Colitis occurs when the colonic lining becomes inflamed as a reaction to injury or infection or an autoimmune disease like inflammatory bowel disease. Chronic colitis can cause long-term damage to the colon and affect the quality of life.
Symptoms
When you have colitis, you may experience
- Pain in the abdomen
- Bloating
- Diarrhea which may contain blood or mucous
- Passing blood per anus
- Loss of appetite
- Weight loss
- Fever
If you have chronic colitis, you may develop
- Dehydration
- Fatigue
- Anemia
Causes
There are different types of colitis with differing causes.
- Infectious colitis is a temporary condition caused by viral, bacterial, or parasitic infections. The most common causes are Salmonella and E. coli which contaminate food or water. Antibiotics are required to eliminate these infectious agents.
- Antibiotic-associated colitis or Pseudomembranous colitis (PMC) causes by a specific bacterium known as Clostridioides difficile (formerly Clostridium difficile; C. diff) that lives in the intestines. When taking certain antibiotics, other bacteria which control C. diff may die off, causing C. diff to overgrow, leading to colitis.
- Necrotizing enterocolitis (NEC) occurs in premature infants due to underdeveloped immunity. It is a life-threatening condition.
- Allergic colitis is an allergic reaction to specific proteins, such as lactose or soy
- Ischemic colitis occurs when there is an inadequate blood supply to part of the colon due to a blockage of blood vessels from blood clots, aneurysms, and atherosclerosis.
Inflammatory bowel diseases (IBD), including ulcerative colitis and Crohn’s disease, are autoimmune conditions that can be genetic and environmentally triggered.
- Patients may have extra-colonic manifestations such as skin rash, arthritis, or uveitis.
- Radiation colitis is usually a temporary side effect of radiotherapy treating cancers in an adjacent organ. However, it can become a chronic condition in some people.
- Diversion colitis occurs in people who have a colostomy.
Complications
Severe, long-term, chronic colitis can cause complications, including:
- Perforation from chronic inflammation. The colon wall can become weakened and rupture easily. If there is a hole in the colonic wall, the bacteria in the colon can infect the abdomen and move into the bloodstream, leading to septicemia.
- Toxic megacolon. The severe inflammation can widen the colonic lumen and interrupt muscle contraction, leading to a colonic obstruction, abdominal distension, and a higher risk of rupture.
- Higher risk of colon cancer. The cellular changes in the chronically inflamed colon can progress to cancer. Patients with chronic colitis for more than ten years have an increased risk of colon cancer.
Diagnosis
- Medical history taking and physical examination
- Blood tests
- Stool tests
- Imaging studies
- Endoscopic examinations, including colonoscopy and flexible sigmoidoscopy
Treatment
- Treatment of colitis is according to the etiology, such as antibiotics or antiviral for infectious colitis, diet adjustment for allergic colitis, stop antibiotics for antibiotic-associated colitis, and anti-inflammatory drugs for IBD.
- Surgery can be an option for treating the complications of colitis, such as bowel gangrene from fulminant colitis or ischemic colitis, colonic obstruction, and massive bleeding which endoscopy or vascular intervention cannot control.
Lifestyle modification and home remedies
Depending on the type of colitis, your doctor may recommend the following:
- Low-residue diet
If you have temporary colitis or radiation colitis, your doctor may recommend low-in-fat-and-fiber foods that are soft, well-cooked, and easy to digest. - Anti-inflammatory diet
Processed foods are high in fat and sugar, which can increase inflammation. Your doctor may recommend an anti-inflammatory diet such as nuts, avocados, olive oil, and oily fish containing unsaturated fats to decrease chronic inflammation. - Elimination diet
Eliminate certain foods from your daily meal and add them back one at a time so you can observe how your bowel system responds to them. Therefore, you can personalize a healthy meal for your digestive system. Your doctor may recommend this diet, particularly if you have an inflammatory bowel disease.
