Crohn’s Disease vs Ulcerative Colitis : IBD

Inflammatory bowel disease or IBD refers to a group of auto-immune disorders in which the intestines become inflamed. Ulcerative colitis and Crohn’s disease are chronic inflammatory bowel disease which have relapsing and limiting course. The diseases have many similarities and it is important to differentiate them.

Crohn's disease vs UC

Ulcerative Colitis vs Crohn's Disease

Crohn’s Disease Ulcerative Colitis
Most common site Terminal ileum Rectum
Distribution Mouth to anus Rectum to colon “backwash” ileitis
Spread Discontinuity “skip” lesions Continuous
Gross features
  • Focal aphthous ulcers with intervening normal mucosa
  • Linear fissures
  • Cobblestone appearance
  • Thickened bowel wall “linitis plastic”
  • Creeping fat
  • Extensive ulceration
  • Pseudo-polyps
Micro Noncaseating granulomas Crypt abscess
Inflammation Transmural Limited to mucosa and submucosa
Complication
  • Strictures
  • String sign on barium study
  • Obstruction
  • Abscess
  • Fistula
  • Sinus tract
  • Toxic megacolon
Genetic Association HLA-B27
Extraintestinal manifestation Uncommon Common
Cancer risk Slight 1-3% 5-25%
Presentation Variable : Pain, diarrhea, weight loss Bloody diarrhea

Reference:
Kaplan USMLE Lecture Notes

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