Chapter 4: Common Digestive Problems

4.5 Inflammatory Bowel Disease

Inflammatory bowel disease (IBD) refers to a number of inflammatory conditions in the intestine. The two most common are Crohn’s disease and ulcerative colitis. These two conditions differ mainly in the areas of the intestine that are affected. Crohn’s disease can occur anywhere throughout the GI tract, but most commonly occurs in the last part of the ileum.

Crohn’s disease may also involve all layers of the intestine.[1] Ulcerative colitis are ulcers, or sores, in the lining of the colon and/or rectum.[2] It is estimated that up to 1 million people have IBD in the United States. Half of these individuals have Crohn’s disease, and the other half have ulcerative colitis.[3]

Table 4.51 Differences between Crohn’s disease and ulcerative colitis[4]

Crohn’s Disease Ulcerative Colitis
Location Inflammation may occur anywhere along the digestive tract Large intestine (colon) is typically the only affected site
Inflammation Inflammation may occur in patches Inflammation is continuous throughout affected areas
Pain Pain is commonly experienced in the lower right abdomen Pain is common in the lower left part of the abdomen
Appearance
  • Colon wall may be thickened and may have a rocky appearance
  • Ulcers along the digestive tract are deep and may extend into all layers of the bowel wall
  • Colon wall is thinner and shows continuous inflammation
  • Mucus lining of large intestine may have ulcers, but they do not extend beyond the inner lining
Bleeding Bleeding from the rectum during bowel movements is not common Bleeding from the rectum during bowel movements

The exact causes of these two diseases is not known. One hypothesized cause for Crohn’s disease is an overactive immune system that results in the chronic inflammation and collateral damage to the cells of the intestine, resulting in formation of lesions.

Crohn’s disease and ulcerative colitis present symptoms similar to other gastrointestinal diseases, such as irritable bowel syndrome and GERD. However, there are areas where the symptoms of the two do not overlap. Table 4.52 lists the typical symptoms of each.

Table 4.52 Comparison of the symptoms of Crohn’s disease and ulcerative colitis.[5]

Symptoms of Crohn’s Disease
  • abdominal pain, cramping, or swelling
  • anemia
  • fever
  • gastrointestinal bleeding
  • joint pain
  • malabsorption
  • persistent or recurrent diarrhea
  • stomach ulcers
  • vomiting
  • weight loss
Symptoms of Ulcerative Colitis
  • abdominal pain or discomfort
  • anemia caused by severe bleeding
  • bloody diarrhea
  • dehydration
  • fatigue
  • fever
  • joint pain
  • loss of appetite
  • malabsorption
  • rectal bleeding
  • urgent bowel movements
  • weight loss

  1. http://www.niddk.nih.gov/health-information/health-topics/digestive-diseases/crohns-disease/Pages/facts.aspx ↵
  2. https://www.niddk.nih.gov/health-information/digestive-diseases/ulcerative-colitis ↵
  3. http://www.ccfa.org/info/about/crohns ↵
  4. http://www.columbia-stmarys.org/Crohn_vs_Ulcerative_Colitis [inactive] ↵
  5. http://www.columbia-stmarys.org/Crohn_vs_Ulcerative_Colitis [inactive] ↵
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