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GI Disorders: Crohn’s vs Ulcerative Colitis

Nurse Mike (Mike Linares)
By SimpleNursing | Published September 3rd, 2018
Published September 3rd, 2018
Doctor examine patient in hospital bed

Crohn’s disease and ulcerative colitis are chronic conditions that fall under the umbrella of Inflammatory Bowel Disease. Understanding the key differences and similarities between these conditions is essential for nursing students to deliver effective, safe patient care.

Inflammatory bowel disease (IBD) is entirely different from irritable bowel syndrome (IBS). Having irritable bowel syndrome means that there is the presence of pain and irritation. Mainly, there is irritability. However, there is no presence of inflammation. Inflammation and irritation are two separate issues.

Jump to Sections

  1. Pathophysiology of Crohn’s Disease
  2. Ulcerative Colitis Pathophysiology
  3. Inflammatory Bowel Disease Causes
  4. Crohn’s vs Ulcerative Colitis
  5. Crohn’s and Ulcerative Colitis Nursing Considerations

As a nursing student, it’s crucial to develop a solid understanding of various health conditions to provide effective care to patients. One such condition that requires our attention is Inflammatory Bowel Disease (IBD), which encompasses two main forms: Crohn’s disease and ulcerative colitis. 

Both of these chronic conditions affect the gastrointestinal (GI) tract, leading to inflammation and various symptoms. In this overview, we will explore the key differences and similarities between Crohn’s disease and ulcerative colitis, as well as their relationship to IBD.

Pathophysiology of Crohn’s Disease

As a test tip reminder, you can easily remember Crohn’s disease as “Crown’s disease” because of the granulomas that are present inside the gastrointestinal tract, which look like jewels to a crown. 

Crohn’s disease is a condition that can happen anywhere in the gastrointestinal tract – from the mouth to the rectum. The primary concern with Crohn’s disease is the presence of granulomas.


Granulomas happen when macrophages seclude bacteria like a small block and result in a protective covering, usually around a bacteria, foreign body, or virus; in most cases, tuberculosis viruses.

As for Crohn’s disease (Crown’s disease), the small granulomas attached to the bacteria are the ones causing the pain, distention, and inflammation of the gastrointestinal tract.

Ulcerative Colitis Pathophysiology

In colitis and ulcerative colitis, the large intestine or the colon is the main concern.

Ulcers are openings inside the gut that causes bloody stool (at least 15 episodes a day); this is the usual diagnosis of ulcerative colitis. The suffix, “-itis” means that there is the presence of inflammation. Therefore, with ulcerative colitis, there is an open-source of bleeding inside the colon that also causes inflammation.

Colitis, on the other hand, is not about granulomas but scar formations with an inflamed colon. Due to the edema in the colon, there is a loss of colon absorption and elasticity.

Inflammatory Bowel Disease Causes

The causes for inflammatory bowel diseases like Crohn’s disease and colitis or ulcerative colitis are the three S’s, namely:

  • Stress
  • Sickness
  • Smoking

When the body has inflamed bowel disease, it attacks itself which is also known as an autoimmune disorder. In this situation, the body thinks it’s foreign and tries to attack.

Crohn’s vs Ulcerative Colitis

Here are key differences between Crohn’s disease and ulcerative colitis, including their etiology, clinical manifestations, diagnostic approaches, and treatment strategies.


Crohn’s DiseaseUlcerative Colitis
Thought to involve an abnormal immune response to gut bacteria.Autoimmune response triggered by an unknown factor.
Genetic predisposition and environmental factors may contribute.Genetic susceptibility plays a significant role.
Can affect any part of the gastrointestinal tract, from the mouth to the anus, in a patchy, skip lesion pattern.Primarily affects the large intestine (colon) and rectum, starting from the rectum and extending proximally in a continuous manner.

Clinical Manifestations

Crohn’s DiseaseUlcerative Colitis
Abdominal pain and cramping.Bloody diarrhea, often with abdominal pain.
Diarrhea, often with mucus or blood.Urgency and increased frequency of bowel movements.
Weight loss, fatigue, and malnutrition.Rectal bleeding and tenesmus (feeling of incomplete evacuation).
Fistulas, abscesses, and strictures may occur.Anemia, weight loss, and fatigue.
Extraintestinal manifestations, such as joint pain, skin rashes, and eye inflammation, are possible.Extraintestinal manifestations, like joint pain, skin lesions, and eye inflammation, may be observed.

Nursing Diagnostic Approaches

Crohn’s DiseaseUlcerative Colitis
Medical history and physical examination.Medical history and physical examination.
Blood tests to assess inflammation and nutritional status.Blood tests to assess inflammation and anemia.
Imaging studies, such as computed tomography (CT) scans or magnetic resonance imaging (MRI).Flexible sigmoidoscopy or colonoscopy with biopsies.
Endoscopic procedures, including colonoscopy and upper gastrointestinal (GI) endoscopy with biopsies.Imaging studies, such as CT scans or barium enemas, may be used in specific cases.

Treatment Strategies

Crohn’s DiseaseUlcerative Colitis
Medications to induce and maintain remission, such as aminosalicylates, corticosteroids, immunomodulators, and biologics.Medications, such as aminosalicylates, corticosteroids, immunomodulators, and biologics, to induce and maintain remission.
Nutritional therapy to address malnutrition and promote healing.Nutritional support to manage symptoms and improve healing.
Surgical intervention in cases of complications or severe disease, including strictureplasty, bowel resection, or ostomy creation.Surgical options may include colectomy with ileal pouch-anal anastomosis or permanent ileostomy in refractory cases

Crohn’s and Ulcerative Colitis Nursing Considerations

When caring for a patient with a heightened immune system, the main goal is to decrease the elements that cause the condition to worsen. Therefore, the nurse has to make sure that the patient:

  • Is not be exposed to stressful events or situations
  • Refrains from getting sick
  • Stops smoking 

These three causes are the main culprits for the exacerbation of this type of autoimmune disorder.

Prepare for Success in Your Nursing Exams and Beyond

Are you a nursing student looking for a comprehensive and convenient study tool to grasp key information about complex conditions like Crohn’s disease and ulcerative colitis? 

SimpleNursing is designed specifically to aid your understanding of critical nursing concepts. With interactive modules, detailed explanations, and engaging visuals, you’ll gain a deep understanding of these conditions and their management. 

Whether you’re studying for an exam or preparing for clinical rotations, our tool will be your trusted companion. 

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Nurse Mike (Mike Linares)
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Editorial Team

Education: SimpleNursing Editorial Team Education