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

I recorded this video on November 3rd and here I am finally posting it almost 4 months later. I’m so on top of things!  

In this video I discuss whether or not you can have both of the most commonly known inflammatory bowel diseases - Crohn’s disease and ulcerative colitis.  Also covered is Indeterminate Colitis, Crohn’s Colitis, and some other definitions. Plus whether or not they can turn from one into the other. 

You cannot have both Crohn’s disease and ulcerative colitis.  Though both diseases are very similar and patients experience a lot of the same symptoms they are two different diseases and you cannot have both of them.  It is important to understand how they are different…

How are Crohn’s disease and ulcerative colitis different:

  • Fissures, fistulas, and strictures are much more common in Crohn’s disease than they are in ulcerative colitis. 
  • Malabsorption is seen in Crohn’s patients more often because the majority of nutrient absorption takes place in the small bowel where Crohn’s disease can be present, making it more difficult for the body to absorb nutrients.  Ulcerative colitis is not located in the small bowel. 
  • Ulcerative colitis patients experience bleeding from the rectum during bowel movements more commonly than Crohn’s disease patients.  
  • In ulcerative colitis you see continual inflammation throughout the colon.  It normally starts in the rectum and progresses from there as disease worsens.  In Crohn’s disease you can have “skip patterns” of inflammation. Meaning you can have healthy bowel in-between two sections of diseased bowel. This does not happen with UC.
  • Crohn’s disease patients experience granulomas - inflamed cells that become lumped together to form a lesion.  These are not seen in ulcerative colitis patients. 
  • With Crohn’s disease ulcers can penetrate all layers of the bowel.  In ulcerative colitis patients ulcers only affect the inner (mucosa) lining. 
  • Crohn’s disease can be found anywhere in the digestive system. Ulcerative colitis is only located in the colon. Though sometimes the very last portion of the ileum is also inflamed.

It is also important to understand that IBD is a very complex disease and sometimes it isn’t always possible for the doctor to tell right away whether or not you have Crohn’s disease or ulcerative colitis. Sometimes the disease is only showing up in the colon but has characteristics that maybe look like it could be Crohn’s disease.  When it isn’t possible to distinguish between the two a patient is given the diagnosis of Indeterminate Colitis.  Later on it might be more evident as to which IBD it is and then a diagnosis is made.

Crohn’s Colitis: Crohn’s Colitis does not mean the patient has both Crohn’s disease and ulcerative colitis.  It means that the patient has Crohn’s disease that is only present in the colon.  It isn’t ulcerative colitis because it is showing the characteristics of Crohn’s disease mentioned above such as: skip patterns of disease, granulomas, fistulas, etc.  

Links with more information!

The word colitis vs. the words ulcerative colitis:

What is Crohn’s Colitis? Can you have both diseases:

The Differences Between Ulcerative Colitis and Crohn’s Disease by Amber Tresca:

An old video of mine (man my hair has grown in a year!) about the colon and it’s job just so you understand your colon better: