Alongside Crohn’s Disease, Ulcerative Colitis falls into a group of conditions known as Inflammatory Bowel Disease. Although the two share many commonalities, there are key differences between the two.

What is Ulcerative Colitis vs Crohn’s Disease

Ulcerative colitis affects the innermost lining of the large intestine (colon) and the rectum, whereas Crohn’s disease can affect any portion or layer of the gastrointestinal tract.

Neither is curable; both are chronic, long term conditions that must be managed through a combination of lifestyle change and medication. However, except in the very rare case of extreme medical complications, neither Crohn’s disease nor ulcerative colitis are life-threatening conditions.

Different Types of Ulcerative Colitis

Though this may be one condition, doctors will usually diagnose ulcerative colitis based on where it occurs.  Types based on location include the following:

• Ulcerative proctitis – This form sees the inflammation near the rectum (anus). The only indication of the disease is often rectal bleeding.  This is typically the mildest form of the condition.
• Proctosigmoiditis – Here, the inflammation occurs both in the rectum and the lowest end of the colon, called the sigmoid colon. Among the symptoms of this version of the condition are abdominal cramping and pain, bloody diarrhea, and the inability to have a bowel movement despite the urge to do so (also known as tenesmus).
• Left-sided colitis – In this form, the inflammation runs from the rectum right through the sigmoid colon and into the descending colon. Among the symptoms of this type are abdominal cramping and pain on the left side, bloody diarrhea, and unexplained weight loss.
• Pancolitis – This is a form of ulcerative colitis that can impact the entire length of the colon. It can cause flare-ups of bloody diarrhea that may be rather severe at times.  Fatigue, abdominal pain and cramping and substantial weight loss are also common.
• Acute severe ulcerative colitis – This is the most extreme form but is also quite rare. Here, the inflammation affects the full length of the colon and causes profuse diarrhea, severe pain, substantial bleeding, inability to eat, and fever.

Why Do Symptoms Happen?

Ulcerative colitis occurs as the consequence of an autoimmune response; the body mistakes healthy bacteria and food in the colon as a threatening foreign substance and mounts an immune response that causes inflammation and damage to the lining of the colon. Symptoms include cramping, gas, diarrhea and urgency, abdominal pain before, during, or after a bowel movement, bloody stool, loss of appetite, and weight loss.

Ulcerative colitis often occurs in flares: those living with ulcerative colitis may go many weeks or months without a flare or may go just days between flares. Flares occur in response to triggers. Specific triggers vary between individuals, but commonly include spicy foods, foods high in fiber, and emotive stress. Although food itself does not cause ulcerative colitis, there are specific trigger foods individual to each case of ulcerative colitis; one person’s list of trigger foods is completely different from another’s.

What to Do if You Think You Have Ulcerative Colitis

If you’re not sure whether or not you or a loved one have this condition, it is highly recommended that you make an appointment to speak with a doctor. Though very rarely life-threatening, it can lead to problematic complications if left untreated. Signs that you should make an appointment include:

• Abdominal pain
• Bloody stool
• Persistent diarrhea that doesn’t seem to be helped using over the counter medications
• Diarrhea that wakes you up at night
• An unexplained fever that sticks around longer than one or two days.

If you or a loved one has been diagnosed with ulcerative colitis, a doctor or registered dietitian will likely recommend that you keep a food journal to help identify potential trigger foods. Many of those living with ulcerative colitis have found that high spice and high fiber foods tend to be most triggering; alcohol is another common trigger. Although those with this condition are usually able to consume a large variety of foods, there are certain individuals who find themselves more limited than others.

Luckily, most people are able to find foods within nearly every category of food that do not cause flares. For example, many people with the condition find that high-fiber breads and rice (for example, brown rice) trigger their symptoms, lower fiber options (such as white breads and white rice) do not cause the same symptoms. Similarly, while many people find that raw vegetables exacerbate a flare, cooked vegetables do not.

How to Treat This Condition

Many of those with Ulcerative Colitis find that the behavioral changes required to prevent flares become easier over time; however, upon diagnosis, many patients struggle with the disappointment of giving up favorite foods. While disappointment is understandable, most individuals are able to find alternatives that mimic the flavors and textures of their favorite foods, helping them manage their condition and prevent flares.