Differential Diagnosis for Crohn's Disease
The following differential diagnoses are organized into categories to help guide the diagnostic process.
Single Most Likely Diagnosis
- Ulcerative Colitis: This is the most likely diagnosis to consider alongside Crohn's disease, as both are forms of Inflammatory Bowel Disease (IBD) with similar symptoms, including chronic diarrhea, abdominal pain, and weight loss. The distinction between the two often relies on the extent and location of inflammation, as well as the presence of complications.
Other Likely Diagnoses
- Irritable Bowel Syndrome (IBS): Although IBS is a functional disorder without inflammation, its symptoms can overlap with those of Crohn's, including abdominal pain and changes in bowel habits. However, IBS typically does not cause weight loss, fever, or bloody stools.
- Infectious Colitis: Bacterial, viral, or parasitic infections can cause colitis that mimics Crohn's disease, with symptoms such as diarrhea, abdominal pain, and fever. Identifying the infectious agent is crucial for appropriate treatment.
- Diverticulitis: This condition involves inflammation of the diverticula in the wall of the colon and can present with abdominal pain, changes in bowel habits, and fever, similar to Crohn's disease.
Do Not Miss Diagnoses
- Intestinal Ischemia: This condition, which involves insufficient blood flow to the intestines, can present with severe abdominal pain and bloody stools, similar to a flare of Crohn's disease. Missing this diagnosis can lead to bowel infarction and death.
- Colon Cancer: Although less common in young patients, colon cancer can cause symptoms similar to Crohn's disease, including changes in bowel habits, abdominal pain, and weight loss. It is particularly important to consider in patients with a family history or other risk factors.
- Appendicitis: Acute appendicitis can present with abdominal pain and fever, similar to Crohn's disease, especially if the appendix is located near the cecum. Delayed diagnosis can lead to perforation and peritonitis.
Rare Diagnoses
- Eosinophilic Gastroenteritis: A rare condition characterized by eosinophilic infiltration of the gastrointestinal tract, which can cause abdominal pain, diarrhea, and weight loss, similar to Crohn's disease.
- Behçet's Disease: A form of vasculitis that can affect the gastrointestinal tract, causing symptoms such as abdominal pain, diarrhea, and bleeding, which can be mistaken for Crohn's disease.
- Chronic Intestinal Pseudo-obstruction: A rare disorder characterized by impairment of the muscle contractions that move food, fluid, and air through the intestines, leading to symptoms such as abdominal pain, nausea, vomiting, and changes in bowel habits.