What is the Difference Between Ulcerative Colitis and Lymphocytic Colitis

Ulcerative colitis and lymphocytic colitis are both types of inflammatory bowel diseases that cause inflammation in the large intestine or colon. People with inflammatory bowel diseases (IBD) have chronic intestinal inflammation. IBD is an autoimmune condition that can run in families, but it can also develop randomly without a family history.

The key difference ulcerative colitis and lymphocytic colitis is their visibility under a microscope. Ulcerative colitis causes inflammation in the colon’s inner lining that can be observed under colonoscopy while lymphocytic colitis causes inflammation in the colon’s inner lining that can only be observed under a microscope.

CONTENTS

1. Overview and Key Difference
2. What is Ulcerative Colitis 
3. What is Lymphocytic Colitis
4. Similarities – Ulcerative Colitis and Lymphocytic Colitis
5. Ulcerative Colitis vs Lymphocytic Colitis in Tabular Form
6. FAQ – Ulcerative Colitis and Lymphocytic Colitis
7. Summary – Ulcerative Colitis vs Lymphocytic Colitis

What is Ulcerative Colitis?

Ulcerative colitis is a long-term inflammatory bowel disease where the colon and rectum become inflamed. The symptoms of ulcerative colitis include recurring diarrhea, stomach pain, needing to defecate frequently, arthritis, mouth ulcers, swollen fat under the skin causing bumps and patches, irritated and red eyes, and problems with bones. Ulcerative colitis is an autoimmune condition.

Figure 01: Ulcerative Colitis

A diagnosis of ulcerative colitis can be done by physical symptoms evaluation, blood test, stool studies, and colonoscopy. Furthermore, ulcerative colitis is treated through medications such as amino salicylates (ASAs), corticosteroids and immunosuppressants, and surgery (remove some or all of the bowel).

What is Lymphocytic Colitis?

Lymphocytic colitis is a type of microscopic colitis. This type of colitis is only detectable under a microscope. In lymphocytic colitis, there is an abnormally high density of lymphocytes in the intestinal lining. This condition is very rare and more commonly seen in older adults. The symptoms of lymphocytic colitis may include watery diarrhoea, abdominal pain, fatigue, and weight loss.

Figure 02: Lymphocytic Colitis

Lymphocytic colitis can be diagnosed through physical symptoms evaluation, biopsy, and microscopy. Furthermore, treatment options for lymphocytic colitis include antidiarrheal medications such as Loperamide, budesonide, cholestyramine, bismuth subsalicylate, and diet changes.

Similarities Between Ulcerative Colitis and Lymphocytic Colitis

1. Ulcerative colitis and lymphocytic colitis are two inflammatory bowel diseases (IBD).
2. Both are autoimmune conditions that affect the large intestine.
3. They are characterized by diarrhoea and weight loss.
4. Both conditions can be diagnosed through physical symptoms evaluation.
5. They can be treated through antidiarrheal medications.

Difference Between Ulcerative Colitis and Lymphocytic Colitis

Definition

1. Ulcerative colitis is a common inflammatory bowel disease that often starts in early adulthood.
2. Lymphocytic colitis is a rare inflammatory bowel disease that often starts in older adulthood.

Symptoms

1. Symptoms of ulcerative colitis include watery diarrhoea, bloody diarrhoea with mucus, abdominal pain, weight loss, fatigue, mouth ulcers, fever, joint pain, and anemia.
2. Symptoms of lymphocytic colitis include watery diarrhoea, abdominal pain, weight loss, and fatigue.

Diagnosis

1. Ulcerative colitis is diagnosed by physical symptoms evaluation, blood test, stool test, and colonoscopy.
2. Lymphocytic colitis is diagnosed by physical symptoms evaluation and microscopy.

Treatment

1. Ulcerative colitis can be treated by antidiarrheal medications and surgery.
2. Lymphocytic colitis can be treated by antidiarrheal medications and diet changes.

This table summarizes the difference between ulcerative colitis and lymphocytic colitis.

Summary – Ulcerative Colitis vs Lymphocytic Colitis

Ulcerative colitis and lymphocytic colitis are two inflammatory bowel diseases. Ulcerative colitis is very common and often seen in early adulthood while lymphocytic colitis is very rare and often seen in older adulthood. Moreover, the inflammation caused by ulcerative colitis can be detected through colonoscopy whereas the inflammation caused by lymphocytic colitis can only be detected through microscopy. This is the summary of the difference between ulcerative colitis and lymphocytic colitis.

FAQ: Ulcerative Colitis and Lymphocytic Colitis

1. What is a common finding of ulcerative colitis?

• Symptoms of ulcerative colitis are urgency, incontinence, fatigue, weight loss, increased frequency of bowel movements, mucus discharge, nocturnal defecations, abdominal discomfort (cramps), bloody diarrhoea, mouth ulcers, joint pain, and anemia.

2. What are the diagnostic markers for ulcerative colitis?

• Perinuclear ANCA (pANCA) found on the inside of the nuclear membrane is good marker that indicates the presence of ulcerative colitis. Positive pANCA and negative ASCA (anti-saccharomyces cerevisiae antibodies) findings suggest ulcerative colitis while negative pANCA and positive ASCA suggest the presence of Crohn disease which is an another IBD.

3. How is ulcerative colitis diagnosed?

• Doctors order endoscopy of the large intestine (colonoscopy) with biopsies to diagnose ulcerative colitis and rule out other digestive diseases. They do blood tests and stool tests as well.

4. What foods are bad for lymphocytic colitis?

• Fatty foods, stimulants like alcohol, coffee, carbonated drinks, and gas-producing foods such as beans, onions, carrots, raisins, bananas, apricots, prunes, cabbage, water spinach, watercress, and milk should be avoided in lymphocytic colitis.

5. What is the first-line treatment for lymphocytic colitis?

• The first line treatments include antidiarrheal medications like Loperamide or diphenoxylate, bismuth subsalicylate, corticosteroids like budesonide and bile acid sequestrants like colesevelam and colestipol.

Reference:

1.“Ulcerative Colitis.” Mayo Clinic, Mayo Foundation for Medical Education and Research.
2. “Lymphocytic Colitis: Symptoms & Treatment Options.” Cleveland Clinic.

Image Courtesy:

1. “Ulcerative colitis” By Samir at English Wikipedia (CC BY-SA 3.0) via Commons Wikimedia
2. “Lymphocytic colitis – CD3, intermed. mag” By CoRus13 – Own work (CC BY-SA 4.0) via Commons Wikimedia

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