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

Medically reviewed by Carmen Pope, BPharm. Last updated on Dec 14, 2021.

Official answer


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.

  • Crohn's Disease and Ulcerative Colitis Similar Signs and Symptoms Medicine.Net
  • Ulcerative Colitis vs Crohn's Disease. UCLA Health.
  • Surgery for Ulcerative Colitis. Crohn’s and Colitis Foundation. 2021

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