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Crohn’s Disease (CD) and Ulcerative Colitis (UC), often referred to as Crohn’s and Colitis, are the two main forms of Inflammatory Bowel Disease (IBD). As the name suggests these are diseases of the digestive system involving inflammation which can be severe and damaging.
The Medical Perspective:
From the medical perspective, there is no known cause or cure for Crohn’s Disease or Ulcerative Colitis. Physicians treat both diseases with drugs to address acute symptoms and then to induce and maintain remission. Sometimes surgery is performed. In the case of Colitis, surgical removal of the entire colon (large intestine) may stop all signs and symptoms of the disease so in a way this affects a ‘cure’, albeit a drastic one.
In 2004, R.R. Cima and J.H. Pemberton of the Mayo Clinic said in Gut magazine that, “surgery in UC is curative.” However, Mark Silverberg of Mount Sinai Hospital says that physicians in Toronto, facing one of the world’s highest rates of Crohn’s and Colitis, do not make this claim. They consider surgery a “treatment” rather than a “cure.”
Following surgery, patients may need to wear a pouch on the outside of the body to collect wastes from the intestines. Another option is to attach the small intestine to the anus, thereby creating an imitation colon. Dr. Silverberg points out that this surgery (IPAA or “J-pouch” surgery) still results in an average of 7 bowel movements per day. Up to 50% of patients experience inflammation of the small intestine after IPAA surgery. Documents from the IPAA Registry at the Boston Medical Center admit that not much is known about why patients have complications after J-pouch surgery.
Symptoms:
A number of the symptoms of these two conditions are quite similar. Here’s a list of symptoms Crohn’s Disease and Ulcerative Colitis have in common:
- Abdominal pain and cramping
- Frequent diarrhea
- Nausea and vomiting
- Weight loss
- Lack of energy
- Flare-ups and remissions
In contrast to Crohn’s and Colitis, Irritable Bowel Syndrome or IBS is a functional disorder; no inflammation or damage is present in the bowel. Many of the symptoms of IBS are the same as IBD. When sufferers go to the doctor for help and the tests show no sign of inflammation or damage, patients may be given the diagnosis of IBS once other possibilities have been ruled out.
There are some typical differences between Crohn’s and Colitis that doctors look for when making a diagnosis. Many of these differences are not readily apparent to the sufferer and require medical testing to detect and assess.
Symptoms more typical of Crohn’s Disease:
- Inflammation can be anywhere from mouth to anus but is often at the end of the small intestine and the beginning of the large intestine
- Patches of inflammation occur between healthy section of tissue
- Pain on lower right side of abdomen
- Not much blood (if any) in stools
- Almost constant ‘sharp’ pain during flare-ups
- Granulomas may be present upon testing. Granulomas are lesions that form when inflamed cells lump together. Granulomas do NOT occur with Colitis, so their presence confirms Crohn’s disease.
- Complications such as strictures, fissures and fistulas are common
Symptoms more typical of Ulcerative Colitis:
- “False Urges” to have a bowel movement, little or no stool is excreted. This is the hallmark symptom of Colitis
- Symptoms begin at rectum and move up the colon
- Only the colon (large intestine) is affected
- Continuous area of inflammation in the colon, (no patches)
- Pain on lower left side of abdomen
- Severe and BLOODY diarrhea
- During flare-ups, pain is mostly associated with bowel movements
- During flare-ups, pain feels more like a ‘cramp’ than ‘sharp’
What to eat for Crohn’s and Colitis:
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