B. Goblet cell depletion – Explanation
Inflammatory bowel disease: key differences
The two main types of inflammatory bowel disease are Crohn’s disease and Ulcerative colitis. They
have many similarities in terms of presenting symptoms, investigation findings and management
options. There are however some key differences which are highlighted in table below:
| Crohn’s disease (CD) | Ulcerative colitis (UC) | |
| Features | Diarrhoea usually non-bloody Weight loss more prominent Upper gastrointestinal symptoms, mouth ulcers, perianal disease Abdominal mass palpable in the right iliac fossa |
Bloody diarrhoea more common Abdominal pain in the left lower quadrant Tenesmus |
| Extraintestina | Primary sclerosing cholangitis more common | |
| Complications | Obstruction, fistula, colorectal cancer | Risk of colorectal cancer high in UC than CD |
| Pathology | Lesions may be seen anywhere from the mouth
to anus |
Inflammation always starts at rectum and never spreads beyond ileocaecal valve Continuous disease |
| Histology | Inflammation in all layers from mucosa to serosa
|
No inflammation beyond submucosa (unless fulminant disease) – inflammatory cell infiltrate in lamina propria
|
| Endoscopy | Deep ulcers, skip lesions – ‘cobble-stone’
appearance |
Widespread ulceration with preservation of adjacent mucosa which has the appearance of polyps (‘pseudopolyps’) |
| Radiology | Small bowel enema
|
Barium enema
|
