What are the symptoms of pediatric Crohn disease of the colon?

Updated: Oct 23, 2018
  • Author: Andrew B Grossman, MD; Chief Editor: Carmen Cuffari, MD  more...
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Answer

Colonic Crohn disease may be clinically indistinguishable from ulcerative colitis (UC), with symptoms of bloody mucopurulent diarrhea, cramping abdominal pain, and urgency to defecate (see the Table below).

Table. Characteristics and Presentations Differentiating Crohn Disease From Ulcerative Colitis (Open Table in a new window)

 

Crohn Disease

Ulcerative Colitis

Characteristic

Distribution

Entire GI tract

Colon only, although gastritis recognized

Skip lesions

Continuous involvement proximally from rectum

Pathology

Full thickness

Mucosa only

Granulomas (30%)

No granulomas

Radiology

Entire GI tract

Colon only

Skip lesions

Continuous involvement proximally from rectum

Fistulas, abscesses, fibrotic strictures

Mucosal disease only

Cancer risk

Increased

Estimated 1%/y, starting 10 y after diagnosis

Presentation

Bleeding

Common

Very common

Obstruction

Common

Uncommon

Fistula

Common

None

Weight loss

Common

Uncommon

Perianal disease

Common

Rare

GI = gastrointestinal.


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