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Difference between IBD and Crohn’s disease

Introduction:

Inflammatory bowel disease is a group of diseases characterized by the inflammation of the bowels. Crohn’s disease and Ulcerative colitis are the two major types of inflammatory bowel diseases. The exact cause of these diseases is unknown. However, the mechanism is found to be a faulty immune system. The body sets up an uncontrolled inflammatory reaction against its own intestinal lining.

Difference in presentation:

Inflammatory bowel disease which includes ulcerative colitis as its major component affects primarily the rectum or could spread to a part or the entire colon (large intestine). It affects the internal lining of the large intestine. Ulcerative colitis is found to be more common than the other inflammatory bowel diseases. The most common symptoms are diarrhea, bleeding in stools, painful passage of stools, passage of mucus in stools, and crampy abdominal pain. The diarrhea is often nocturnal or after a meal.  A moderate to severe disease can also present with loss of appetite, nausea, vomiting, fever and weight loss.

Crohn’s disease, which is a type of IBD can affect any part of the gastrointestinal tract from the mouth to the anus. It is a chronic, inflammatory autoimmune disease. The inflammation many a times can skip leaving normal areas in between patches of diseased intestine. The commonest site of inflammation is the terminal ileum (end of the small intestine just before large bowel begins). The common symptoms are abdominal pain, diarrhea, fever, and weight loss. The abdominal pain usually precedes defecation and is better after defecation. Passage of blood in stools is not as common in Crohn’s disease as in the other inflammatory bowel diseases. Crohn’s disease also shows extra intestinal manifestations like anemia, skin rashes, inflammation of the joints, and inflammation of the eyes.

Difference in treatment:

Inflammatory bowel disease being an autoimmune disorder can only be controlled with medicines. The patient is known to undergo waxing and waning of the symptoms. The commonly used drugs are immune modifying agents and corticosteroids which help in reducing the inflammation of the intestines. There is not much use of antibiotics in ulcerative colitis. Surgery is also an option in case of ulcerative colitis as it primarily affects the large intestine. Removal of the large intestine in case of severe disease causes cessation of symptoms.

Crohn’s disease is also known to present with alternating periods of increasing and decreasing symptoms. The medicines used to treat Crohn’s disease are those to control flare-ups, steroid medicines, and immune modifying agents to reduce inflammation. Crohn’s disease often calls for use of antibiotics to control the symptoms. Surgery is not a treatment of choice for Crohn’s disease as it is not limited to a part of the intestines. Also, too many surgeries itself can worsen the symptoms of Crohn’s disease.

Summary:

Inflammatory bowel disease is a group of chronic autoimmune diseases affecting the intestines and Crohn’s disease is one of the types of inflammatory bowel disease. These diseases commonly go into phases of remission (inactivity) and relapse (activation of symptoms). Apart from the common symptoms of diarrhea, bleeding and abdominal pain, Crohn’s disease in particular shows non- intestinal manifestations too. While antibiotics are mostly used to control the symptoms of Crohn’s disease, the treatment of choice in severe Ulcerative colitis is surgical removal of the large intestine. Dietary guidelines like restricting dairy products and high fiber food helps control symptoms of inflammatory bowel disease including Crohn’s disease.


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