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

Older Age and Obstructive Sleep Apnea (OSA): Mechanism

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

3 weeks 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…

3 weeks ago

Nocturia and OSA: Mechanism

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

1 year ago

ASD vs. VSD Murmur Difference

ASD (Atrial Septal Defect) Wide, Fixed split S2 (in contrast to the normal variation in…

1 year ago

Mechanism of a Mixed Apnea

Mixed apneas are characterized by absent respiratory effort and airflow in the first section of…

2 years ago

How Does Hypothyroidism Cause Hypoventilation?

Although rare, the differential diagnosis of hypoventilation and hypercapnia respiratory failure includes hypothyroidism. It is…

2 years ago

This website uses cookies.