Crohn's Disease and Ulcerative Colitis
Both the diseases, Ulcerative Colitis and Crohn's Disease, while seemingly related, are distinct diseases in terms of etiology, pathology, clinical presentation and prognosis. A summary table highlighting these attributes in presented below:
PARAMETER | CROHN'S DISEASE | ULCERATIVE COLITIS |
---|---|---|
Sex Ratio | 02:01:00 | 01:01:00 |
Role of Genetics in causation | Greater | Minimal or nil |
Cigarette-smoking Relationship | Smokers are at greater risk of developing CD (nicotine can aggravate disease) | Ex-smokers and Non-smokers are at greater risk of developing UC (nicotine may be preventive) |
Immunological Culprit | Inflammation though to be triggered by Th1 cells; IL-12 is increased | Inflammation though to be triggered by Th2 cells; IL-5 is increased |
Commonly Involved areas | Ileum & Proximal Colon | Distal Colon & Rectum |
Typical symptoms | Abdominal pain, weight loss, diarrhea, fever | Abdominal pain, weight loss, diarrhea, rectal bleeding, |
Blood & mucus from rectum | Rare | Common |
Abdominal mass | May be present in right-lower quadrant of abdomen | Rare |
Extra-intestinal manifestations | Common | Common |
Ileus (reduced or absent motility of intestines) | Common | Rare |
Colonic obstruction | Common | Rare |
Perianal fistula | Common | No |
Protein-Calorie Malnutrition | More likely (25-80% have hypoalbuminemia) | Less likely (25-50% have hypoalbuminemia) |
Nutritional status | Relatively poor | Better preserved |
Nature of Involvement | Interrupted lesions (skip-lesions common) | Uninterrupted lesions |
Extent of Inflammation | Transmural (can extend through the thickness of the wall) | Limited to mucosa |
Associated lesions/pathologies | Strictures, Fistulas, Granulomas | None of these |