Colitis Causes, Types, Treatment, Symptoms & Diet

Facts About and Definition of Colitis

What Is Colitis?

Colitis is an inflammation of the colon, also known as the large intestine. While there are many causes of colitis including infections, poor blood supply (ischemia), and autoimmune reactions, they share common symptoms of abdominal pain and diarrhea.

What Are the Symptoms of Colitis?

Symptoms of colitis will depend upon the type of colitis a person has, but in general, colitis most often is associated with abdominal pain and diarrhea.

Other symptoms of colitis that may or may not be present include

What Are the Types of Colitis?

There are many types of colitis. The most common include:

6 Common Causes of Colitis

Inflammation of the colon can be caused by a variety of illnesses and infections. Some of the most common causes are discussed in the next few sections.

What Causes IBD, Microscopic, and Chemical Colitis?

There are two types of inflammatory bowel disease; 1) ulcerative colitis, and 2) Crohn's disease.

When to Seek Medical Care for Colitis

Diarrhea is a common symptom of colitis, and most episodes resolve in a matter of hours.

Medical care should be accessed if any of the following conditions exist:

Which Type of Doctor Treats Colitis?

Gastroenterologists are the medical specialists that treat diseases of the gastrointestinal organs such as colitis. In some cases colitis may be managed by primary care specialists or internal medicine specialists. Depending on the type of colitis, other specialists may be involved in the treatment, including infectious disease specialists or surgeons. Pediatricians or pediatric gastroenterologists are involved in the care of infants, children, and teens with colitis.

What Questions Will the Doctor Ask Me about My Colitis?

The health-care professional will perform a physical examination on the patient by taking vital signs, and focusing on the abdomen feeling for areas of tenderness, for masses, or abnormally enlarged organs.

The health-care professional also will take a past medical history to assess the risk factors for peripheral vascular disease (narrowing of the arteries), for example, smoking, high blood pressure, high cholesterol, and diabetes. These risk factors are important in exploring ischemic bowel as the cause for colitis.

The health-care professional may ask the patient the following questions:

What Exams and Tests Diagnose Colitis?

While unpleasant, the rectal examination is very important. Using a finger, the doctor feels inside the rectum, exploring for any masses or tumors. The color and consistency of stool can be evaluated, and if it is not grossly bloody, can be tested for occult blood (blood that is present but cannot be seen with the naked eye).

The history will assist the health-care professional decide the tests to order and what cultures would be appropriate. Blood tests help assess the stability of the patient, and also explore any potential issues associated with colitis.

If a specific cause of colitis is not readily apparent, then colonoscopy may be considered. A gastroenterologist will insert a long flexible fiberoptic camera into the anus and examine the full length of the colon. The appearance of the colon by itself may be enough to make the diagnosis. Biopsies (small pieces of tissue) may be taken from the lining of the colon and examined by a pathologist (a medical doctor specializing in the diagnosis of tissues) to help confirm the diagnosis. Microscopic colitis (lymphocytic and collagenous) can only be diagnosed with biopsy of the affected area.

Colonoscopy is an essential cancer screening test and is especially important for those patients who have had blood in their stool that cannot be explained by another diagnosis.

Computerized tomography (CT) may be used to image the colon and the rest of the abdomen. Different types of colitis have distinctive patterns that may help a radiologist recognize a specific diagnosis. A CT scan may be ordered urgently if the history and physical examination performed by the health-care professional leads to concern that an urgent or emergent problem exists that might require surgery. On occasion, a barium enema or other imaging tests such as ultrasound may be used to evaluate the anatomy of the colon and assist in diagnosis.

What Is the Treatment for Colitis?

The definitive treatment of colitis depends upon the cause. Many cases require little more than symptomatic care, including clear fluids to rest the bowel and medications to control pain. Some patients become acutely ill and will need intravenous (IV) fluids and other interventions to treat their illness.

Can Surgery Cure Colitis?

What Follow-Up Care Is Necessary After Being Diagnosed With Colitis?

Can Colitis Be Prevented?

Infectious colitis remains a common illness worldwide, affecting millions daily. The lack of clean drinking water and adequate sanitation are the main causes, leading to thousands of potentially preventable deaths each day. In developed countries, poor hand washing and poor kitchen hygiene allow the potential for infectious colitis. Prevention lies in cleanliness.

Inflammatory bowel diseases are difficult to prevent at the present time. The likely causes are heredity and perhaps an abnormal auto-immune response to an unknown stimulus in the body.

Since ischemic colitis is caused by narrowing of the blood vessels to the bowel, decreasing the risks for other types of circulatory problems such as peripheral vascular disease, heart attack, and stroke will also decrease the risk for ischemic colitis. The common risk factors are smoking and poor control of high blood pressure, high cholesterol levels, and diabetes.

What Is the Outlook for a Person With Colitis?

Understanding the cause of a specific colitis has allowed more targeted therapy. For example, observation has replaced surgery to remove the colon as standard therapy for some people with ulcerative colitis, and limiting the use of antibiotics has decreased the number of resistant bacteria that can cause infectious diarrhea. Worldwide, initiatives to increase access to clean water and adequate hygiene are perhaps the most important way to save lives.

Reviewed on 1/14/2019

REFERENCES:

Peppercorn, M. A. MD, et al. Clinical manifestations, diagnosis, and prognosis of ulcerative colitis in adults." UpToDate. Updated: Aug, 21, 2017.<http://www.uptodate.com/contents/clinical-manifestations-diagnosis-and-prognosis-of-ulcerative-colitis-in-adults>

Kasper, D., et al. "Harrison's Principles of Internal Medicine. McGraw-Hill Education/Medical. 19th edition. 2015

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