Crohn’s Colitis (Granulomatous Colitis)
Digestive HealthCrohn's Disease

What Is Crohn’s Colitis?

What Is Crohn’s Colitis?
Everyday Health
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Published on October 23, 2025
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Crohn’s disease is a chronic inflammatory condition that can damage any part of the gastrointestinal tract, from the mouth to the anus.

 But a subtype called Crohn’s colitis, sometimes called granulomatous colitis or colonic Crohn’s, only affects the large intestine (colon).

This type of Crohn’s may sound similar to ulcerative colitis, another inflammatory disease that only impacts the large intestine, but they have distinct differences.

 Below, learn the basics about Crohn’s colitis, plus how to tell the difference between this condition and other types of inflammatory bowel disease.

What Is Crohn’s Colitis?

As mentioned, Crohn’s colitis is a subtype of Crohn’s disease that only affects the colon. “We typically label Crohn’s based on what part of the gastrointestinal tract it affects,” says Sara Kamionkowski, DO, a gastroenterologist at MetroHealth in Cleveland Heights, Ohio.

“‘Colitis’ means inflammation in the colon; thus Crohn’s colitis is inflammation involving any part or all of the colon,” she says.

Common symptoms of Crohn’s colitis, which overlap with those of other forms of the illness, include:

Skin and joint symptoms happen more often with this type of Crohn’s than with any other form of the disease.

How Does Crohn’s Colitis Differ From Other Types of Crohn’s Disease?

In Crohn’s disease, the immune system reacts abnormally, which causes inflammation in the gastrointestinal (GI) tract.

 “Depending on the location of disease, symptoms will vary,” says James Cox, MD, a gastroenterologist and assistant professor and director of communication skill development in the department of physician communication at the Burnett School of Medicine at Texas Christian University in Fort Worth, Texas.
Besides Crohn’s colitis, other types of the disease include:

  • Ileocolitis affects the end of the small intestine, as well as the large intestine, causing diarrhea, cramping, abdominal pain, and weight loss; it’s the most common form of the illness.
  • Ileitis affects a part of the small intestine called the ileum, causing similar symptoms to ileocolitis.
  • Gastroduodenal Crohn’s disease affects the stomach and first part of the small intestine (duodenum), causing nausea, vomiting, poor appetite, and weight loss.
  • Jejunoileitis affects the middle third of the small intestine (jejunum), causing diarrhea, fistulas (tunnels from the intestine to the skin), and abdominal pain after meals.

Crohn’s colitis is often diagnosed later in life, compared with other Crohn’s disease subtypes, which are often diagnosed between ages 15 to 35, says Jamil Alexis, MD, a gastroenterologist at Stamford Health in Connecticut. Crohn’s colitis is also more common in women, he says.

How Does Crohn’s Colitis Differ From Ulcerative Colitis?

Colon inflammation from Crohn’s colitis looks different than ulcerative colitis (UC).

 The two differ in several ways, including their inflammation patterns and which layers of the bowel wall are affected, says Dr. Alexis. There are also differences in what’s found during an endoscopy, in which your GI tract is visually inspected, as well as in what tissue samples show, he says.
Our intestines have a number of layers of tissue that can be affected by inflammation. Ulcerative colitis usually only involves inflammation of the innermost lining of the colon, while Crohn’s colitis typically involves its entire thickness, from the inner lining to the outer wall, says Dr. Kamionkowski.

 “It can even involve inflammation in some of the structures just outside the intestines.”
These two conditions also differ in how inflammation appears on the colon wall. “Inflammation from Crohn’s can skip areas of the intestine or appear patchy,” says Kamionkowski. “UC only involves inflammation in the colon, and that inflammation is continuous and will not skip areas.”

People with Crohn’s colitis may also develop tunnels from the intestines to the anal area (fistulas) and painful collections of pus (abscesses) around the anus, which don’t occur as often with UC, says Kamionkowski.

 “Despite these differences, sometimes it can be challenging to differentiate between Crohn’s and UC, as the symptoms often overlap.”

Treatment Differences Between Crohn’s Types

Crohn’s disease has no cure, so its treatment focuses on treating inflammation and managing symptoms. Depending on your symptoms, your provider may recommend anti-inflammatory medications or ones that calm your immune system.

 Sometimes, antidiarrheal medications are also used, or treatments for the pain you may experience with Crohn’s.
Be sure to clear the use of antidiarrheals with your doctor first — they may be ineffective or even harmful if you have strictures (a narrowing of part of the intestine) or certain infections.

“The medications used to treat the different areas of Crohn’s involvement can vary but are usually more or less the same,” says Dr. Cox. “[For example,] the use of enemas or suppositories can specifically treat the [end] part of the colon and rectum.”

If your medication regimen for Crohn’s colitis isn’t working, discuss your options with your doctor. There are a number of options for Crohn’s that you may be able to try.

The Takeaway

  • Crohn’s colitis is a type of Crohn’s disease that only affects the large intestine, or colon.
  • Common symptoms of Crohn’s colitis include diarrhea, rectal bleeding, skin lesions, joint pain, fatigue, abdominal pain, and anal abscesses, fistulas, or ulcers.
  • Although Crohn’s colitis affects the colon, it differs from ulcerative colitis in terms of which intestinal layers are involved and the amount of intestinal lining affected.

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Waseem Ahmed, MD

Medical Reviewer

Waseem Ahmed, MD, is an assistant professor of medicine in the Karsh Division of Gastroenterology and Hepatology at Cedars-Sinai Medical Center in Los Angeles and serves as Director, Advanced Inflammatory Bowel Disease Fellowship and Education within the F. Widjaja Inflammatory Bowel Disease Institute.

He received his undergraduate degree from the University of Michigan and attended medical school at Indiana University. He then completed an internal medicine residency at New York University, followed by a fellowship in gastroenterology and hepatology at Indiana University, and an advanced fellowship in inflammatory bowel disease at the Jill Roberts Center for Inflammatory Bowel Disease at New York-Presbyterian Hospital/Weill Cornell Medicine. Prior to his current role, Dr. Ahmed served as an assistant professor of medicine within the Crohn’s and Colitis Center at the University of Colorado from 2021-2024.

Dr. Ahmed is passionate about providing innovative, comprehensive, and compassionate care for all patients with inflammatory bowel disease (IBD). His research interests include IBD medical education for patients, providers, and trainees; clinical trials; acute severe ulcerative colitis; and the use of combined advanced targeted therapy in high-risk IBD.

He enjoys spending time with his wife and dog, is an avid follower of professional tennis, and enjoys fine dining.

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Abby McCoy, RN

Author

Abby McCoy is an experienced registered nurse who has worked with adults and pediatric patients encompassing trauma, orthopedics, home care, transplant, and case management. She is a married mother of four and loves the circus — that is her home! She has family all over the world, and loves to travel as much as possible.

McCoy has written for publications like Remedy Health Media, Sleepopolis, and Expectful. She is passionate about health education and loves using her experience and knowledge in her writing.

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Resources
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