Differences in distribution between ulcerative colitis and Crohns disease

What are the differences in distribution between ulcerative colitis and Crohns disease?

Ulcerative colitis is left-sided colonic disease, beginning at the anorectal junction and extending continuously and retrogradely a variable distance (proctosigmoiditis, left-sided colitis, pancolitis). Ulcerative colitis symmetrically involves a bowel segment.

Crohn’s disease involves the colon and terminal ileum in 55% of patients.

Terminal ileal involvement alone is seen in 14% of patients. Terminal ileal and distal small bowel involvement alone is seen in 13% of patients. Pure colonic involvement is seen in about 15% of patients.

Crohn’s disease is discontinuous, having patchy involvement locally and between loops, called skip areas. Crohn’s disease is asymmetric, first involving the mesenteric side of bowel.

Comparison of Crohns Disease and Ulcerative Colitis

Right-sidedExtends proximally from rectum
Terminal ileal changes in 85%Backwash ileitis in 10%
Aphthoid ulcersMucosal granularity
Ulcers on background of normal mucosaUlcers on background of mucosal granularity
Severe perianal diseaseColon cancer in larger percentage of patients
Sinus tracks and fistulasSclerosing cholangitis in larger percentage of patients
Abscess formation

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