UC vs. Crohn's diagnosis

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Eva Lou
Veteran Member

Date Joined Sep 2006
Total Posts : 3432
   Posted 11/28/2007 5:08 PM (GMT -6)   
Hi people! I recently had a surgical consult with a colorectal surgeon- we had planned a proctocolectomy in November, but lucky for me, I went into remission about 2 weeks before my scheduled surgery. I was diagnosed with UC in 2003, via flex sig. I have had a bunch of those, but no colonoscopy. I never questioned my diagnosis until recently- I suspect I have a fistula, which are rare in UC but common in Crohn's (my suspicions will be confirmed/denied soon- CAT scan scheduled for this Friday). But while talking with the surgeon, we discussed the fact that when they remove your colon, a pathology report is done. The surgeon said "Short of the pathology report, there is really no definitive test to diagnosis UC versus Crohn's." Which makes sense! Soooo... Do you think this is true? And have many of you been misdiagnosed? How did they finally decide what it was you actually had?
diagnosed with UC '02
Asacol- 8 tabs/day
Remicade infusions
Imuran- 100mgs/day
Prednisone- 15mgs/day

Regular Member

Date Joined Jul 2007
Total Posts : 456
   Posted 11/28/2007 5:48 PM (GMT -6)   
If there's any question of UC vs. Crohn's, have them give you a colonoscopy with biopsies before having any surgery.  In UC they remove the colon and you're considered cured.  With Crohn's they remove as little as possible, because it can, and probably will, come back.
Sometimes it's really hard for the doctors to decide between UC and Crohn's.  A lot of us have had our diagnoses changed.  I was diagnosed in June of this year, and my doctors have already said Crohn's, no wait- it's UC, oh nevermind Crohn's. 

Veteran Member

Date Joined Apr 2005
Total Posts : 2346
   Posted 11/28/2007 5:50 PM (GMT -6)   
They take biopsies during a colonoscopy and that can tell you if it is uc or crohns most of the time. I was told UC in the beginning, but that was because I had a stupid, jerk of a dr. Also, you can have sbft, the capsule.....these can all tell you if you have small bowel involvement or not, and that woud mean crohns if those came back positive.

Elite Member

Date Joined Feb 2004
Total Posts : 20558
   Posted 11/28/2007 6:37 PM (GMT -6)   
Well I can tell you 2 definitive ways that they can tell the difference via colonoscopy..

1. With CD it can go through the many layers of the intestinal lining, thus leading to why fistulas are common with CD and NOT UC. UC inflammation remains on the surface of the intestinal lining.

2. With crohns there are skipped patterns of inflammation (healthy tissue in between inflammed tissues) with UC the entire area will be inflammed.

And most obvious is that CD can affect the entire GI tract from the mouth to the anus, UC is limited to the colon/rectom only.

My bum is broken....there's a big crack down the middle of it!  LOL  :)

Regular Member

Date Joined Dec 2006
Total Posts : 177
   Posted 11/28/2007 6:47 PM (GMT -6)   
When they take biopsies during colonoscopies, one thing they are looking for are abnormal cells called granulomas- these only occur in Crohn's, not UC. I was first diagnosed with UC from an incomplete colonoscopy (I reacted to the meds so they had to stop) and a few weeks later had another scope, with biopsies, and they found granuloma cells and changed my diagnosis to Crohn's. Good luck with your CT, hope you get some answers!

Mormor Vicky
Veteran Member

Date Joined Mar 2007
Total Posts : 684
   Posted 11/28/2007 8:49 PM (GMT -6)   
My daughter had the granulomas. As far as I know I don't have them but we both suffer from fistulas.
Vicky / 47 years old
DX'd with Crohn's during a resection August 2006
DX'd with Steriod induced Diabetes November 2006
Considered in Clinical remission but have minor signs of disease activity
Daughter (26) also has Crohn's since she was 12.
Currently on 4000mg of Pentasa only for Crohn's
No longer able to take 6-MP because of Bone-Marrow Suppression
Cymbalta, Metformin, Lipitor

New Member

Date Joined Jun 2007
Total Posts : 10
   Posted 11/29/2007 12:07 AM (GMT -6)   

I was told I had UC for 10 yrs. and then had my colon removed 9 years ago and now I had a bad flare and I had a blood test done and was told I have Crohns

Now I am on Lomotil and Remicade ever 6 weeks. Had two treatments so far seems to be helping.

Veteran Member

Date Joined May 2005
Total Posts : 4219
   Posted 11/29/2007 12:42 AM (GMT -6)   
Just keep in mind not everyone w/ crohns has granulomas. I don't.
26 Year old married female.  Diagnosed w/ CD 3 years ago, IBS for over 10 years before that, which was probably the CD.  Currently on Pentasa 4 pills/4x day, hysociamine prn, nexium, and ortho evra.  Good times!!!

Regular Member

Date Joined May 2005
Total Posts : 221
   Posted 11/29/2007 1:15 AM (GMT -6)   

O.K so I have a question, I had a colonoscopy done on Monday, and even though I'm going in to see her on the 11th to discuss bipsies and such, she gave me some pictures (even though i woke up during the procedure confused ) and used the words granularity and friability to discribe what she had seen.  Are granulomas what she's discribing? Does anyone know what these terms mean?   Just wondering since the topic was up.


Paula :-)

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