Both conditions are inflammatory bowel diseases (IBD) that have similar symptoms involving inflammation of the digestive tract. However, Crohn’s patients may have inflammation anywhere along the digestive tract (from mouth to anus), while UC sufferers have inflammation confined to their large intestines. Although initial treatment options for the two conditions can be similar or even the same, later treatment options are significantly different.
The Objective: Reducing Inflammation
Because the objective for both Crohn’s and colitis treatment is to reduce or eliminate the inflammation in the digestive tract, many of the same medications are initially used to suppress the body’s excessive immune response responsible for that inflammation. If, however, medications such as aminosalicylates and/or corticosteroids do not work for you, your doctor may suggest treatments that are more specific to your diagnosis.
Antibiotics Are More Commonly Used in Crohn’s Therapy
Although Crohn’s patients may develop inflammation anywhere in their digestive tracts, the most common location is in the lower section of the small intestine and the initial section of the large intestine. Additionally, ulcers or sores in the inflamed areas have a tendency to form into tracts of their own, known as fistulas. Because these fistulas commonly become infected, antibiotics are often a part of Crohn’s treatment, but not colitis treatment. In some cases, Crohn’s patients respond well to long term antibiotic therapy and remain free from flare-ups for long periods of time.
Surgery is Performed More Often for Crohn’s Than Colitis Patients
The most significant different between colitis and Crohn’s diseas is in the percentage of patients who eventually require surgery. When the inflammation of UC or Crohn’s cannot be controlled by medication any longer, surgery to remove the afflicted portion(s) of the digestive tract becomes the next step.
According to the Crohn’s and Colitis Foundation of America, as many as 75% of all Crohn’s patients require one or more surgeries1 to regain control of their lives, whereas 25% to 50% of UC patients end up in the operating room.2
Different Surgeries Required for Each Condition
Additionally, the specifics of surgery for Crohn’s vs. colitis patients are significantly different. Surgery usually becomes necessary when Crohn’s sufferers develop one or more fistulas or intestinal blockages as a result of scarring or swelling. The process involves removal of the damaged section of the digestive tract and rejoining of the two healthy ends (known as anastomosis). This often allows the patient to remain symptom-free for many years; although in the majority of cases Crohn’s symptoms do return later in life.
Surgery for colitis treatment, on the other hand, can alter a person’s life more significantly. Colectomy, or the removal of the large intestine, is performed when medications are no longer successful because UC patients experience inflammation throughout their entire colon. Depending upon the specifics of each case, the surgery may require an ileostomy if the rectum of the patient is also removed. The opening created from the ileostomy allows the exiting bodily wastes to be collected in a pouch which is surgically attached to the end of your small intestine. The pouch remains outside of your body and is securely held in place with tape.
Begin Treatment Early to Delay or Avoid Surgery
If you suspect you have either UC or Crohn’s or have been recently diagnosed, the sooner you begin treatment, the more likely you are to successfully control the inflammation inherent in these diseases. Regular checkups and screenings are important. But communicating with doctor early about any symptoms you’re experiencing can help him or her tailor a treatment plan specific to your needs—one that can keep your symptoms in check and help you avoid complications that can lead to surgery.
1 Available at: http://www.ccfa.org/what-are-crohns-and-colitis/what-is-crohns-disease/crohns-treatment-options.html. [Accessed April 17, 2015].
2 Available at: http://www.ccfa.org/what-are-crohns-and-colitis/what-is-ulcerative-colitis/colitis-treatment-options.html. [Accessed April 17, 2015].