Colitis is an inflammation of the large intestine that can be caused by many different disease processes. These processes include acute and chronic infections, inflammatory disorders (ulcerative colitis, Crohn's colitis, lymphocytic and collagenous colitis), lack of blood flow (ischemic colitis), and history of radiation to the large bowel.

Symptoms can include abdominal pain, diarrhea, dehydration, abdominal bloating, increased intestinal gas, and bloody stools.

Exams and Tests

Colitis may be identified by flexible sigmoidoscopy or colonoscopy -- in both of these tests, a flexible tube is inserted in the rectum, and specific areas of the colon are evaluated. Biopsies taken during these tests may show changes related to inflammation.

Other studies that can identify colitis include:

Barium enema
Abdominal CT scan
Abdominal MRI
Abdominal x-ray

Treatment is directed at the underlying cause of disease, whether it be infection, inflammation, lack of blood flow, or another cause.

This is a chronic digestive disease characterized by inflammation and ulceration of the intestines. The many forms of colitis include Crohn’s disease, ulcerative colitis, spastic colitis, and pseudomembranous colitis.

Causes

The causes for the main types of colitis are not yet known, although infections, gender, age, and heredity may play significant roles. Pseudomembranous colitis, a subtype of colitis, occurs as a reaction to antibiotic use which led to an imbalance in normal intestinal flora.

Symptoms

Although there are some symptoms which are specific to a particular type of colitis, there are symptoms which can be found in all. These are:

Pain
Tenderness in the abdomen
Rectal bleeding
Blood and mucus in the stool
Weight loss and anorexia
Fatigue
Changes in bowel habits
Joint pains
Presence of ulcers and inflammation in the colon upon visualization

Diagnosis

The most commonly-used diagnostic procedures for colitis are sigmoidoscopy and colonoscopy, which utilizes a long, flexible tube with a light and a camera attached to the terminal end to enable a visualization of the inside of the colon. This will reveal the presence of inflammation, ulceration, perforations, as well as the extent of intestinal damage.

X-rays and CT scans are also helpful in giving a visual image of thickened mucosal lining and strictures which are present in colitis. Stool cultures will reveal the presence of bacteria, mucus, pus and blood while blood tests will often show elevated WBC levels, elevated erythrocyte sedimentation rates, and low albumin levels. An elevated ESR is often indicative of acute exacerbated colitis.

Treatment

Treatment of colitis involves the administration of antibiotics to treat and prevent infection as well as anti-inflammatory to reduce inflammation. Steroids like prednisone and hydrocortisone, which also have anti-inflammatory effects, are also given especially when anti-inflammatory are not sufficient. However, patients taking these drugs need to be monitored for side effects like nausea, vomiting and increased susceptibility to infection.

In severe cases where complications, like perforations, excessive bleeding or toxic megacolon has occurred, surgery to remove the infected portions is often done. Surgery is also the last resort for patients who do not respond to drug therapy.

A colectomy or the removal of the entire colon is often effective in totally curing the patient. The procedure to remove the colon and the rectum, called a proctolectomy, is often followed by an ileoanal anastomosis (a small pouch is created by attaching the end of the small intestine called the ileum to the inside of the rectum and anus) or an ileostomy( creation of a small hole in the surface of the abdomen where the ileum is attached to allow the passage of wastes).

Dietary modification is an essential part of treatment. Patients are often advised to remove saturated fats, processed sugars, as well as high-fiber foods from the diet. Dairy products which can exacerbate the condition may also be restricted and patients are advised to switch to other protein sources like soya, beans and nuts. Supplementation of vitamins and minerals is important to prevent malnutrition and electrolyte imbalance.

Prognosis

Although colitis is a chronic condition most patients are able to lead normal and productive lives with the right treatment. Maintenance medications and adherence to the prescribed dietary regimen can reduce the chances of a recurre.

Understanding Colitis Recommended Resources:

University of Maryland Medical Center

The Ohio State University Medical Center