnosed?
The first step in diagnosing is to rule out more common ailments. Stool tests are performed to eliminate possible infectious diseases as the cause. They may also do a CT scan on the abdomen.
Once all other possibilities are eliminated your gastroenterologist may choose one of two procedures; sigmoidoscopy or colonoscopy. These are both relatively painless, dependent on the degree of the disease. The first is sigmoidoscopy, where they check only the rectum and lower colon area. The second is a test of the entire colon called a colonoscopy, which allows the physician to take biopsies of the colon lining. These procedures are done while the patient is awake but due to the nature of the medications, there is an amnesic effect. Therefore, you will not remember much of the test.
They may also do an endoscopy which is a tube you swallow, that shows the upper portion of the digestive system, which is more significant in diagnosing Crohn's.
Many of the symptoms are very similar. They include, but not limited to:
- abdominal pain and cramping
- blood in the stool
- loss of appetite
- mucus in the stool
- persistent diarrhea
- ulceration in the digestive tract
There are also some common non-digestive related symptoms, such as delayed growth in younger children, eye irritations, fever, weight loss, and more severe PMS symptoms. Nausea is more commonly associated with Crohn's, although it is present in more severe cases of UC.
Some of the more unusual symptoms I have experienced, even now after having been cured is getting eye inflammation called episcleritis, as well as joint pain. Both have been attributed to my diagnosis.
Are There Treatments for IBDs?
The most common treatment is medication. As stated earlier, UC can be cured. Having gone through the surgery, non-electively, I would not encourage anyone to do it electively unless their symptoms are severe. I am 16 years post-op. Although I function normally, there are still things that are atypical about my digestion. The first few years, my symptoms seemed very similar to a mild case of the disease.
The cure included removing my entire colon except for my rectum. This allowed me to be able to have my ilium reconnected to my rectum, so I could use the bathroom without the use of an ostomy. Due to the severity of the disease and the newness of the surgery at the time, they were unable to do the full surgery in one step. So I did have a six month period where I had an ostomy. In place of a colon, they form a pouch from the bottom portion of your ileum. It is amazing how effective this structure is, but it takes years for it to adjust. During the adjusting time, things are not always easy. The reason it is not encouraged for Crohn's patients is that even if the colon is the only affected area, chances of them getting sick in a different section of the digestive tract is very likely.
Feel free to ask any questions or contact me if you just want to talk to someone who has been there. If you think you have the disease, definitely contact your doctor. For the first five years post-op, I ran a website where I had contact with hundreds of people who had the disease. I can tell you very much what it like first-hand, as well as what others experienced. Medically speaking, I'm not qualified; therefore, a nurse or doctor needs to be notified. I am here for emotional support, not medical advice. I have found that there are amazing nurses (and doctors) out there; find one that is a good fit for you.
- BOSCARINO, JOSEPH A. “Posttraumatic Stress Disorder and Physical Illness: Results from Clinical and Epidemiologic Studies.”Annals of the New York Academy of Sciences, Wiley/Blackwell (10.1111), 12 Jan. 2006, nyaspubs.onlinelibrary.wiley.com/doi/abs/10.1196/annals.1314.011.
- “Crohn's & Colitis.”What Is Crohn's Disease | Causes of Crohn's | Crohn's & Colitis Foundation, www.crohnscolitisfoundation.org/what-are-crohns-and-colitis/diet-and-nutrition/?gclid=Cj0KCQjwxbzdBRCoARIsACzIK2kCyHZKIo50BzwFHGqLKTKLwbc0JiViWYpCG154rpVdxAgGQriONWUaAnQXEALw_wcB.
- Stojanovich, L, and D Marisavljevich. “Stress as a Trigger of Autoimmune Disease.”Current Neurology and Neuroscience Reports., U.S. National Library of Medicine, Jan. 2008, www.ncbi.nlm.nih.gov/pubmed/18190880.