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  • Q&A with Australian Health Practitioners

    Do I have Ulcerative colitis or Crohns? Confused about CT scan

    I have been diagnosed with UC but a recent CT Scan shows inflammation in my sigmoid colon and anus only. I am a bit confused. I thought having UC means continual inflammation, not in different parts of my colon. I am now wondering do I have UC? OR Crohn's? Can a UC diagnose change?
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    A/Prof James Toh

    Colorectal Surgeon (Bowel), General Surgeon

    Dr James Toh is a colorectal and general surgeon working at Westmead Hospital and Westmead Private Hospital. He is experienced in minimally invasive laparoscopic surgery, … View Profile

    Ulcerative colitis on a macroscopic level nearly always involves the rectum and is confluent, rather than having skip lesions. Furthermore, in UC, anal involvement is rare. If you have skip lesions and anal involvement, you may need to revisit the diagnosis of UC with your gastroenterologist. It is difficult sometimes to differentiate between UC and Crohn's disease - for cases where diagnosis is unclear, these are considered indeterminate colitis. A colonoscopy with biopsies is important for diagnosis and assessing severity. CT is not the gold standard for diagnosis of IBD, although it may be helpful im evaluating complications that may arise including perforation, strictures, fistulae and obstruction. 

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