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  • Q&A with Australian Health Practitioners

    What is the difference between Crohn's disease and ulcerative colitis?

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    Prof. Andrew Day

    Paediatrician

    Paediatric Gastroenterologist View Profile

    Both crohn disease and ulcerative colitis belong to the group of conditions called Inflammatory Bowel Disease (IBD)

    Crohn disease (CD) can involve any part of the gut - anywhere from the mouth to the bottom. The changes in CD can be right through the wall of the bowel (i.e. deep changes). There are some particular features seen at scope test (e.g. colonoscopy) and upon exam of the biopsies (samples) taken during scope tests. First CD can be patchy - soome involved areas, then some non-involved areas. Secondly, granulomas can be present in CD. These are a feature seen under the microscope, where cells accumulate together.

    UC traditionally just involves the large bowel (colon). It genins right at the bottom and is continuous for a variable distance up the bowel. It may just be the last few centimeters, or may involved the whole length of the large bowel. The chnages seen under the microscope in UC tend to be more superficial - just on the surface parts of the bowel. UC does not lead to patchy changes or granulomas.

    Sometimes people can have features of IBD, but we can't decide whether they have CD or UC. This is called IBD Unclassified (IBDU). It is still IBD, and for many people it becomes clear over time whether they really have CD or UC.

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