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What is Colitis?

Colitis is a digestive condition characterized by the inflammation of the inner lining of the large intestine (colon) which can cause abdominal pain, bloating and diarrhea. It may also be associated with inflammation of the small intestine (enteritis) or inflammation of the rectum (proctitis).

Causes of Colitis

Causes of colitis include:

  • Infection due to viruses or parasites
  • Food poisoning associated with bacteria
  • Allergic reaction
  • Ischemia (poor blood supply)
  • Autoimmune disorder
  • Conditions such as Crohn’s disease and ulcerative colitis which have unknown causes
  • Radiation
  • Medications 

Types of Colitis

Based on the causes, types of colitis include:

  • Crohn’s colitis: Crohn’s disease can cause inflammation anywhere in the gastrointestinal tract including the colon.
  • Ulcerative colitis: Inflammation of the colon with the formation of ulcers is typical of this type of colitis.
  • Fulminant colitis: This is a rare serious form of ulcerative colitis characterized by bloody diarrhea and abdominal pain requiring emergency care.
  • Ischemic colitis: This refers to the inflammation of the colon due to restricted blood flow.
  • Infectious colitis: This type is inflammation of the colon due to infection from viruses. bacteria or parasites.
  • Microscopic colitis: This condition is due to increased collagen or lymphocytes in the colon lining and may be identified by examining a tissue sample under the microscope.
  • Diversion colitis: This type of colitis involves inflammation of the mucosal lining of the colon following surgery to divert fecal matter away from the colon.
  • Chemical colitis: In this condition, inflammation is caused due to the interaction with chemicals.

Symptoms of Colitis

Symptoms of colitis vary based on the site of inflammation and severity. They include:

  • Abdominal pain and cramps
  • Bloodstained stool
  • Dehydration
  • Fever
  • Diarrhea
  • Increased bowel movement
  • Fatigue 
  • Low appetite
  • Erythema
  • Mucous and pus in the stool
  • Rectal bleeding
  • Anemia
  • Joint pain

Diagnosis of Colitis

Your doctor will review your symptoms and medical history and may perform the following diagnostic tests:

  • Blood test:  In this test, complete blood count is evaluated which determines the level of RBCs, WBCs and platelets. Increases in levels could indicate bleeding, infection and inflammation in the colon. The levels of ESR and C-reactive protein also determine inflammation.
  • Stool examination: The stool is examined for blood. Stool culturing is done to identify the presence of bacterial or parasitic infection.
  • Imaging test: CT and MRI scans can produce clear images of the rectum and colon.
  • Colonoscopy: A thin flexible light tube with a camera attached to its end will be inserted inside your intestine to view inflammation in your colon and a biopsy (sample of tissue) may be taken for further examination.
  • Sigmoidoscopy: A slender light tube with a light and camera at one end is inserted into the last portion of the colon to examine the sigmoid and the rectum.
  • Barium enema X-ray: This test involves injecting liquid barium into the colon through the rectum to help visualize the inflamed colon better.

Treatment for Colitis

Treatment for colitis is mainly based on its cause and includes:

  • Medications: This is used for different causes:
    • Antibiotics: Helps treat bacterial infections
    • Anti-inflammatory drugs: Reduces the pain and inflammation
    • Over the counter medications:  To treat diarrhea
    • Immunomodulatory drugs: These drugs suppress your immune system and prevent inflammation 
  • Nutrition: You are instructed to consume nutritious foods and liquids to prevent malnutrition which may be caused by diarrhea.
  • Surgery: If medications are found to be ineffective, surgery may be recommended to remove the entire colon or part of it (colectomy).

Prevention from Colitis

Colitis can be prevented by avoiding conditions that trigger symptoms. Some preventive measures include:

  • Avoiding alcohol consumption
  • Maintaining proper hygiene
  • Regular exercise
  • Reducing caffeine intake
  • Avoiding consumption of dairy products if you are lactose intolerant
  • Maintaining a healthy diet
  • Drinking plenty of water
  • Reducing fiber intake
  • American Board of Internal Medicine
  • American Medical Association
  • American College of Gastroenterology
  • Texas Medical Association
  • Memorial Hermann Foundation
  • HCA Healthcare
  • Methodist Church
  • Howard University College of Medicine
  • American Society for Gastrointestinal Endoscopy
  • UT Health San Antonio