As part of my recent Therapeutics III syllabus, I’ve been exploring Inflammatory Bowel Diseases (IBD) — particularly the clinical distinction between Ulcerative Colitis (UC) and Crohn’s Disease (CD). Understanding how to differentiate them is essential for effective treatment planning.
Here’s a quick comparison between both listed in table attached as image form below :
Case Example from My University Paper
Let’s apply this with a real-world case we analyzed:
Mr. XYZ is a 32 year old software engineer who presents with a 2-month history of frequent loose stools (6-7 times daily) containing blood and mucus, accompanied by lower abdominal cramping, urgency, and tenesmus. He reports fatigue, decreased appetite, and a 5 kg weight loss. His family history reveals autoimmune disease (father with rheumatoid arthritis). He recently quitted smoking. Physical examination shows pallor and mild tenderness in the left lower abdomen. Laboratory investigations reveal mild anemia and elevated inflammatory markers (ESR, CRP). Colonoscopy demonstrates continuous mucosal inflammation from the rectum to the sigmoid colon. Stool cultures are negative for infection.
Diagnosis: Ulcerative Colitis with mild anemia
Supported by symptoms + colonoscopy findings
Negative stool cultures rule out infection.
Continuous inflammation + tenesmus + rectal involvement = classic UC.
Risk Factors in Mr. XYZ :
Recent smoking cessation (protective in UC but risk increases after quitting).
Family history of autoimmune disease.
Age group (young adult, typical UC onset).
Non-Pharmacological Management:
Nutritional support & iron-rich diet.
Stress reduction (yoga, counseling).
Regular monitoring of weight, hemoglobin, and CRP.
Avoid NSAIDs (may worsen UC).
Vaccinations (if immunosuppressive therapy planned).
Pharmacological Options:
- Aminosalicylates (5-ASA) – e.g., mesalamine suppository or oral.
- Corticosteroids – short-term for moderate flares.
- Immunomodulators – azathioprine (if steroid-dependent).
- Biologics – infliximab (for moderate-severe disease)
Patient Counseling for Mr. XYZ :
1.Adhere to medications even if symptoms improve.
2.Recognize signs of flare-up (increased stool frequency, blood).
3. Report side effects (e.g., infection signs from biologics).
4.Attend regular follow-ups and colonoscopy surveillance.
5.Don’t stop treatment suddenly.
6.Keep hydrated and nutritionally supported.
7.Avoid Triggering factors (spicy and junk food, stress).
8.Maintain sleep hygiene.
Sharing this case and table not just to reinforce my learning, but to communicate complex topics in a clear, clinical format.
Would like to hear from you, your thoughts and experience.
