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Conditions That Can Look Like Crohn's Disease

Medically Reviewed by Neha Pathak, MD on October 13, 2020

Crohn’s disease causes long-term inflammation in your digestive tract, also called your gut. Its many symptoms include diarrhea, belly pain, weight loss, bleeding, and tiredness. But those problems also can be common to many different conditions.

Here are some conditions that can look like Crohn’s but aren’t.

Ulcerative Colitis (UC)

Like Crohn’s, this is an inflammatory bowel disease. Inflammation from UC affects your large intestine, or colon, and rectum. Crohn’s, by contrast, can happen anywhere in your gut. UC can cause sores called ulcers in the lining of your colon. It and Crohn’s both can leave you tired and your poop bloody or slimy. With ulcerative colitis, you may poop more or need to poop right away. That also can happen with Crohn’s. But Crohn’s is more likely than UC to cause complications like fistulas, strictures, and abscesses.

Irritable Bowel Syndrome (IBS)

This isn’t caused by inflammation. With IBS, your bowels look normal on imaging tests like CT scans and in biopsies. It differs from inflammatory bowel disease (IBD), of which Crohn’s is one type. IBS is sometimes called a sensitive gut. Symptoms include feeling gassy, changes to your poop like diarrhea and constipation, and belly pain or bloating that may get better after a bowel movement. Your poop could also be slimy from mucus. Your symptoms may also come and go.

Celiac Disease

This is an autoimmune when your body can’t process gluten, a protein in wheat, barley, and other foods. Gluten can damage your small intestine if you have celiac disease. But many people with Crohn’s can eat gluten without trouble. Over time, celiac disease prevents your body from absorbing certain nutrients from what you eat and drink. Its symptoms may include bloat, weight loss, diarrhea, tiredness, and anemia.

Food Allergy

Your body can overreact to harmless foods by mounting an immune response to protect you. Signs of an allergic reaction include belly cramps, nausea, diarrhea, hives, rash, and trouble breathing. Even tiny amounts of a food can trigger your allergy.

Food Intolerance

Unlike with food allergy, this doesn’t involve your immune system. Food intolerance is when your gut can’t break down certain foods normally. Your tummy can hurt, you can feel nauseous and throw up, or have diarrhea, heartburn, cramps, bloating, and gas. These symptoms usually show up only after you eat a lot of the problem food or have it often.

Colon Cancer

Also called colorectal cancer, it often has no noticeable symptoms until late. But when they do show up, the symptoms can mimic those of Crohn’s disease.

You might notice that your poop is bloody or that you’re bleeding from your bottom. Other symptoms of colon cancer include stomach discomfort, weakness or fatigue, unexplained weight loss, and feeling like you can’t empty your bowels.

Vasculitis

This is inflammation of your blood vessels. There are many forms of vasculitis. But many of them aren’t common. Some can cause symptoms, such as mouth sores, that are similar to Crohn’s. Those types include:

  • Behcet’s disease
  • Microscopic polyangiitis (MPA)
  • Granulomatosis with polyangiitis (GPA, Wegener’s granulomatosis)
  • Eosinophilic granulomatosis with polyangiitis (EGPA, Churg-Strauss syndrome)
  • IgA vasculitis (previously known as Henoch-Schönlein purpura or HSP)

Common Variable Immune Deficiency

People with this disorder lack enough of the proteins they need to fight off infections. That can give you diarrhea and belly pain, and cause weight loss.

Intestinal Ischemia

This is a group of conditions that can be deadly. It happens from lack of blood flow to your intestines. The most common form of this disorder is colon ischemia (ischemic colitis). It can cause a cramping pain in the bottom of your stomach and diarrhea with blood. People with it often have had heart or blood vessel surgery, take certain types of medicine, or do intense exercise.

Diverticulitis

It’s normal for people over the age of 40 to have small bulging pouches along their digestive tract, usually in the colon. The name of these bumps is diverticula. They are normally harmless. Diverticulitis is when they get inflamed and infected. If this happens, you most commonly could have pain in the bottom left side of your tummy that lasts for a few days. Or you may feel it more on the right side, particularly if you are of Asian descent. Other symptoms include a tender tummy, nausea, vomiting, constipation, and fever. Sometimes you also might have diarrhea.

Drug-Induced Enteritis and Colitis

Nonsteroidal anti-inflammatory drugs (NSAIDs) and immune-based treatments are often the cause of this. You can get ulcers in your gut from NSAIDs. Those medications can also make your small intestine narrower, which can lead to a blockage inside of it.

Infections

Infections, including bacteria like salmonella, can cause diarrhea, tummy pain, and other symptoms that look like from Crohn’s disease.

WebMD Medical Reference

Sources

SOURCES:

Crohn’s & Colitis Foundation: “Strictures,” “Intestinal ischemia,” “IBD Mimics: Most Common Conditions Misdiagnosed as IBD,” “Overview of Ulcerative Colitis,” “Signs and Symptoms of Crohn’s Disease,” “Overview of Crohn's Disease,” “Special IBD Diets.”

Mayo Clinic: “Diverticulitis,” “Solitary rectal ulcer syndrome,” “Common variable immunodeficiency,” “Sarcoidosis,” “Ischemic colitis,” “Behcet's disease,” “Vasculitis,” “Colon cancer,” “Celiac disease,” “Irritable bowel syndrome,” “Inflammatory bowel disease (IBD),” “Crohn's disease.”

American Cancer Society: “What Is Colorectal Cancer?”

MedlinePlus: “Common variable immune deficiency.”

Cleveland Clinic: “Food Problems: Is it an Allergy or Intolerance.”

Merck Manual Consumer Version: “Rectum and Anus.”

Celiac Disease Foundation: “Dermatitis Herpetiformis,” “What is Celiac Disease?”

Genetic and Rare Diseases Information Center: “Microscopic polyangiitis,” “Granulomatosis with polyangiitis,” “Eosinophilic granulomatosis with polyangiitis,” “ANCA-associated vasculitis.”

University of North Carolina Kidney Center: “IgA Vasculitis (Formerly Henoch-Schönlein Purpura or HSP).”

New York University Langone Health: “Your Gut Feeling: A Healthier Digestive System Means a Healthier You.”

International Foundation for Gastrointestinal Disorders: “Introduction to IBS.”

World Journal of Gastroenterology: “Segmental colitis associated diverticulosis syndrome.”

Cedars Sinai: “Is It IBS or IBD?”

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