February 21, 2025 Michelle Schmanski

What is the Difference Between Crohn’s Disease and Colitis?

Crohn’s disease and ulcerative colitis are two common forms of inflammatory bowel disease (IBD), but they are not the same. Though they both cause chronic inflammation in the digestive tract, they differ in a few key ways. Understanding the difference between Crohn’s disease and colitis can help people manage symptoms better. It can also help them make informed decisions about treatment options.

The Difference Between Crohn’s Disease and Colitis

Inflammatory bowel disease (IBD) is an umbrella term for several chronic conditions of the digestive tract. These conditions all lead to some form of inflammation. The two most common types of IBD are:

• Crohn’s disease
• Ulcerative colitis

While both conditions share many overlapping symptoms, there are a few distinctions:

• Where inflammation occurs
• How it behaves
• The type of treatments needed

GI Anatomy

Understanding IBD starts with understanding the anatomy of the GI tract, which begins at the mouth and ends at the anus. Major structures in this system include the:

• Esophagus: the tube that carries food from your mouth to your stomach
• Stomach: where food mixes with digestive juices
• Small intestine: responsible for nutrient absorption and made up of the duodenum, jejunum, and ileum
• Large intestine or colon: absorbs water and electrolytes, forming stool
• Rectum and anus: where stool is stored and then passed out of the body

Crohn’s disease can affect any part of the gastrointestinal tract, from the mouth to the anus. However, it most commonly involves the end of the small intestine (ileum) and the beginning of the colon. In contrast, ulcerative colitis is confined to the large intestine and rectum.

Overlapping Symptoms of Crohn’s and Colitis

The hallmark of these diseases is chronic inflammation. Both can have periods of worsening symptoms, known as flare-ups, and little or no symptoms, known as remission.

Crohn’s disease and ulcerative colitis also have some overlapping symptoms. This makes it difficult to differentiate between the two without specific testing. Symptoms they share are:

• Abdominal pain or cramping
• Diarrhea, sometimes with blood
• Weight loss
• Reduced appetite
• Fatigue
• Urgent bowel movements
• Bloating and gas

Understanding Crohn’s Disease

Crohn’s disease can strike any part of the GI tract but frequently affects the ileum and parts of the colon. Inflammation can occur in patches with healthy tissue in between inflamed areas. This presentation is often referred to as skip lesions. Crohn’s inflammation can penetrate deep into the layers of the bowel, not just the lining.

Crohn’s disease can lead to complications like:

• Malabsorption
• Narrowed areas called strictures
• Fistulas which are abnormal passages between organs

Crohn’s Disease Treatment

While there’s currently no cure, treatment aims to reduce inflammation, manage symptoms, and maintain remission. Management can include a combination of:

Medications

• Aminosalicylates (5-ASAs): Anti-inflammatory drugs for mild symptoms
• Corticosteroids: Help control moderate to severe flare-ups
• Immunomodulators: Adjust the immune response to curb inflammation
• Biologic therapies: Target specific components of the immune system for moderate or severe cases

Diet and Lifestyle

• Adjusting your diet to avoid triggers like high-fiber or high-fat foods
• Staying hydrated
• Supplements like iron or vitamin B12 if absorption difficulties are an issue

Surgery

In some cases, removing severely damaged sections of the intestines or addressing complications such as fistulas can help improve quality of life. However, it is important to know that surgery is not curative, and Crohn’s disease can recur in the parts of the GI tract that remain.

Understanding Colitis

Colitis is a general term for inflammation of the colon. Colitis in the context of IBD usually means ulcerative colitis.

Unlike Crohn’s disease, ulcerative colitis is confined to the large intestine and rectum. It also involves a continuous area of inflammation starting from the rectum and moving upward through the colon. The inflammation typically affects only the innermost lining of the colon.

Ulcerative colitis can sometimes increase the risk of colon cancer if left uncontrolled for many years.

Ulcerative Colitis Treatment

Ulcerative colitis, like Crohn’s, has no cure. However, removing the colon can effectively eliminate the disease in severe cases. Common treatments include:

Medications

• 5-ASAs like mesalamine to reduce inflammation in mild to moderate cases
• Corticosteroids for flare-ups
• Immunosuppressants to keep the immune system in check
• Biologics and JAK inhibitors for moderate to severe disease not responding to other treatments

Lifestyle Adjustments

• Identifying and avoiding trigger foods like spicy or high-residue foods
• Management techniques to help reduce flare-ups related to stress

Surgery

In severe cases that don’t respond to medication, a proctocolectomy may be the best option. This surgery removes the colon and rectum. It can cure ulcerative colitis because the disease only affects the colon.

When Should I Visit a GI Specialist?

If you experience symptoms such as persistent diarrhea, unexplained abdominal pain, or blood in your stool, it’s time to see a gastroenterologist.

A GI specialist can perform diagnostic tests such as:

• Colonoscopy
• Endoscopy
• Imaging
• Lab work

These tests can be used to pinpoint the cause, diagnose your condition, and develop a treatment plan to manage your symptoms. They can help you understand the difference between Crohn’s disease and colitis. With a diagnosis, you can start to manage your symptoms and get your life back on track.

Don’t continue to live with symptoms of IBD – schedule an appointment today!

Request Appointment

Related:

• 6 Tips for Living with Crohn’s Disease
• 7 Ulcerative Colitis Treatments You Should Know