K41 -- October 2010 -- Crohn's or Colitis?
Intro: Crohn's disease and ulcerative colitis are inflammatory bowel diseases that share many symptoms: stomach pain, cramping, the need to always be near a bathroom. The two conditions may seem similar, but in truth, they're quite different and require different treatments. And because they can often be tricky to tell apart, some patients suffer symptoms for years before they find relief.
"I love the outdoors."
Not long ago, Ann Strom wouldn't have had the energy to get out and rollerblade. Ann was diagnosed with Crohn's disease and symptoms were bad.
"Really sharp pains and not really able to eat, and like as soon as I ate, it would just cramp up and I would be uncomfortable, in pain."
All through high school and through the first part of college Ann suffered.
She couldn't do sports or other typical activities because she was always sick and she always needed to be near a bathroom. The disease was ruling her life.
"I was back and forth on all different kinds of medications, not really having one that was ultimately controlling it."
That is not unusual. You see inflammatory bowel disease is a spectrum. At one end is Crohn's disease, which affects the entire digestive tract. At the other end is ulcerative colitis, which only affects the colon and rectum. But many people fall into the middle somewhere, and that can make diagnosis difficult, says Mayo Clinic Dr. Robert Cima.
"There are medicines that work really well for Crohn's and there are medications that work really well for ulcerative colitis. They don't necessarily work well for both."
The same holds true for surgical therapy.
"What we would do for Ann if she had Crohn's colitis would have been totally different than what we did for her, but she had ulcerative colitis.
After coming to Mayo Clinic, Ann got the right diagnosis. Tests showed it was ulcerative colitis, not Crohn's, which meant only her colon was diseased. She would benefit from surgery. This image shows normal anatomy, with the colon and rectum in place. Over the course of three surgeries, Dr. Cima removed them and constructed what's called a J pouch from small intestine. The J pouch replaces the rectum and allows Ann to function normally.
"I'm feeling the best I've felt since I was 14."
The right diagnosis and treatment after years of battling the disease.
For Medical Edge, I'm Vivien Williams.
Since Ann had ulcerative colitis, not Crohn's, she was able to have this surgery. Crohn's is harder to remove surgically because it affects the entire digestive tract and is often not localized. The good news, though, is that medications for both inflammatory bowel diseases are getting better, but you still need the right diagnosis for them to work.
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