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Symptoms, Treatments, and Differences of Crohn's and Ulcerative Colitis

Angela was diagnosed with ulcerative colitis17. At 20, she had a colectomy, where they removed her colon.

Is IBS an IBD? What's the Difference?

An IBD stands for inflammatory bowel disease, whereas IBS stands for irritable bowel syndrome. There are only two IBDs, ulcerative colitis and Crohn's disease. The fundamental difference between IBD and IBS is that Crohn's and ulcerative colitis usually result in ulcerations, whereas IBS does not.

One reason IBD is confused with IBS is that irritable bowel is often called spastic colitis and colitis. Coincidentally, both IBDs can be referred to as just colitis since that merely means colon inflammation. Often at the earlier phases of an IBD, a doctor may misdiagnose irritable bowel syndrome. One of the most significant predictors that it might be something else is if you see blood in your stool. Keep in mind hemorrhoids can also cause blood in the stool. Hemorrhoids are often caused by frequent bowel movements, characteristic of both IBDs and IBS. Therefore, do not assume you have something more severe in the presence of blood. Instead, seek medical attention to rule out hemorrhoids.

Ulcerations in ulcerative colitis. With IBS, there will be no ulcerations.

Ulcerations in ulcerative colitis. With IBS, there will be no ulcerations.

Does Stress Cause Inflammatory Bowel Disease?

Contrary to popular belief, emotional stress is not a cause for Inflammatory Bowel Diseases. On the other hand, stress can trigger a flare-up, the same way all diseases can flare during a time of stress. Many myths surround IBDs as well.

Due to the similarities of the diseases, they are often confused in both diagnosis and symptoms. The main difference is ulcerative colitis affects the colon, whereas Crohn's can target any part of your digestive system from the mouth to the anus, which does not mean that Crohn's is a more severe disease. Someone with Crohn's may have a more mild case than someone with ulcerative colitis; it depends on the severity of the symptoms in the individual.

There is a "cure" for ulcerative colitis, unlike Crohn's disease. I use quotes because I have been "cured" of ulcerative colitis. Unfortunately, there are lifelong ramifications to being cured since the only cure is complete removal of your large intestine, which should not be a decision to be taken lightly, as I have met numerous people who have regretted their decision. Without my colon, I had five to eight bowel movements for the first five years after and now have three to five bowel movements a day. Diarrhea is experienced differently without a colon. Also, I experienced many complications afterward, such as blockage, abscesses, and pulmonary embolism as a result of surgery. There are other complications, as well. Yet, I am glad to be cured as I had nearly lost my life prior.

Both IBDs have inherited diseases. Twenty percent of people with UC have one other close relative with another IBD disorder, either Crohn's or UC itself. Since the diseases are closely related, a person with ulcerative colitis may have a relative who has Crohn's. Both run on both sides of my family. Currently, there has not been a gene identified as the IBD carrier; therefore, there is not a test to see if you will get the disease.

Not only can Crohn's affect a more significant portion of the digestive tract, but it also affects more layers of the colon wall. Ulcerative colitis only inflames the innermost lining, whereas Crohn's affects several layers of the intestinal wall.

How is Ulcerative Colitis and Crohn's Diagnosed?

The first step in diagnosing is to rule out more common ailments. Stool tests are performed to eliminate possible infectious diseases as the cause. They may also do a CT scan of the abdomen.

Once all other possibilities are ruled out, your gastroenterologist may choose either sigmoidoscopy or colonoscopy. These are both relatively painless, dependent on the degree of the disease. The first is a sigmoidoscopy, checking only the rectum and lower colon area. The second is a test of the entire colon called a colonoscopy, which allows the physician to take biopsies of the colon lining. The patient is awake during this procedure, but the medications have an amnesic effect. Therefore, you will not remember much of the test.

They may also do an endoscopy, a tube you swallow, that shows the upper portion of the digestive system, which is more significant in diagnosing Crohn's.


Many of the symptoms are very similar. They include, but are not limited to:

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  • abdominal pain and cramping
  • bloating
  • blood in the stool
  • loss of appetite
  • mucus in the stool
  • persistent diarrhea
  • ulceration in the digestive tract

Some common non-digestive-related symptoms include delayed growth in younger children, eye irritations, fever, weight loss, and more severe PMS symptoms. Nausea is more commonly associated with Crohn's, although it is present in more severe cases of UC.

Some of the more unusual symptoms I have experienced, even now after having been cured, are getting eye inflammation called episcleritis and joint pain. These can be related to ulcerative colitis.


Are There Treatments for IBDs?

The most common treatment is medication. As stated earlier, UC is theoretically curable. Having gone through the surgery non-electively, I would not encourage anyone to do it electively unless their symptoms are severe. I am 16 years post-op. Although my digestive system functions normally, there are still atypical things about my digestion. In the first few years, my symptoms seemed very similar to a mild case of the disease.

The cure included removing my entire colon except for my rectum, which allowed me to have my ilium reconnected to my rectum so that I could use the bathroom without using an ostomy. Due to the severity of the disease and the newness of the surgery, they were unable to do the entire surgery in one step. So I did have a six-month period where I had an ostomy. In place of a colon, they form a pouch from the bottom portion of your ileum. It is incredible how effective this structure is, but it takes years to adjust. During the adjusting time, things are not always easy. It is not encouraged for Crohn's patients because even if the colon is the only affected area, chances of them getting sick in a different section of the digestive tract are very likely.

