Crohn’s Disease vs Ulcerative Colitis : IBD

Crohn's disease vs UC

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 DiseaseUlcerative Colitis
Most common siteTerminal ileumRectum
DistributionMouth to anusRectum to colon “backwash” ileitis
SpreadDiscontinuity “skip” lesionsContinuous
Gross features
  • Focal aphthous ulcers with intervening normal mucosa
  • Linear fissures
  • Cobblestone appearance
  • Thickened bowel wall “linitis plastic”
  • Creeping fat
  • Extensive ulceration
  • Pseudo-polyps
MicroNoncaseating granulomasCrypt abscess
InflammationTransmuralLimited to mucosa and submucosa
Complication
  • Strictures
  • String sign on barium study
  • Obstruction
  • Abscess
  • Fistula
  • Sinus tract
  • Toxic megacolon
Genetic AssociationHLA-B27
Extraintestinal manifestationUncommonCommon
Cancer riskSlight 1-3%5-25%
PresentationVariable : Pain, diarrhea, weight lossBloody diarrhea

Reference:
Kaplan USMLE Lecture Notes

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