Crohn’s disease and ulcerative colitis are two types of inflammatory bowel disease that can cause similar symptoms. While there have been older reports of people with both, the overwhelming majority of people have either one or the other.

Inflammatory bowel disease (IBD) refers to conditions that cause chronic inflammation in the digestive tract. Researchers estimate about 1% of people in the United States have IBD.

The main types of IBD are Crohn’s disease and ulcerative colitis (UC). While Crohn’s can affect any part of the digestive tract, UC only occurs in the large intestine.

You may be wondering whether it’s possible to have Crohn’s and UC at the same time. While this has been reported in very rare cases, most people only have either Crohn’s or UC, not both.

Additionally, a doctor may make a diagnosis of indeterminate colitis, which simply means the type of IBD you have is not clear.

Older reports have detailed situations where people have had coexisting Crohn’s and UC, but it’s generally not possible to have them at the same time. Most people receiving an IBD diagnosis have either Crohn’s or UC.

UC only affects the colon and rectum, which are parts of the large intestine. Crohn’s can occur anywhere along the digestive tract, from the mouth to the anus. However, some features of these diseases can make it seem like you have both.

In most people with Crohn’s, it affects both the small and large intestines. Despite the involvement of the colon, it doesn’t mean you have both Crohn’s and UC.

Further, about 20% of people with Crohn’s have disease that only affects their colon. This is called colitis and isn’t UC.

Generally speaking, Crohn’s and UC cause specific tissue changes in the digestive tract. A doctor can look at these under a microscope after collecting a biopsy sample, which can help them make a diagnosis of either Crohn’s or UC.

However, in some situations, a doctor may have difficulty distinguishing between the two. In this case, a diagnosis of indeterminate colitis (IC) may be made. Researchers estimate that 5% to 15% of IBD diagnoses are IC.

IC isn’t the same as having both Crohn’s and UC. It simply means a doctor cannot make a clear distinction between them at the time. Some people with an initial diagnosis of IC eventually receive a diagnosis of either Crohn’s or UC.

Crohn’s and UC share several symptoms. These include:

Additional symptoms of Crohn’s can include:

Further symptoms of UC include:

  • feeling an urgent need to have a bowel movement
  • tenesmus, which is when you feel like you need to have a bowel movement despite the fact that your bowels are empty

IBD can also cause a variety of problems outside of the digestive tract. These are called extraintestinal symptoms and can include things like:

Crohn’s is generally more severe and is associated with higher morbidity and mortality. Some research also suggests people with Crohn’s have a lower quality of life than those with UC.

However, both types of IBD can cause severe and potentially life threatening complications. These can include things like:

According to a 2023 review of research, people with a history of IBD also have an estimated two- to threefold increased risk of developing colorectal cancer.

Further, IBD increases the risk of several other health conditions, like:

  • heart disease
  • liver disease
  • arthritis

It’s important to talk with a doctor if you have:

  • frequent and severe abdominal pain
  • blood in your stool
  • persistent diarrhea
  • unexplained weight loss
  • fever that occurs with any of the symptoms above

It’s possible that something other than IBD is causing these symptoms. A doctor can order tests to find out what’s behind your symptoms and develop a treatment plan.

After performing a physical exam and getting your medical history, a doctor can order the following tests to help diagnose IBD:

Medications or surgery typically treat IBD. Since there’s no cure for IBD, the goal is to manage symptoms, reduce the likelihood of flare-ups, and prevent complications.

Medications used for IBD can include:

Surgery may be recommended for severe IBD or for IBD that’s causing frequent or serious complications.

The effects of IBD can also affect appetite and nutrient intake. As such, doctors may suggest that you work with a dietitian or nutritionist to ensure that you’re getting appropriate nutrition.

While there have been older reports of people with both Crohn’s and UC, it’s generally not possible to have both of these conditions. Most people receive a diagnosis of one or the other.

In some scenarios, a doctor may not be able to readily differentiate which IBD you have. In this situation, you’ll receive a diagnosis of indeterminate colitis (IC). However, IC is not the same thing as having both Crohn’s and UC.

Crohn’s and UC can cause potentially serious complications and impair quality of life. Be sure to visit a doctor if you have symptoms like persistent diarrhea, blood in your stool, or recurring abdominal pain.