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How do I know it's UC and not Crohn's?

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Ulcerative Colitis
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Posted 10/27/2009 6:24 PM (GMT -5)
I was diagnosed with Ulcerative Colitis about 2 years ago. When I had my colonoscopy it was pretty early on when my symptoms first started to appear or I should say, get bad. I seem to have symptoms of both diseases. I have to go to the bathroom often, bleed and vomit, get weak and dehydrated. I get sores in my throat for no reason. I have been on Asacol (which didn't seem to help) currently take Lialda, Prednisone (was in the hospital last week) Lexapro, and valium. From what I've read they sound somewhat similar but there must be some obvious differences and treatment options. My doctor doesn't seem very thorough to me. I'm just wondering if it's possible that I wasn't even diagnosed correctly? Any thoughts?
Thanks
Posted 10/27/2009 6:29 PM (GMT -5)
You can usually get an answer from your pathology report but I don't believe it is 100% certain.

I am surprised wen people say Asacol doesn't help but Lialda does, aren't they the same exact thing, just a different dose?

I don't know if I have UC or Chrons either but my doctor said they would treat it the same way and since mine is so mild right now, it is not an issue. She said it would become an issue if I were considering surgery but not to worry unless that happens. Everything looks like UC so far.

Hopefully you can get some answers soon. You are always welcome to request a copy of the pathology from your doctors office and try to make sense of it yourself. I don't think it is easy to understand..

Posted 10/27/2009 6:39 PM (GMT -5)
I'm confused about the whole Lialda/Asacol difference myself. I don't know if I can say Lialda is really helping me because I have had to be on Prednisone twice (in a short amount of time) and have needed IV fluids since starting it.
Thanks for the reply, it can't hurt to look at my records.
Posted 10/27/2009 8:24 PM (GMT -5)
I actually replied to your post about this on the crohn's forum.

:)
Posted 10/27/2009 8:36 PM (GMT -5)
Thank you, I thought maybe both forums would have some input. :)
Posted 10/27/2009 8:53 PM (GMT -5)
Generally, the pathology report will let you know. If the inflammation is continuous and only affects the outermost (or would it be innermost? at any rate, the layer that your poop touches!) layer of the colon, it's UC. If it's patchy, and goes deeper, it's CD. Also, CDers have something called granulomas (I believe) that are present.

editing to add:

Lialda and Apriso both have the same active ingredient, but as they dissolve differently, I can see how one of them might work better for a person than the other.

Posted 10/27/2009 10:14 PM (GMT -5)
A granuloma is a microscopic collection of cells which form during an infection or inflammatory state. It cannot be seen during a colonoscopy because it is not a visible mass or nodule.
Granulomas are not specific to Crohn's disease, but if seen are helpful in distinguishing between ulcerative colitis and Crohn's disease. But when a granuloma is found, and the patient has symptoms consistent with Crohn's disease, it can help a physician make a diagnosis of Crohn's disease. Granulomas are not seen on intestinal or colonic biopsies of patients with ulcerative colitis.

polyps may follow a bout of ulcerative colitis or Crohn's disease of the colon. Although the polyps themselves are not a significant threat, having ulcerative colitis or Crohn's disease of the colon increases your overall risk of colon cancer....basically both polyps and granulomas can be found in crohn's where as with UC it's limited to polyps only.

:)
Posted 10/28/2009 6:38 AM (GMT -5)
I suppose docs are different but my GI wanted to be sure of the dx. My colonoscopy showed 'idiopathic' or that they were sure it was colitis but not sure what type. When I went to my GI for the first time with these colonoscopy findings he ordered tests to figure it out. My family doc, surgeon and GI all thought it was likely UC b/c of my symptoms and area that was diseased but the GI ordered the barium x-ray of the stomach and small bowel plus the Prometheus test. The Upper GI and small bowel x-ray showed all clear and the Prometheus test said 'consistent with UC' so that is now my official dx.

My GI did say that likely either way (Crohn's or UC) that right now my treatment would be the same but he just felt better having a def. dx for the future.

Good luck!
Posted 10/28/2009 4:30 PM (GMT -5)
i was kind of in the same boat as you when i was first diagnosed. my GIs called it Indeterminate Colitis. Apparently, (and I'm going by what my doctors told me) there are some locations of symptoms that are specific to Chron's and therefore UC people do not experience symptoms in those locations and that's how you can tell the difference. Don't quote me, but I believe that UC is restricted to the large intestine/colon and the rectum. Chron's can be in the colon or the small intestine and sometimes people with Chron's have problems in the esophagus. When I was diagnosed I did not have whatever it is that people with Chron's normally have, but I also didn't have everything that UC deals with either or something like that and so my doctors referred to it as Indeterminate Colitis. I consider myself to be in remission from UC though.

Hope that helps
Posted 10/28/2009 6:28 PM (GMT -5)
Yes, that's correct UChick, Crohn's can affect the entire GI tract from mouth to anuse, UC is limited to the colon/rectom only....the other distinctivness ways to tell them apart is with CD the inflammation can go through the many layers of the intestinal lining, where as with UC it's limited to the surface of the lining only...also with CD there are skipped patterns of inflammation (healthy tissues mixed in the presence of inflammation) with UC the entire affected area will be completely inflamed with no skipped pattern of inflammation.

:)
Posted 10/28/2009 9:57 PM (GMT -5)
Thank you so much. You are all so helpful.
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