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Crohn's Disease Forum » Support Forum » Undiagnosed Club » You can have both Crohns AND Ulcerative Colitis


02-22-2013, 04:48 PM   #1
GutlessWonder86
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You can have both Crohns AND Ulcerative Colitis

** Administrator Edit - You CAN have both Crohn's and Ulcerative Colitis. The thread title has been edited to showcase that. Please see the last post of this thread for an explanation.
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THIS IS JUST AN FYI FROM AN IBD PATIENT WHO'S DONE RESEARCH AND WANTED TO SHARE ON HER WEBPAGE. I just copied what she posted to share with everyone here.

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: http://www.inflamed-and-untamed.com/...rative-colitis

What is Crohn’s Colitis? Can you have both diseases: http://www.inflamed-and-untamed.com/...-both-diseases

The Differences Between Ulcerative Colitis and Crohn’s Disease by Amber Tresca: http://ibdcrohns.about.com/od/ulcera...a/diffuccd.htm

Last edited by GutlessWonder86; 02-22-2013 at 07:04 PM.
02-22-2013, 04:59 PM   #2
Kev
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Well, I guess I can do the impossible. Had both, concurrently. Confused the heck out of everyone. The U.C. spread like wildfire.. doctors never saw it move so fast before, and I'm talking GI's with 40+ years experience combined. And it masked the Crohns. Until a fistula showed up. Then, 2 years back, both the internal scarring and biopsy confirmed Crohns w U.C.

Man oh man, I love 'these' experts. They adamantly stand by their opinion until someone else disproves their pet theory.
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02-22-2013, 05:09 PM   #3
Jennifer
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If they are two separate diseases then I don't see how its not possible to have both. Do you have a source that states its impossible to have both? Thus far you only mentioned the difference between the two.
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02-22-2013, 05:15 PM   #4
GutlessWonder86
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look at the link below from what I posted originally..


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

http://www.inflamed-and-untamed.com/...-both-diseases


read what is posted slowly. look at the links I provided. I mean you just can't have both at the same time. You can have 1 and then the diagnosis can change due to biopsy findings and what was seen on a CT/MRI/Xray....
02-22-2013, 05:48 PM   #5
Kev
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I don't know about your source. But I do know I had both.. concurrently. Either I am the sole exception to the 'rule' in the whole world, or this 'theory' is just that... a theory.

Now, this isn't something I dream t up. I posted on this site year ago detailing the trouble the doctors were having 'determining' whether I had UC, CC or CD. What they saw inside me was complete involvement of the colon with the exception of the surgical scar areas. This is typical of UC. However, later scopes showed scar formations within the uniformly involved area that can only come from Crohns. Those photos are posted on this site too. Together with the fistula, and the scarring, they biopsied and found I also had Crohns. I was told that my case is atypical, exceedingly rare, but it happens.

I'm not posting this to be controversial, or difficult. It is just that your post flies in the face of what I know to be the facts in my particular case. If it happened with me, there is no reason to think it couldn't happen to others... even if it is one case in a thousand.
02-22-2013, 05:50 PM   #6
Gculk
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look at the link below from what I posted originally..


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

http://www.inflamed-and-untamed.com/...-both-diseases


read what is posted slowly. look at the links I provided. I mean you just can't have both at the same time. You can have 1 and then the diagnosis can change due to biopsy findings and what was seen on a CT/MRI/Xray....
Ok, so there is no 'proof' there that Crohn's and UC can't be concurrent. It says it. But what they say afterwards contradicts that. If two diseases are pathologically different, as are Crohn's and UC, then if one section of intestine or bowel shows the pathology for Crohn's, and one section has the different pathology for UC, then poof. The patient has both.

Kev up there says he had it.

