There are two main types of Inflammatory Bowel Disease: Crohn's Disease and Ulcerative Colitis.
If you are living with IBD, like I did for 16 years, you are most likely dealing with one of these two. There are also two additional types worth knowing about, Indeterminate Colitis and Microscopic Colitis.
Each type affects the gut differently in terms of location, depth and pattern of inflammation, and knowing which one you are dealing with changes everything about how you manage it.
IBD refers to a group of chronic conditions where the immune system mistakenly attacks the digestive tract, causing ongoing inflammation and tissue damage.
Research suggests it involves a complex interaction between genetic susceptibility, environmental triggers and immune dysregulation.
Unlike IBS, IBD is a structural disease that shows up on colonoscopies, biopsies and blood tests. It can develop at any age but is most commonly diagnosed between the late teens and early 40s.
Your gut controls 70% of your immune system, 90% of your serotonin production, your energy levels and your mood. Understanding what type of IBD you are dealing with is the first step toward managing it.
This article breaks down each type, how they compare, and practical ways to support your gut naturally alongside medical care, including plant-based approaches like Cosmic Hue.
Types of Inflammatory Bowel Disease (IBD)
1. Crohn's Disease
Crohn's can affect any part of the digestive tract from the mouth to the anus, though it most commonly targets the end of the small intestine (ileum) and the beginning of the colon.
Research suggests that Crohn's is driven by a complex alteration of the inflammatory response, involving changes to innate immunity in the gut lining alongside immune cell migration to sites of inflammation.
The inflammation penetrates through all layers of the bowel wall, not just the surface lining, and it often appears in patches known as skip lesions, with diseased tissue followed by stretches of perfectly healthy tissue.
Common symptoms include abdominal pain, chronic diarrhoea, weight loss, fatigue and malnutrition.
I personally lived with Crohn's for 16 years. After a bowel perforation, emergency surgery and dropping to 5 stone, I rebuilt my health through plant medicine.
Today I am medication-free and symptom-free. Read my full story here.
2. Ulcerative Colitis
Ulcerative Colitis (UC) is strictly a disease of the colon (large intestine) and rectum. Research suggests that UC is triggered by a breakdown in the normal interaction among genetics, immunity, the microbiome and the environment.
Unlike the patchy pattern of Crohn's, inflammation in UC is continuous, always starting in the rectum and spreading upward. It affects only the innermost lining (mucosa) of the colon.
Common symptoms include bloody diarrhoea, urgency to have bowel movements, abdominal discomfort and rectal bleeding.
There are several subtypes of Ulcerative Colitis. Ulcerative proctitis is limited to the rectum. Proctosigmoiditis affects the rectum and sigmoid colon. Left-sided colitis extends up the left colon. Pancolitis involves the entire colon.
3. Indeterminate Colitis
Sometimes the gut shows signs of both Crohn's and UC at the same time, and doctors cannot tell which one it is. This happens in roughly 10 to 15% of colon-related IBD cases.
When a colonoscopy or biopsy does not give a clear answer, the diagnosis is labelled as Indeterminate Colitis. As the disease develops over time, it often becomes easier for doctors to identify whether it is Crohn's or UC.
4. Microscopic Colitis
With microscopic colitis, the colon appears completely normal during a standard colonoscopy. Inflammation is only visible under a microscope when a biopsy sample is examined. Research suggests it involves an inappropriate immune response in the gut, with a possible genetic basis.
It typically causes frequent, watery diarrhoea.
Two subtypes exist, collagenous colitis, where a thick layer of collagen develops in the tissue, and lymphocytic colitis, where increased white blood cells accumulate in the colon lining.
Key Differences of IBD Types
| Feature | Crohn's | UC | Indeterminate | Microscopic |
| Location | Mouth to anus | Colon and rectum | Colon | Colon |
| Pattern | Patchy | Continuous | Overlapping | Invisible to eye |
| Depth | All layers | Inner lining | Varies | Inner lining |
| Key symptom | Pain, weight loss | Bloody diarrhoea | Varies | Watery diarrhoea |
How to Support Your Gut Naturally
IBD management is highly personal and typically involves medication, dietary adjustments and lifestyle changes. Natural support can complement medical treatment, not replace it.
