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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