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BACKGROUND


Table 1: Comparisons of Characteristics of CD and UC CD


Occurrence Symptoms


More females than males All ages, peak onset 15-35 years


Diarrhea, fever, sores in the mouth and around the anus, abdominal pain and cramps, anemia, fatigue, loss of appetite, weight loss, pain and swelling in the joints


Terminal ileum involvement Common Colon involvement Rectum involvement Peri-anal disease


Often Often


Common Distribution of Disease Endoscopic Findings Depth of inflammation


Fistulas between organs Stenosis


Surgical ‘cure’ Patchy areas of inflammation Deep and snake-like ulcers


May be transmural, extending through or affecting the entire thickness of the wall of an organ or cavity deep into tissues


Common Common


Granulomas on biopsy Common


Often returns following removal of affected parts, decreased likelihood of pregnancy


Drug treatment


(antibiotics sulfasalazine, corticosteroids, immune modifiers, biologic therapies)


Treatment Diet and nutrition


Surgery (repair fistulas, remove obstruction, resection and anastomosis)


No existing cures. Cure Complications Smoking Mortality risk


Maintenance therapy is used to reduce the chance of relapse


Blockage of intestine due to swelling or formation of scar tissue, abscesses, sores or ulcers (fistulas), malnutrition


Higher risk for smokers


Increased risk of colorectal cancer and overall mortality


UC


Similar for males and females All ages, usual onset 15-45 years


Bloody diarrhea, mild fever, abdominal pain and cramps, anemia, fatigue, loss of appetite, weight loss, pain and swelling in joints


Not


Always Always Never


Continuous area of inflammation but can be patchy once treated


Diffuse ulceration endoscopic changes can be mild


Shallow, mucosal


Never Rarely Rarely


Usually ‘cured’ by removal of colon (colectomy), decreased likelihood of pregnancy after ileoanal pouch


Drug treatment


(5-aminosalicylates, antibiotics sulfasalazine, corticosteroids, immune modifiers, biologic therapies)


Surgery (rectum/colon removal) with creation of an internal pouch (ileoanal pouch)


Through colectomy only. Maintenance therapy is used to reduce the chance of relapse


Bleeding from ulcerations, perforation (rupture) of the bowel, malnutrition


Lower risk for smokers


Increased risk of colorectal cancer. No change in mortality risk


THE IMPACT OF INFLAMMATORY BOWEL DISEASE IN CANADA 18


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