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IBD Awareness Month – what’s the difference between Crohn’s and ulcerative colitis?

Crohn’s and Ulcerative Colitis are both types of Inflammatory Bowel Disease (IBD). They are often grouped together as they both cause chronic inflammation of the gut. It is important to understand the difference between the two as each condition is complex and needs to be managed very separately. Hopefully this article will give you and your loved ones more information about Crohn’s and ulcerative colitis to enable you to have a greater understanding of the conditions.

Crohn’s Disease:

  • Crohn’s disease is a lifelong condition where parts of the digestive tract become inflamed. It can affect any part of the gastro-intestinal tract from the mouth to the anus, but most commonly affects the end of the small bowel (ileum) and the beginning of the large bowel (colon).
  • It can affect the entire thickness of the bowel wall. Often the areas of inflammation are patchy with normal gut in between.
  • The disease can occur at any age, but is most often diagnosed in adolescents and adults between the ages of 20-30.

Ulcerative Colitis:

  • Ulcerative Colitis is also a long term condition where the colon and rectum become inflamed. Small open sores or ulcers can develop on the colon’s lining and can bleed and produce pus, which produce abdominal pain and then stimulates the colon to frequently empty.
  • It is different to Crohn’s in that it only affects the inner-most lining of the large intestine/colon rather than any other parts of the gastro-intestinal (GI) tract. This condition is the result of your immune system’s overactive response.
  • Research has suggested that ulcerative colitis may be triggered by an interaction between a virus or bacterial infection in the colon and the body’s immune response.
  • Ulcerative colitis can occur at any age though most people are diagnosed in their mid-thirties.

Causes of IBD:

The causes of IBD are not known. What is known is that there is an increased risk of developing IBD if you have a relative with the disease or you have a problem with your immune system

Symptoms of IBD:

The most common symptoms are listed below. It is important to note that not everyone has all of these symptoms or people may have other symptoms such as vomiting, anaemia and a high temperature. 

  • Pain, cramping and swelling of the stomach
  • Bloody diarrhoea which can reoccur
  • Weight loss
  • Fatigue and extreme tiredness

Often the symptoms of IBD can come and go. When the symptoms are severe it is classed as a “flare-up”. This can often be followed by long periods without symptoms which is called “remission”.

 Treatment of IBD:

There is no cure for Crohn’s or ulcerative colitis at present. Treatments aim to relieve the symptoms and prevent them from recurring and incorporate lifestyle changes, alterations in diet, medicines (known as combination therapy) and surgical procedures to repair or remove portions of your GI tract.


For those with ulcerative colitis, where medications have not improved symptoms, surgery may be considered.  The operation removes the colon (colectomy) and is dependent on the extent of disease, age and general health. Two approaches to surgery may be considered, firstly (and the most common) is the removal of the entire colon and rectum, with the creation of an end ileostomy. For some patients the creation of an internal pouch is then possible. This involves using the small bowel to create a reservoir or ‘pouch’ which is then attached to the anal sphincter. This eliminates the need for the patients to wear an external stoma appliance. A further (less common option) is the creation of a colostomy to bypass parts of affected colon, however this does not always help to resolve symptoms in the long term. 

Again, surgery may also become necessary for those with Crohn’s if medications can no longer control symptoms alone, or you develop an abscess, fistula, fissure or intestinal obstruction. Strictures (narrowing of the intestine) are also another issue Crohn’s sufferers  may face, which can lead to surgery in order to overcome. Surgery involves the removal of the diseased segment of the bowel. The two ends of the healthy bowel are joined (anastomosis) together. Whilst these procedures may cause your symptoms to disappear for some time, frequently it recurs in later life. 

Help & Support:

Living with Inflammatory Bowel Disease (IBD) can be difficult due to unpredictable flare ups, requiring regular check-ups which can interfere with work and social life. Help and support is available for those who are suffering, by listening and talking through any worries they may have and being there for them when they need it most.

Crohns & Colitis UK

Crohns & Colitis Foundation

IBS Network

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