Research suggests that the gut-brain connection plays a significant role in IBD, with psychological stress potentially influencing disease activity and flare frequency.
Nutrition and Diet
Keeping a food diary to track personal triggers is one of the most practical first steps, as IBD triggers vary significantly from person to person.
Smaller, more frequent meals can reduce the burden on an inflamed digestive system.
Adequate hydration supports digestion and is especially important during flare-ups when the body loses fluids.
A FODMAP diet approach may help some IBD patients identify specific food triggers, though it should be guided by a dietitian.
Stress, Exercise, and Sleep
Stress hormones directly affect gut motility, inflammation and sensitivity through the vagus nerve. Managing stress is essential for IBD because it is part of the treatment.
Breathing exercises and stress reduction strategies that activate the parasympathetic nervous system can directly calm gut activity.
Regular moderate exercise such as walking, yoga or swimming supports gut motility and reduces the stress response.
Consistent sleep patterns help your gut follow its natural circadian rhythm, supporting more predictable digestion.
Additional Targeted Support
For thousands of years, cultures worldwide have used plants and herbs to support digestive health.
Research suggests that certain botanical compounds may offer anti-inflammatory, antioxidant and gut-soothing properties that can complement conventional IBD treatment.
Studies suggest that marshmallow root contains mucilage compounds that may help coat and soothe the digestive lining, while ashwagandha may help reduce cortisol and support the body's stress response, which is relevant given the role of stress in IBD flare-ups.
Other plants with traditionally recognised gut-supporting properties include cat's claw, astragalus, echinacea, stinging nettle and fennel.
This is exactly why I formulated Cosmic Hue.
After years of studying and experimenting with over 30 plants during my own recovery from Crohn's, I created a 7-plant blend that brings marshmallow root, ashwagandha, cat's claw, fennel and more into one daily cup designed to work alongside your existing routine and medical care.
Thousands of customers living with Crohn's, UC and other gut conditions have shared positive experiences. You can read their stories here.
Frequently Asked Questions
What does IBD pain feel like?
IBD pain varies by type and severity. Crohn's often presents as deep abdominal cramping, while UC is more commonly felt as urgency and discomfort in the lower left abdomen. Flare-ups can range from a dull persistent ache to sharp pain that comes and goes.
How do you know if you have IBD or IBS?
IBD involves visible structural inflammation and damage that shows up on colonoscopies, biopsies and scans. IBS is a functional disorder with no visible inflammation.
A gastroenterologist can distinguish between the two through testing, so if you are experiencing persistent symptoms, seeking a proper diagnosis is essential.
Conclusion
There are four recognised types of IBD: Crohn's Disease, Ulcerative Colitis, Indeterminate Colitis and Microscopic Colitis. Each affects the gut differently in terms of location, depth and pattern of inflammation.
Understanding your specific type empowers better conversations with your healthcare team and more informed decisions about your care.
I know from personal experience that the right knowledge paired with the right support can change everything. Tracking food triggers, managing stress, staying active and incorporating plant-based remedies can all contribute to a stronger foundation alongside your medical treatment.
Cosmic Hue brings seven gut-supporting plants into one daily cup. I created it from my own recovery and it is now part of the daily routine for thousands of people.
If you are looking for a simple, natural way to support your gut, start your journey here.
Author: I'm Manny, the founder of Fifth Ray and a certified Gut Health Coach. After battling Crohn's Disease for 16 years, I transformed my gut health through plant-based healing. My story has been featured on BBC, ITV, and Daily Mail.
Disclaimer: This information is for education only. Cosmic Hue is not intended to diagnose, treat, cure, or prevent any disease. Always speak to your healthcare provider before changing your routine.
References
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