The behaviour of Crohn’s disease differs from ulcerative colitis. This means that
the possible operations are somewhat different. In particular pouch procedures
are not advisable for all cases. Patients will be assessed on an individual basis.
Crohn’s disease is an inflammation of the intestine and like ulcerative colitis, we
do not know the cause. Unlike ulcerative colitis it can affect any part of the
intestine, not just the large bowel. It is therefore quite possible for the small bowel
to be involved. The inflammation in Crohn~s disease is not just limited to the
mucosal lining of the intestine, it goes all the way through the bowel wall. This is
particularly important in the anal region where penetration of the bowel wall by
the inflammatory process can lead to abscesses. When anal abscesses are
present, the anal sphincter muscle may not work properly to maintain continence
of faeces.
the possible operations are somewhat different. In particular pouch procedures
are not advisable for all cases. Patients will be assessed on an individual basis.
Crohn’s disease is an inflammation of the intestine and like ulcerative colitis, we
do not know the cause. Unlike ulcerative colitis it can affect any part of the
intestine, not just the large bowel. It is therefore quite possible for the small bowel
to be involved. The inflammation in Crohn~s disease is not just limited to the
mucosal lining of the intestine, it goes all the way through the bowel wall. This is
particularly important in the anal region where penetration of the bowel wall by
the inflammatory process can lead to abscesses. When anal abscesses are
present, the anal sphincter muscle may not work properly to maintain continence
of faeces.
Signs and Symptoms of Crohn's Disease and Ulcerative Colitis
| Sign/Symptom | Crohn's Disease | Ulcerative Colitis |
| Area of intestinal tract affected | Lower ileum most common but can flare up anywhere, including the colon; "patches" of normal tissue between affected areas: can affect entrie intestinal wall | Any part of inner most lining of colon, continues with no "patches" of normal tissue |
| Diarrhea | Typically four or more episodes per day | Typically four or more episodes per day |
| Abdominal pain/cramping | Moderate to severe abdominal tenderness in right lower quadrant | Mild tenderness, lower abnominal cramping |
| Blood in stool | Present; amount depends on disease severity | Present; amount depends on disease severity |
| Fatigue | Result of excessive blood loss, anemia, and poor nutrient absorption | Result of excessive blood loss and anemia |
| Fever | Low-grade in severe cases | Low-grade in severe cases |
| Physical examination | Peritoneal irritation, abdominal or pelvic mass | Rectal exam may show peri-anal irritation, fissures, hemorrhoids, fistulas, and abscesses |
| Weight loss/anorexia | Weight loss and anorexia common due to poor digestion and intestinal absorption | Weight loss in more severe cases |
| Appetite | Often decreased during periods of disease exacerbation | Often decreased during periods of disease exacerbation |
| Risk of colon cancer | Increased | Increased |
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