Feel free to ask any questions or contact me if you want to talk to someone who has been there. If you think you have the disease, definitely contact your doctor. For the first five years post-op, I ran a website where I had contact with hundreds of people who had the disease. I can tell you what it is like first-hand and what others experienced. I'm not qualified; therefore, you must contact a nurse or doctor. I am here for emotional support, not medical advice. I have found that there are amazing nurses (and doctors) out there; find one that is a good fit for you.

Works Cited

  • BOSCARINO, JOSEPH A. “Posttraumatic Stress Disorder and Physical Illness: Results from Clinical and Epidemiologic Studies.” Annals of the New York Academy of Sciences, Wiley/Blackwell (10.1111), 12 Jan. 2006,
  • “Crohn's & Colitis.” What Is Crohn's Disease | Causes of Crohn's | Crohn's & Colitis Foundation,
  • Stojanovich, L, and D Marisavljevich. “Stress as a Trigger of Autoimmune Disease.” Current Neurology and Neuroscience Reports., U.S. National Library of Medicine, Jan. 2008,

This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.

© 2010 Angela Michelle Schultz


Angela Michelle Schultz (author) from United States on April 21, 2012:

I'm glad that I answered the questions you had.

Sage in a Cage on April 21, 2012:

Really interesting article! I found it difficult wading through google trying to find info on IBD. You answered all my questions.

Angela Michelle Schultz (author) from United States on November 20, 2011:

Thank you so much for adding this knowledge to my hub! It always helps to have more insight!

reflux from USA on November 15, 2011:

People will take Ulcerative colitis and Chrons as IBS because IBS and IBD have the same symptoms,but these are IBD.IBS is a syndrome, not a disease, it does not lead to colon cancer, and it does not cause bleeding. Ulcerative colitis, however, is a disease, can put patients at risk for colon cancer, and bleeding is a common symptom.

Angela Michelle Schultz (author) from United States on January 29, 2011:

I know people who are not quite as fortunate as me right now as well.

frogyfish from Central United States of America on January 28, 2011:

Am thankful I do not have this problem, but know of several who do. It can be such a life-altering disease! Glad you are doing so well with your health!

Angela Michelle Schultz (author) from United States on July 25, 2010:

Those are very great hubs! I might have to add them soon. :)

Sarika Mehra on July 25, 2010:

very well described ,I have written some articles on this you may like to read them . and

Angela Michelle Schultz (author) from United States on June 11, 2010:

I'm glad to inform you. It's definitely a disease I'm well aware of.

edguider on June 11, 2010:

Never even read into Ulcerative Colitis, your hub put it all into perspective for me. Thanks..

Angela Michelle Schultz (author) from United States on April 12, 2010:

Thank you Money Glitch. The nomination is so exciting. :)

Money Glitch from Texas on April 12, 2010:

Great info on Crohns and Ulcerative Colitis. I had heard of both but never could determine the difference. Thanks for sharing your insight and Congrats on being nominated to the HubNuggets Wannabe Contest for this week.

Angela Michelle Schultz (author) from United States on April 11, 2010:

Thank you so much Faybe, I am glad that you have a better understanding of the diseases! And thank you so much. I am so geeked about the nomination!

Faye Constantino from Florida on April 11, 2010:

Wow, this is incredible information. I have friends who suffer from UC and one who suffers from Crohn's, I always though their symptoms were similar. but never knew the difference. You have been generous in sharing your experiences and knowledge with others. I know Crohn's sufferers feel very alone, as do my friends with UC. Congratulations on your nomination!

Angela Michelle Schultz (author) from United States on April 11, 2010:

Thank you so much ripplemaker. I'll have to check out yours too!

Michelle Simtoco from Cebu, Philippines on April 11, 2010:

Congratulations angela_michelle for your Hubnugget nomination! You are on the roll! hahahaha I wrote a hub about IBS and love this hub which explains the difference. Thumbs up! To the Hubnuggets,

Angela Michelle Schultz (author) from United States on April 09, 2010:

Betherann! Oh I take back what I said, I won last months hubbernugget! I didn't know I received another hubbernugget nomination! I just was notified in the mail. That is so cool! Two months in a row. That is just wild!

Angela Michelle Schultz (author) from United States on April 09, 2010:

Trish, I hope your cases isn't very severe. It's hard to live with. I think the statistic is 20 percent of people who have the disease will have a relative who has the disease. So you are with the majority who don't have other family members who have the disease. Part of the reason they believe it is familial is because there are certain races who have higher prevalence, whereas area where they grew up or lived do not play a large factor. Basically, like many diseases, it can be dormant in several generations, then one person has the gene, but also has the triggers. Many diseases are like that, for instance type one diabetes, rheumatoid arthritis. Just because you have the gene, doesn't mean you will have it, but as you pass it down the generation, they are more likely to have it. Another reason they believe it is hereditary, is because there is a high correlation between identical twins. Which means chances of it being genetic are more likely rather than environmental. That being said, I'm quite certain environment plays a large role in that! My theory anyway.

Angela Michelle Schultz (author) from United States on April 09, 2010:

betherann, thank you very much. I actually ended up winning! That was kind of cool! I appreciate you voting this up!

Tricia Mason from The English Midlands on April 09, 2010:

I was originally diagnosed with Crohns and later with UC. I haven't inherited it, though. No-one else in my family has it.

Beth Morey from Montana on April 09, 2010:

Voted up! Congrats on the HubNugget nomination.

Angela Michelle Schultz (author) from United States on April 07, 2010:

Thank you, it was very important for me at one time, so I assumed there were others who need it as well!

Research Analyst on April 07, 2010:

this is good information thanks

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