I'm not a dummy saying Crohn's colitis means Crohn's and ulcerative colitis, I'm meaning that you can't have your cake and eat it too. Either the pathologies are the same and having one means you'd have the other (location dependent), or they are different and then in certain rare cases a person could have both.
02-22-2013, 06:34 PM   #7
GutlessWonder86
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Another definition that can be confusing is Indeterminate colitis. You get this diagnosis when doctors are unclear whether the disease in your colon is Crohn’s disease or ulcerative colitis. Over time they may be able to tell and your diagnosis could change to one or the other or it may stay as indeterminate.
02-22-2013, 06:38 PM   #8
GutlessWonder86
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more information from someone who knows..

http://www.inflamed-and-untamed.com/...and-ulcerative
02-22-2013, 07:00 PM   #9
Gculk
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Another site defining Crohn's and UC.

FIND SCHOLARLY SOURCES. Kev here says his doctor said he had both.

http://www.healthcentral.com/ibd/c/question/39654/45881

Some people saying they were diagnosed with UC and Crohn's. I also saw posts on a different forum saying the same thing but can't find it atm.

You can find unbased claims for anything on the internet. If you think you're right, find a scholarly article about it!
02-22-2013, 07:01 PM   #10
GutlessWonder86
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Culk, I was just doing an FYI. if you have problems with my sharing, I'm sorry you feel that way.

Last edited by Jennifer; 02-22-2013 at 07:37 PM. Reason: Unsupportive comments deleted.
02-22-2013, 07:11 PM   #11
GutlessWonder86
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Here is a Q&A site with a doctor answering questions.

Can you have BOTH Crohn's and UC?? She answers it for the patient.

http://www.healthcentral.com/ibd/c/question/39654/45881

here's proof for you Culk. Right from the doctor's mouth. have a great night.
02-22-2013, 07:27 PM   #12
Gculk
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Your FYI, and 'Straight from the doctor's' mouth is directly contradicting the testimony of a patient in this very thread. And in the thread you linked.

I have no problem with you doing an FYI if you support it, but this isn't the unassailable fact that you make it out to be. As such, this thread should be a discussion, rather than a statement.

Actually, I'm going to guess that you misslinked. That one doesn't have any doctor saying no Crohn's and colitis.
02-22-2013, 07:33 PM   #13
GutlessWonder86
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I was able to get to the link. here it is with the MD answering questions.


: Can you have both crohn's disease and ulcerative colitis?
My husband was diagnosed with Ulcerative Colitis 8 years ago. He has been in a flare up for almost a year now and now doctors are discussing Crohn's disease. We are wondering can you be diagnosed with both?




Cola,

Your husband wouldn't be diagnosed with both UC and Crohn's. In my case I was diagnosed with UC ten years ago. A few months ago when I was in a flare some of my symptoms made my doctor think I was trending more in the Crohn's direction. I could have a colonoscopy done to verify her theory, but for me, the treatments that I use for the UC helped the flare calm down and all is back to normal.


But no, he wouldn't have both. It's one or the other. They can be tricky to diagnose and sometimes it's not until symtpoms get worse or new symptoms arise that a definitive diagnosis can be made for one or the other.

A colonoscopy and a look at his small bowel will be the most likely tests they do to figure this out.

Good luck,
Elizabeth


TabithaG

Sorry, but I find it interesting that you can't be diagnosed with both UC & Crohn's Disease. My brother was diagnosed with BOTH 6 years ago. I myself have been dealing with issues and was explaining my family history to my PCP and he told me the same thing -- you can't be diagnosed with both, yet he HAS been diagnosed with both.

How is it possible for one doctor to make an official diagnosis of both, yet others say it's impossible?

Elizabeth Roberts, Health Guide
268917/16/09 3:11pm
Hi,

You're right, there is a diagnosis now called Crohn's Colitis. More than a year ago when I answered that question I was unaware that this diagnosis existed. But, over the past 6 months I've heard more and more GI's (gastroenterologists) discuss this new diagnosis within the IBD family.

So, you are correct.


