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Crohn's Disease vs. Ulcerative Colitis

Which IBD? Crohn's Disease or Ulcerative Colitis?

When a diagnosis of Inflammatory Bowel Disease, or IBD, is given, it is difficult to further categorize the diagnosis as Crohn's Disease, Ulcerative Colitis or Other IBD. This diagnosis is particularly difficult when the Colon is involved and a diagnosis of Indeterminate IBD may be given.

The Criteria allowing Crohn's Disease to be differentiated from Ulcerative Colitis are shown in the Table below:
Crohn's Disease (CD)Ulcerative Colitis (UC)
Patchy Tissue DistributionContinuous Tissue Distribution
Rectum May or May not be InvolvedRectum Involved
Ileal InvolvementNo Ileal Involvement*
Presence of GranulomasNo Granulomas
FissuresNo Fissures
Transmural Lymphoid AggregatesNo Transmural Aggregates
* - Except in cases of "Backwash Ileitis"


Odze R. Diagnostic problems and advances in inflammatory bowel disease. Mod Pathol. 2003; 16(4): 347-358.

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