Crohn's disease differential diagnosis
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Crohn's disease |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Differentiating Crohn's Disease from other Diseases
The most common disease that mimics the symptoms of Crohn's disease is ulcerative colitis, as both are inflammatory bowel diseases that can affect the colon with similar symptoms. It is important to differentiate these diseases, since the course of the diseases and treatments may be different. In some cases, however, it may not be possible to tell the difference, in which case the disease is classified as indeterminate colitis.
| Crohn's disease | Ulcerative colitis | |
|---|---|---|
| Terminal ileum involvement | Commonly | Seldom |
| Colon involvement | Usually | Always |
| Rectum involvement | Seldom | Usually[1] |
| Involvement around the anus | Common[2] | Seldom |
| Bile duct involvement | No increase in rate of primary sclerosing cholangitis | Higher rate[3] |
| Distribution of Disease | Patchy areas of inflammation (Skip lesions) | Continuous area of inflammation[1] |
| Endoscopy | Deep geographic and serpiginous (snake-like) ulcers | Continuous ulcer |
| Depth of inflammation | May be transmural, deep into tissues[2] | Shallow, mucosal |
| Fistulae | Common[2] | Seldom |
| Stenosis | Common | Seldom |
| Autoimmune disease | Widely regarded as an autoimmune disease | No consensus |
| Cytokine response | Associated with Th1 | Vaguely associated with Th2 |
| Granulomas on biopsy | Can have granulomas[2] | Granulomas uncommon[1] |
| Surgical cure | Often returns following removal of affected part | Usually cured by removal of colon |
| Smoking | Higher risk for smokers | Lower risk for smokers[1] |
References
- ↑ 1.0 1.1 1.2 1.3 Kornbluth, Asher (2004). "Ulcerative Colitis Practice Guidelines in Adults" (PDF). American Journal of Gastroenterology. 99 (7): 1371–1385. doi:10.1111/j.1572-0241.2004.40036.x. PMID 15233681. Retrieved 2006-11-08. Unknown parameter
|month=ignored (help); Unknown parameter|coauthors=ignored (help) - ↑ 2.0 2.1 2.2 2.3 Hanauer, Stephen B. (March 1 2001). "Management of Crohn's Disease in Adults" (PDF). American Journal of Gastroenterology. 96 (3): 635–643. doi:10.1111/j.1572-0241.2001.03671.x. PMID 11280528. Retrieved 2006-11-08. Unknown parameter
|coauthors=ignored (help); Check date values in:|date=(help) - ↑ Broomé, Ulrika (2006). "Primary sclerosing cholangitis, inflammatory bowel disease, and colon cancer". Seminars in Liver Disease. 26 (1): 31–41. doi:10.1055/s-2006-933561. PMID 16496231. Unknown parameter
|coauthors=ignored (help); Unknown parameter|month=ignored (help)