Ulcerative Colitis vs Crohn's Disease: What Are The Early Signs and How Are They Diagnosed?



Person experiencing abdominal pain.If you are consistently experiencing abdominal pain, changes in your bowel movements, blood or mucus in your stool, fatigue, weight loss, or vomiting, it’s time to check in with your doctor. While these symptoms could be attributed to many common gastrointestinal (GI) issues, they are also indicators of Crohn’s disease or ulcerative colitis, collectively known as inflammatory bowel disease (IBD).


If you suspect you may have IBD, it is important to talk about it with a doctor. The sooner IBD is diagnosed and treated, the better health outcomes patients experience.

What is IBD?

Crohn’s disease and ulcerative colitis are chronic inflammatory diseases of the GI tract. In Crohn’s disease, inflammation can occur anywhere in the GI tract from the mouth to the anus, whereas in ulcerative colitis, inflammation is limited to the colon.


While many IBD symptoms are gut-related, including pain and urgency, patients can also experience extraintestinal manifestations (EIMs), or IBD symptoms outside of the gut. The most common EIMs are joint pain, anemia, and issues with skin, bone, eye, liver, and kidney health.


Most IBD patients are diagnosed when they are between 15 and 35 years old, though anyone can be diagnosed with IBD at any age.


Healthcare professionals may perform blood or stool tests as part of the initial evaluation before performing an endoscopy or colonoscopy to examine the GI tract and make a determination as to whether a patient has IBD.

How do you know if you have Crohn’s disease or ulcerative colitis?

The early signs of IBD often mimic other GI conditions, including acute infections like food poisoning or norovirus, better known as a stomach bug. Since they have similar names and multiple overlapping symptoms, IBD is often confused with irritable bowel syndrome (IBS), a chronic condition that causes patients to experience pain and changes in their bowel movements, but unlike IBD, IBS does not cause any inflammation in the GI tract.


While it’s common to experience gut issues from time to time, it is important to talk to your doctor if your symptoms last more than a few days.

What is the difference between Crohn’s disease and ulcerative colitis?

As mentioned earlier, the main difference between Crohn’s disease and ulcerative colitis is that ulcerative colitis causes inflammation in the colon, whereas Crohn’s disease can cause inflammation anywhere in the GI tract. Additionally, ulcerative colitis causes continuous areas of the colon to be inflamed, while patients with Crohn’s disease will have patches of inflamed areas mixed closely together with healthy tissue.


There are many medical and surgical treatments available for IBD, but there are currently no cures for Crohn’s disease or ulcerative colitis. You can see a comprehensive list of IBD medication options by viewing our IBD Medication Guide.


Patients with ulcerative colitis or Crohn’s disease may require surgery. You can learn more about surgical procedures for ulcerative colitis here, and surgical procedures for Crohn’s disease here.

Can you have both Crohn’s disease and ulcerative colitis?

It is not possible to have both Crohn’s disease and ulcerative colitis. What causes some confusion is that a patient may be initially diagnosed with ulcerative colitis and have their diagnosis changed to Crohn’s disease, or vice versa, a few years later. Additionally, there is a form of Crohn’s disease, known as Crohn’s colitis, that causes inflammation only in the colon. Neither a change in diagnosis nor having Crohn’s colitis is the same as having both Crohn’s disease and ulcerative colitis.

Learn more about Crohn’s disease and ulcerative colitis

If you have been diagnosed with Crohn’s disease or ulcerative colitis, or think you may have IBD, our IBD Help Center is here to help. You can contact our IBD Help Center by emailing [email protected] or calling 1-888-MY-GUT-PAIN.


You can make an impact on IBD cures! Please consider making a donation to the Crohn's & Colitis Foundation.