Difference 6: Treatment Response – The Path to Remission
Finally, the response to treatment differs between UC and CD, reflecting their unique pathologies. The mainstay of treatment for both conditions is medication to reduce inflammation and induce remission, followed by maintenance therapy to prevent relapse. However, the choice of medication and the response to treatment can vary between the two.
In UC, treatment often begins with aminosalicylates, a group of anti-inflammatory drugs that are particularly effective for colonic disease. Steroids may be used for acute flare-ups, and immunosuppressive drugs may be added for patients who don’t respond to first-line treatment. A unique aspect of UC treatment is the use of topical therapy, where medication is delivered directly to the colon through enemas or suppositories. This form of treatment takes advantage of the fact that UC is a mucosal disease confined to the colon.
In contrast, the treatment of CD often requires more potent immunosuppressive drugs or biologic agents, especially in patients with transmural or extensive disease. The patchy nature of CD also means that some patients may not respond to topical therapies as well as those with UC. Additionally, the presence of complications like strictures or fistulas in CD often necessitates surgical intervention, which is less commonly required in UC.(6)
