Review Question - QID 101146

Fistulas between the bowel and several structures, including perianal skin, the bladder, other parts of the bowel, and the vagina, are features of Crohn disease rather than ulcerative colitis.

Bloody diarrhea, sigmoid colon inflammation (Crohn often is rectal sparring), and joint pain suggest ulcerative colitis but may appear in Crohn disease as well. Other features commonly present in Crohn disease but not ulcerative colitis include involvement of the entire GI tract rather than the distal colon, intestinal strictures, non-contiguous lesions, mucosal ‘cobblestoning’, transmural inflammation, non-caseating granulomas, and non-bloody diarrhea.

Illustration A shows an endoscopic image of Crohn's colitis showing deep ulcerations. Illustration B depicts an overview of the comparisons between Crohn's and ulcerative colitis.

Incorrect answers:
Answer 1: Left lower quadrant pain may be present in both ulcerative colitis and Crohn disease.
Answer 2: Both Crohn disease and ulcerative colitis can cause biliary obstruction and jaundice. Biliary obstruction in ulcerative colitis is linked to primary sclerosing cholangitis.
Answer 3: Loss of large bowel haustra is a feature of ulcerative colitis.
Answer 4: Mucosal and submucosal ulcerations are present in ulcerative colitis. Transmural lesions are a marker for Crohn disease