Elizabeth

Diane

OMG!!! Thank You ! I've have UC for 18 years,,,several years ago I was told by the same dr> I have Crohns!...Ive moved across the country ,,,this dr. calls it colitis! So yes! I believe you can have both!!


CULK, I edited my first post and if you READ it, I stated that it's FYI from a patient who wanted to SHARE her experience AND THAT I COPIED AND PASTED WHAT SHE WANTED TO SHARE.
02-22-2013, 07:43 PM   #14
Gculk
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Umm boss, that's a Chef and patient.

Also, she said 'Wouldn't'. Not 'couldn't'. The second bold is a definition of Colitis in the context of Crohn's. Granulomatous colitis, that is.

Also, later on in the thread are first hand accounts of people with both diagnoses concurrently.

An FYI should be something that is unambiguously true.

I don't find it unreasonable that a person could have Crohn's (Granulomatous enterocolitis) and Ulcerative Colitis, with superficial inflammation, cryptitis and crypt abscesses. In order for both diseases to be present, BOTH diagnostic characteristics would have to be present. But there doesn't, to me, seem to be any fundamental exculsivity between the two. Especially considering

WE HAVE A PERSON HERE, AND PEOPLE IN OUR LINKS WHO SAY THEY ARE DIAGNOSED WITH BOTH.
02-22-2013, 07:48 PM   #15
Jennifer
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Let's all just settle down please.
02-22-2013, 07:48 PM   #16
GutlessWonder86
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from another site a Q&A with another MD.


If I have ulcerative colitis, will I get Crohn's disease?


Filter 1 answers by contributor:


Dr. Lisa Ganjhu answered:
No, they are separate diseases that do not lead to each other. You can not have both.

Sometimes differentiating them is difficult since both have similar presentations.
02-22-2013, 07:49 PM   #17
GutlessWonder86
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from another site a Q&A with another MD.


If I have ulcerative colitis, will I get Crohn's disease?


Filter 1 answers by contributor:


Dr. Lisa Ganjhu answered:
No, they are separate diseases that do not lead to each other. You can not have both.

Sometimes differentiating them is difficult since both have similar presentations.



taken from Sharecare:

http://www.sharecare.com/question/ul...crohns-disease
02-22-2013, 07:50 PM   #18
David
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A well documented case of a patient with both Crohn's disease and ulcerative colitis is presented. A 29 year old woman underwent resection of her terminal ileum and ascending colon for typical Crohn's disease with ileocolitis. Eleven years later, an ileoproctocolectomy was performed for typical ulcerative colitis involving the left colon. The resection specimen also showed evidence of colonic Crohn's disease near the anastomotic site. This unusual case shows that Crohn's disease and ulcerative colitis can occur in the same patient. The rarity of such cases supports the concept that Crohn's disease and ulcerative colitis are separate entities, rather than different manifestations of the same disease process.
Source

Three cases of coexisting ulcerative colitis and Crohn's disease are presented. In the first case, the patient had a long-standing history of ulcerative proctitis before developing Crohn's colitis. In the two remaining cases, the patients presented initially with Crohn's disease of the ileum and, subsequent to resection, developed ulcerative colitis. Well-documented cases of patients diagnosed with both ulcerative colitis and Crohn's disease are rare.
Source

Reputable sites, papers, and studies are the name of the game folks. There's a lot of misinformation out there. Let's not perpetuate it. Just because someone has M.D. after their name doesn't make them an expert in Inflammatory Bowel Disease as it is incredibly complicated and they just don't have the time to educate themselves. Many people on this site know more about IBD than many doctors. People tend to treat, as gospel, a statement made by a member of the medical or scientific community. I think we can put our faith in what they say completely, failing to take into account they are only human, and can and do make mistakes. Check each and every stated fact. A life could depend on it.

And just as important, remember that debate is fine, but please do it in a supportive manner. We're a support forum first and foremost.

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