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 | |
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