Crohn's disease and ulcerative colitis are the two main forms of inflammatory bowel disease. As both have many similar characteristics, differentiating them can represent a diagnostic challenge. The two diseases require different treatments and have different prognoses, so it is essential to establish a correct diagnosis. Specialists such as colorectal surgeons and gastroenterologists diagnose and treat them more frequently.
Crohn's disease can affect the gastrointestinal tract anywhere between the mouth and the anus. Ulcerative colitis, on the other hand, affects only the colon. Crohn's disease is an autoimmune disorder in which the body specifically attacks the gastrointestinal tract producing inflammation. The signs and symptoms of Crohn's disease are gastrointestinal bleeding, abdominal pain, weight loss, anemia, frequent bowel movements, and loose stools. These symptoms often require more in-depth studies using a combination of laboratory analysis, imaging, endoscopy or exploratory surgery.
Laboratory tests help determine the level of inflammation in the gastrointestinal tract. The blood tests of C-reactive protein and erythrocyte sedimentation rate are not specific enough, since their values may also be elevated in other inflammatory diseases. Specific biomarkers and serology provide a much more accurate indication of Crohn's disease. Sophisticated serological tests can not only confirm inflammatory bowel disease, but also often differentiate between Crohn's disease and ulcerative colitis.
Diagnostic imaging can help diagnose Crohn's disease, since inflammation appears in various areas of the intestine. A fistula is an abnormal connection between two bodily surfaces, such as between the small intestine and the skin. A contrasted series of the small intestine can identify fistulas and other inflamed and reduced areas. Computed tomography provides similar information and also allows diagnosing the thickened areas of the intestine.
Direct visualization of the bowel by high and low endoscopy can confirm the diagnosis of inflammatory bowel disease and Crohn's disease. In this procedure, the doctor painlessly removes a piece of tissue from the inflamed intestine. A pathologist then examines the biopsy tissue in the laboratory for evidence of inflammation.In some cases, the definitive diagnosis is achieved through diagnostic and exploratory surgery that evaluates the patterns of inflammation.
Obviously, inflammatory bowel disease is a complex group of diseases and that is why it is important to consult and treat with a specialist, such as a colon and rectal surgeon or a gastroenterologist.
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