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Which is worse: Ulcerative colitis or Crohn's disease?

Medically reviewed by Carmen Pope, BPharm. Last updated on Dec 4, 2023.

Official answer

by Drugs.com

Although ulcerative colitis and Crohn’s disease are both long-term, inflammatory conditions that affect the digestive tract, ulcerative colitis (UC) may be considered “worse” because surgery may be required earlier and, in certain circumstances, more urgently, in people with severe and extensive UC.

With sudden, severe UC, medications and intravenous steroids are unable to control the symptoms, and rarely, uncontrolled bleeding can occur from deep ulcerations in the colon. Severe, sudden UC can also lead to toxic megacolon (a rapid enlargement of the colon) which is a potentially life-threatening complication caused by severe inflammation that requires immediate surgery. Symptoms include severe pain, distension or bloating of the abdomen, fever, rapid heart rate, constipation, and dehydration.

References
  • Crohn's Disease and Ulcerative Colitis Similar Signs and Symptoms Medicine.Net https://www.medicinenet.com/crohns_disease_vs_ulcerative_colitis_uc/article.htm
  • Ulcerative Colitis vs Crohn's Disease. UCLA Health. https://www.uclahealth.org/gastro/ibd/ulcerative-colitis-vs-crohns-disease
  • Surgery for Ulcerative Colitis. Crohn’s and Colitis Foundation. 2021 https://www.crohnscolitisfoundation.org/what-is-ulcerative-colitis/surgery

Read next

These foods help settle your stomach and ensure you receive enough vitamins and minerals during an UC flare and include low-fiber fruits such as bananas, cantaloupe, honeydew melon, and cooked or canned fruits; lean protein, which is found in fish, lean cuts of pork, chicken, soy, eggs, and firm tofu; refined grains, found in sourdough, potato or gluten-free bread, white pasta, white rice, mashed potatoes, and oatmeal; fully cooked, de-seeded, skinless, non-cruciferous vegetables such as asparagus tips, cucumbers, potatoes, and squash; homemade protein shakes or oral supplements; using olive oil instead of other oils or fats; apple sauce; or herbal or green tea. Continue reading

The life expectancy of people with ulcerative colitis (UC) is usually the same as anybody without the disease if the condition is well managed and treated and complications do not arise if surgery is needed. One cohort study found that people over the age of 50 years who had extensive colitis when they were first diagnosed were more likely to die within the first two years of diagnosis from complications associated with surgery and other coexisting conditions. Continue reading

Flare ups of ulcerative colitis usually last for days or weeks and are unlikely to get better by themselves. Without treatment they can persist for longer, which can cause further damage to the lining of the colon. Ulcerative colitis tends to be a progressive condition which means that as time goes on, flare ups become more frequent and last for longer and periods of remission get shorter. Continue reading

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