Colitis is a chronic digestive disease characterized by inflammation of the colon.

Colitis is one of a group of conditions which are inflammatory and auto-immune, affecting the tissue that lines the gastrointestinal system (the large and small intestine). It is classed as an inflammatory bowel disease (IBD), not to be confused with irritable bowel syndrome (IBS).

Signs and symptoms

General signs and symptoms of colitis include pain, tenderness in the abdomen, depression, rapid weight loss, aches and pains within the joints, fatigue, changes in bowel habits (increased frequency), fever; swelling of the colon tissue, erythema (redness) of the surface of the colon, ulcers on the colon (in ulcerative colitis) which can bleed, mucus in the stool, blood in stool and rectal bleeding. Diarrhea may present itself, although some forms of colitis are constipation so the stool and bowel movements can appear normal.

Other symptoms may include: gas, bloating, indigestion, heartburn, reflux, Gastro oesophageal reflux disease (GORD or GERD when using the alternative spelling esophageal), cramps, urgency and many other uncomfortable aches in the gastrointestinal system.

Common tests which reveal these signs include X-rays of the colon, testing the stool for blood and pus, sigmoidoscopy, and colonoscopy. Additional tests include stool cultures and blood tests, including blood chemistry tests. A high erythrocyte sedimentation rate (ESR) is one typical finding in acute exacerbations of colitis.

Types

Types of colitis include ulcerative colitis (UC), Crohn's colitis, diversion colitis, ischemic colitis, infectious colitis, fulminant colitis, collagenous colitis, chemical colitis, microscopic colitis, lymphocytic colitis, and atypical colitis.

A well-known subtype of infectious colitis is pseudomembranous colitis, which results from infection by a toxigenic strain of Clostridium difficile (c-diff).^[1] Parasitic infections can also cause colitis.

Any colitis with a rapid downhill clinical course is known as fulminant colitis. In addition to the diarrhea, fever, and anemia seen in colitis, the patient has severe abdominal pain and presents a clinical picture similar to that of septicemia, where shock is present. Approximately half of these patients require surgery.

Irritable bowel syndrome, a separate disease, has been called spastic colitis or spastic colon. This name causes confusion, since colitis is not a feature of irritable bowel syndrome.

Treatment

Treatment of colitis may include the administration of antibiotics and general non-steroidal anti-inflammatory (NSAIDS) medications such as Mesalamine (Asacol) or its derivatives; Azathioprine or similar immunosupressants; steroids such as prednisolone and prednisone; one or several of a number of other drugs that ameliorate inflammation and pain (buscopan). As it is a chronic condition the objective is "remission" rather than cure.

Surgery is required only when the patient suffers from regular or permanent flare ups, especially in cases of fulminant colitis. Surgery usually entails removing the colon and bowel and creating a "pouch" with a portion of the small intestine, which in time adopts the characteristics of the colon.

Medical opinion is divided on the role of diet in colitis and IBD. Anecdotally, some sufferers find a change in diet can be effective at treating the symptoms of colitis and easing the side effects.^[2] These can include reducing the intake of carbohydrates, lactose products, soft drinks, caffeine and spicy foods. This approach has been championed by Elaine Gottschall.

Notes

See also

• CDAD

External links

• Crohn's & Colitis Foundation of Canada
• Crohn's & Colitis Foundation of America
• The National Association for Colitis and Crohn?s Disease (UK)
• Blog for people suffering from Colitis.
• Ulcerative Colitis, National Digestive Diseases Information Clearing House, National Institutes of Health (in the public domain)

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