A very good friend of mine was recently diagnosed with possible Crohns Disease. She has severe diarrhea and abdominal cramping for 2-3 months now. They performed a colonoscopy and found 1 area of inflammed tissue (an ulcer). They sent her for some blood work to "test" for Crohns, but the research I found on the internet said that there is no one good test to determine if Crohns is present or not. They claim that a high white blood cell count and anemia (indicating possible blood in the stool) COULD be Crohns Disease? I am confused.

My question, how is Crohns Disease different from IBS or Ulcerative Colitis? Is the treatment different? The prognosis different? This poor girl is going to think she has a "disease" instead of just a "condition". What is the difference other than the name?

Any information you can provide for us would be helpful! Thanks!

Wen

Hi Wendy

The main difference between IBS and IBDs (Crohns and UC) is that IBS is a 'syndrome'. I guess that means that there are no physical abnormalities, like there would be with Crohns and/or UC (ulcers, inflammation, etc) And IBS does not progress, but IBDs certainly can. IBS has no known cause..and there are many variations of it (constipation predominant, diarrhea predominant, etc) During a colonoscopy, you would not see any outward sign of disease or inflammation of the tissues..or structural abnormalities that might be causing the symptoms. Because of this, IBS is hard to manage and treat, because there is no known medication or regimen that works for everyone..or even all the time for an individual. Also, IBS has never been proved to progress or make someone more at risk for things such as colon cancer or IBDs. There seems to be quite a number of people though with IBS, that also have other autoimmune problems

IBDs..on the other hand WILL show signs (ulcer, inflammation, etc.)

IBDs can be called disorders(diseases) abecause they can/do cause inflammation or ulceration in the digestive tract. The parts most affected (depending on the type of IBD) can be anywhere from the mouth to the anus. UC is seen more often than Crohns.

Like IBS, IBDs are a chronic condition, but people can have quite lengthy remissions at times..with practically no symptoms at all. And flare ups can appear without warning. Some of the symptoms are abdominal pain, rectal bleeding, and diarrhea and constipation. They might also have a temperature and a loss of appetite. I know, other than the rectal bleeding (NOT a sign of IBS)...the other symptoms sound very similar to those with IBS. Many people have been misdiagnosed with IBS, when actually suffering from an IBD..until more thorough testing is done anyway.

People with only mild IBDs can somtimes be treated with antidiarrheals and/or a restricted diet. Others, where the symptoms are more severe need much stronger medications, and may also have to face surgery(in the most severe cases)

The symptoms between Crohns and UC are somewhat similar, but because of where they(ulcers) may occur, it makes it easier to diagnose. UC usually affects the colon and rectum. Crohns is more difficult as some of its earliest symptoms might just be fatigue, joint pain, etc. Many people go years without being correctly diagnosed because of this. Crohns can be seen anywhere between the mouth to the anus (unlike UC, which is generally only in the colon and rectum). It can affect the deepest layers of the lining of the GI tract(deep ulcers and sores). Because it can affect so many different areas of the GI tract, it can cause vague symptoms at first. It also usually shows up in 'patches'. There can be normal tissue right next to diseased/ulcerated tissue...and this gives a certain image to the person performing the colonoscopy that is not hard to identify. I think they call it 'cobblestoning'. Also with Crohns, the deep tissue damage can cause strictures, or narrowings that may eventually cause bowel obstructions...or they may cause fistulas.

UC is most common on the left side of the colon, and it may affect the lower end of the small intestine where it meets the colon. Remember, UC does not affect other parts of the digestive tract like Crohns does, and it hardly ever goes into the deepest tissues of the intestines. But there is a higher risk of colon cancer with UC that there is for Crohns.

The different testing methods that can be used to differentiate(sp) between the two are : flex sigmoidoscopy, colonoscopy, Abd. xray, Upper GI series, endoscopy, barium enema, CT scan. Also stool analysis is almost always done. This can show blood in the stool, bacterial infection, malabsorption, parasites, or the presence of white blood cells. Blood and urine tests are done to check for anemia, inflammation and to see if there is any malnutrition. ESR or sed rate or CRP blood tests can be done to check for inflammation or infection that might be caused by an IBD. And biopsy of intestinal tissue can be taken during an upper endoscopy, sigmoidoscopy or colonoscopy. This can help determine the 'type' of IBD, and to 'rate' the inflammation and tissue damage or to check for any tumors. The tissue biopsy is just a minute piece of tissue and is not painful...but if a person has had UC for any length of time , there are multiple biopsies taken for cancer screening.

This is pretty long-winded, but it can maybe help show the difference between IBDs and IBS . As you mentioned in your post there is a certain percentage (15-20%) of people who have the symptoms AND inflammation, but the type of IBD can't be determined..and the Drs. feel that this is because it is a combination of Crohns and UC.

Dennie,

Your information was very helpful! Thank you so much!

Wendy