What is Colitis

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 the term used to refer to the inflammation of the colon, which may also affect the lowest portion of the small intestine called the ileum.

Colitis is an inflammatory bowel disease although it should not be confused with irritable bowel syndrome, which may also present with similar signs and symptoms. The many types of colitis include ulcerative colitis, Crohn's disease, diverticulitis, ischemic colitis, infectious colitis, fulminant colitis, collagenous colitis, chemical colitis, microscopic colitis, lymphocytic colitis, and atypical colitis.

Causes

The exact cause of colitis is not known. Genes, the environment and exposure to viruses and bacteria may play a role in the development of the disease.

Risk factors

While the disease may strike any type of individual some people are at a greater risk for developing the disease than others. Risks factors include:

• Age - colitis often affects people 15 to 30 years old and less frequently in people who are older. Men are at a greater risk of developing the disease at a latter part in their lives.

• Family history of disease - people with relatives who have been diagnosed with ulcerative colitis, Crohn’s disease and other types of inflammatory bowel diseases are at a greater risk for developing an inflammatory bowel disease.

• Geography - some types of colitis like ulcerative colitis are often found in urban and industrialized areas and less often in rural areas

Symptoms

The most common symptoms of colitis include a pain in the abdomen, weight loss, fatigue, increased frequency of bowel movements, swelling of the colon tissue, ulcers in the colon, bleeding, mucus and blood in the stool, joint pains and fever. Gas and bloating may also be felt by some. In some cases bowel movements may appear normal.

Diagnosis

A sigmoidoscopy or a colonoscopy will reveal the presence of inflammation and ulcers in the colon, as well as the presence of strictures in ischemic colitis. Blood tests will reveal elevated white blood cell count levels and stool samples will indicate the presence of blood and mucus in the stools. An elevated erythrocyte sedimentation rate is often indicative finding in acute exacerbation of the disease.

Treatment

Antibiotics and anti-inflammatory agents, as well as steroids are the primary modes of pharmacologic treatment for colitis. Buscopan, which is an anti-spasmodic, is also given to reduce pain. Because colitis is a chronic condition one of the main goals of treatment is remission rather than cure.

Surgery may only be necessary in the most severe cases like in fulminant colitis and in the event of complications. This often means that the diseased portion of the intestine is removed and the ends are connected back together or a stoma is created to allow the exit of wastes.

Prognosis

Prognosis varies with the disease, although most patients can recover fully with early treatment. Serious complications are rare and only a few will require surgery.

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