Ulcerative Colitis vs Cronhn's Disease

Main points to remember about each disease.

ULCERATIVE COLITIS

• Mucosal and submucosal
• Begins in rectum and may have continuous extension extension to ileocecal valve [called pancolitis].
• Ulceration leaving inflamed mucosa [called pseudopolyps]; crypts abscesses.
• Recurrent LLQ abdominal cramping with bloody diarrhea and mucus.
• Association with PSC and HLA-B27 + arthritis.
• Toxic megacolon, Colon cancer [greater risk than CD]

CROHN'S DISEASE

• Transmural [serosa to mucosa]
• Discontinuous spread; terminal ileum alone [30%]; ileum + colon [50%]; colon alone [20%]; may involve anus [fistulas].
• Non-caseating granulomas [60%]; strictures, fistulas
• Recurrent RLQ colicky pain usually with diarrhea.
• Less association with PSC than UC; HLA-B27 +arthritis.
• Colon cancer, fistulas, SB obstruction; terminal ileum disease: malabsorption [bile salt/acid deficiency], vitamin B12 deficiency.