Categories: Gastrointestinal

Crohn’s Disease vs. Ulcerative Colitis

Differential Dx of Signs and Symptoms

SYMPTOMS Crohn’s Disease Ulcerative Colitis
Defecation Will present porridge-like stool and possibly fatty diarrhea (steatorrhea) Mucus like and will often PRESENT WITH BLOOD/PUS (90%)
Tenesmus Less Common More Common
Fever Common (Affects everywhere) Less Common (would indicate a severe disease state)
SYSTEMIC MARKERS (CRP, Erythrocyte Sedimentation Rate [ESR], Common (Affects everywhere) Less Common (would indicate a severe disease state)
Weight loss Common Less Common
BOTH: will often have often vomiting, diarrhea and bleeding from the rectum

 

Differential Dx of Histologic/ Pathologic Findings

FINDING Crohn’s Disease Ulcerative Colitis
Inflammation in Terminal Ileus Usually Almost never
Colon Involvement Usually 100% (50% if just colon/ rectum, 30% until left splenic flexure, 20% is the entire colon)
Rectum Involvement Almost never Always
Continuous or Skipping SKIPPING (skip lesions) CONTINUOUS
Higher Rate Of Primary Sclerosing Cholangitis No YES
Depth of the Disease Transmural Contained within the mucosal layer
Strictures and Fistulas Yes No
Granuloma If present, it will rule out UC and give diagnosis of Crohn’s if symptoms fit Never
Abdominal Masses May have one in RLQ Almost Never
Toxic Megacolon No Yes
     
       
Get Medical Pearls directly to your inbox every week!
Weekly posts with high yield medical knowledge, directly to your mailbox!
Dr. C Humphreys

Internal Medicine

Recent Posts

Obstructive sleep apnea & Polycythemia: Mechanism

Obstructive sleep apnea (OSA) is thought to lead to secondary polycythemia due to intermittent hypoxia,…

3 hours ago

Pale Stool, Dark Urine & Biliary Obstruction: Mechanism

Catabolism of hemoglobin leads to the release of heme, which converts to biliverdin and then…

3 hours ago

Why is Tongue Scalloping seen with Obstructive Sleep Apnea?

Tongue scalloping refers to the series of indentations along the sides of the tongue that…

1 month ago

Older Age and Obstructive Sleep Apnea (OSA): Mechanism

Older age is recognized as a risk factor for obstructive sleep apnea.[1] But why? Suspected…

6 months ago

How does Weight Affect Obstructive Sleep Apnea (OSA): Mechanism

Being overweight (BMI ≥ 25 kg/m2)/Obese (BMI ≥ 30 kg/m2) is one of the most…

6 months ago

Nocturia and OSA: Mechanism

Nocturia is a common symptom associated with obstructive sleep apnea. [1] Img Cred: Am J…

2 years ago

This website uses cookies.