Mr. Page was initially diagnosed with ulcerative colitis and then diagnosed with Crohn's. How could this happen? What are the similarities and differences between Crohn's disease and ulcerative colitis?

Question

What will be an ideal response?

Answer 1

• UC and CD are very similar, but can be distinguished from one another by the following:
Symptoms
Complications
Antibody testing
Imaging and biopsy results

Crohn's disease Ulcerative colitis
Symptoms • Blood &/or mucus in stool
• Abdominal pain & cramping
• Fever
• Wt loss
• Chronic diarrhea
• Anorexia
• Malnutrition
• Delayed growth in adolescents • Bloody diarrhea with mucus
• Abdominal &/or rectal pain
• Fever
• Wt loss
• Possibly constipation & rectal spasm
• Arthritis
• Dermatological changes
• Ocular manifestations
Complications • Malabsorption
• Malnutrition
• Abdominal fistulas & abscesses
• Intestinal obstruction
• Bacterial overgrowth (blind loop syndrome)
• Gallstones
• Perianal disease
• Neoplasia
• Urinary tract infections
• Kidney stones
• Thromboembolic complications
• Affects any part of the GI tract (from mouth to anus) and may have a "skipping" pattern • Severe bleeding
• Toxic colitis
• Toxic megacolon
• Strictures
• Perforation
• Colonic structures
• Dysplasia
• Carcinoma
• Intolerance to immunosuppression
• Affects the colon and rectum only (continuous)
Diagnosis • Clinical presentation – CDAI score
• Abdominal ultrasound
• MRI
• CT
• Antiglycan antibodies (ASCA/ANCA)
• Calprotectin, lactoferrin, & polymorphonuclear neutrophil elastase • Abdominal ultrasound
• MRI
• CT
• Antiglycan antibodies (ASCA/ANCA)
• Calprotectin, lactoferrin, & polymorphonuclear neutrophil elastase