Crohn's Colitis in the Large Intestine

Crohn's colitis is a term that causes a significant amount of confusion for people who have inflammatory bowel disease (IBD) as well as those who do not have IBD. Crohn's colitis is a form of Crohn's disease, but the addition of the word "colitis" brings with it a mistaken connection to ulcerative colitis. However, Crohn's colitis is in fact, used to refer to a form of Crohn's disease, and not the other main form of IBD, ulcerative colitis. This type of Crohn's disease is diagnosed in about 20% of all patients with Crohn's disease and is also sometimes called granulomatous colitis.

Symptoms and Presentation

The most common symptoms of this form of Crohn's disease include diarrhea (with 40% to 50% of patients seeing blood), weight loss, and abdominal pain. Crohn's disease has pockets of inflammation in the large intestine, separated with areas of healthy tissue. This is one way Crohn's differs from ulcerative colitis: in ulcerative colitis, the inflammation is continuous and is not separated by healthy tissue. Crohn's disease also may make the inside of the intestines look like cobblestones, which does not happen with ulcerative colitis.

Breaking Down the Components of "Crohn's Colitis"

Crohn's. The "Crohn's" in Crohn's colitis refers to Crohn's disease, which is an incurable form of IBD that can affect any part of the digestive tract. In order to better treat patients, physicians and scientists have come up with different ways of referring to the more common forms that Crohn's disease takes. Crohn's colitis is one of the more common forms, and it means that the Crohn's disease is affecting the large intestine (the colon). In some cases, Crohn's disease affects just that one part of the digestive tract, and it, therefore, gets termed "Crohn's colitis." It is still a form of Crohn's disease, and it does not mean that a patient also has ulcerative colitis.

Physicians may classify Crohn's disease in this way because the location of inflammation is important to management and treatment. Someone who has Crohn's disease in their large intestine may need different treatment and follow-up tests than someone who has Crohn's disease only in their small intestine. Having been classified as having Crohn's colitis does not mean that the Crohn's disease will never affect the small intestine. It just means that the Crohn's disease is not present in the small intestine at the current time. If the disease goes on to affect other parts of the digestive tract, a gastroenterologist would update the form of Crohn's disease that a patient is considered to have.

Colitis. Colitis is a very general term, and it means to have inflammation in the large intestine. Colitis could be caused for a variety of reasons that have nothing to do with ulcerative colitis or Crohn's disease, or even IBD. Colitis could also be caused by infection with a parasite, virus, or bacteria; ischemia (a lack of blood flow); or be a side effect of radiation therapy. Some of these forms of colitis are acute, meaning that they come on suddenly, and will respond to treatment and then be resolved, such as with an infection. Colitis that is caused by IBD is considered chronic, and while the disease might be put into remission, it is never cured.

Clearing Up the Confusion

Some important points to remember about Crohn's colitis:

• It is one form of Crohn's disease
• It is not ulcerative colitis
• Patients with Crohn's colitis have inflammation in their large intestine
• About 20% of people with Crohn's disease have the Crohn's colitis form
• "Colitis" means inflammation of the colon, and it should not be mistaken to mean to refer to ulcerative colitis

Also Known As: Granulomatous colitis, Crohn colitis, Crohn's-colitis