Ulcerative Colitis and Crohn's Disease Overview

Study Notes

Ulcerative Colitis and Crohn's Disease

Ulcerative colitis (UC) and Crohn's disease (CD) are chronic inflammatory bowel diseases (IBD) that share similar clinical manifestations but have distinct presentations.
Both UC and CD are characterized by periods of symptom-free remissions interspersed with periods of active disease (flare-ups).
The majority of patients experience the onset of disease between the ages of 15 and 30.
UC primarily affects the rectum and sigmoid colon, potentially extending to the entire large bowel.
CD can affect any portion of the gastrointestinal tract, with the terminal ileum and ascending colon being most commonly affected.
Diarrhea is a dominant symptom of UC, ranging between 5 and 30 stools per day with blood and mucus.
CD often presents with less severe diarrhea compared to UC, with no obvious blood or mucus in the stool.
UC patients typically experience cramping pain in the left lower quadrant (LLQ) that is relieved by defecation, while CD patients may experience cramping or steady pain in the right lower quadrant (RLQ) or periumbilical area.
Nutritional deficiencies are common in both conditions, including anemia, hypoalbuminemia and weight loss.
Constitutional manifestations such as fever are uncommon in UC, but may be accompanied by joint pain (arthritic), skin, or eye involvement.
Fever, fatigue, and malaise are common in CD and may lead to urinary complications.
The depth of involvement in UC is limited to the mucosa (innermost lining of the bowel), while in CD, the entire bowel wall is affected (transmural involvement).
UC presents with a continuous distribution, while CD exhibits patchy distribution with skip lesions.
The appearance of the mucosa in UC is characterized by a granular, dull, hyperemic, and friable surface, with a uniform disease distribution.
The mucosa in CD features a cobblestone appearance, with areas of normal tissue interspersed with ulceration and fissures.
Complications of UC include toxic megacolon, perforation, and massive hemorrhage.
Complications of CD include obstruction, fistulization, abscess formation, and malabsorption.
Long-term risks of UC include colorectal cancer, while CD can lead to colon cancer.
UC can be classified into mild, moderate, and severe based on the frequency and characteristics of stools, presence of systemic toxicity, and overall clinical presentation.

Mild UC

Fewer than 4 stools per day with or without small amounts of blood.
No signs of systemic toxicity (e.g., normal heart rate and temperature).
Normal C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR).
Mild crampy abdominal pain, tenesmus, and constipation.

Moderate UC

Frequent loose, bloody stools (4 to 6 per day).
Mild anemia not requiring blood transfusions.
Mild abdominal pain.
No or minimal systemic toxicity signs.
Adequate nutrition and no weight loss.

Severe UC

Frequent loose bloody stools (6 or more per day).
Severe cramps.
Evidence of systemic toxicity (fever, tachycardia, anemia).

Description

This quiz explores the key differences and similarities between Ulcerative Colitis and Crohn's Disease, both chronic inflammatory bowel diseases. Understand their specific symptoms, affected areas, and the typical onset age of these conditions. Test your knowledge on the clinical manifestations and management strategies for both diseases.