Colitis

What Is Colitis?

Colitis happens when the lining of your colon becomes inflamed. Ulcerative, microscopic, and ischemic colitis are the most common types of colitis. Complications and symptoms vary depending on the type of colitis you have.

What are the types of colitis?

Types of colitis include:

• Allergic colitis — Caused by an allergic reaction to food or medication.
• Infectious colitis — Causes short-term symptoms resulting from viral, parasitic, or bacterial infections.
• Ischemic colitis — Happens when blood flow to your colon is cut off, causing damage due to lack of oxygen.
• Microscopic colitis — Causes colon inflammation that is only visible under a microscope.
• Pseudomembranous colitis — Caused by an overgrowth of C. difficile bacteria.
• Ulcerative colitis — Causes inflammation and ulcers in the lining of your colon (large intestine) and rectum.

What is the difference between ulcerative colitis and colitis?

Ulcerative colitis is a type of colitis. Both conditions cause inflammation in your colon, but ulcerative colitis is a chronic condition that causes ulcers to form in the inner lining of your colon.

How common is colitis?

Colitis is a common condition. According to the National Institute of Diabetes and Digestive and Kidney Diseases, ulcerative colitis — the most common type of colitis — affects 600,000-900,000 people in the U.S.

What causes colitis?

The causes of colitis vary depending on the type of colitis you have. Causes by type include:

• Allergic colitis — Caused by an allergic reaction to food or medication.
• Infectious colitis — Caused by viral, parasitic, or bacterial infections.
• Ischemic colitis — Happens when oxygen-rich blood flow to your colon is restricted. This can create a blockage in your colon. Patients who develop ischemic colitis are usually elderly patients or people with vascular problems.
• Microscopic colitis — Although the cause is unknown, experts believe bacteria, toxins, or viruses may be the main culprits. Nonsteroidal anti-inflammatory drugs may also aggravate patients who already have colitis.
• Pseudomembranous colitis — Caused by an overgrowth of C. difficile bacteria.
• Ulcerative colitis — The cause of ulcerative colitis is unknown. Research suggests that a virus or bacterium may be responsible for interacting with your immune system, triggering a negative inflammatory reaction.

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What Are the Signs and Symptoms of Colitis?

The most common symptoms of colitis are diarrhea, bloody stools, and abdominal pain. Additional symptoms of colitis vary depending on the type you have, and may include:

Microscopic colitis

The main symptom of microscopic colitis is chronic diarrhea. This disease is referred to as microscopic because inflammation cannot be seen unless a tissue sample is examined under a microscope.

Ischemic colitis

Ischemic colitis symptoms come on suddenly. In addition to diarrhea, symptoms may include:

• An urgent need to move your bowels.
• Nausea.
• Red- or maroon-colored blood in your stool or, at times, passage of blood alone without stool.
• Stomach pain, tenderness, or cramping.

Ulcerative colitis

Ulcerative colitis symptoms are usually mild to moderate. Doctors typically diagnose ulcerative colitis based on the location of the symptoms in the colon.

Depending on where colon inflammation occurs, you may experience:

• Abdominal pain or cramping.
• Diarrhea, accompanied by blood or pus.
• Fatigue.
• Fever.
• Rectal pain or bleeding.
• Weight loss.

When should I see a doctor about my colitis symptoms?

If you have colitis symptoms, you should schedule an appointment with your doctor immediately. Early treatment can improve your quality of life and reduce your risk of complications. If you are having emergency symptoms — such as severe abdominal pain or bleeding — you should go to the nearest hospital Emergency Department.

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How Do You Diagnose Colitis?

Your doctor may suspect you have colitis based on your symptoms and may order testing to confirm the diagnosis.

What to expect during your visit

If your doctor suspects colitis, they will:

• Ask about your symptoms.
• Perform a physical exam.
• Order other tests.
• Review your health history and medications.

Tests to diagnose colitis

Tests to diagnose colitis may include:

• Blood tests — Blood tests can check for signs of anemia and other signs of colitis.
• Stool examination — A test called a fecal calprotectin test can look for signs of colon inflammation in your stool.
• Flexible sigmoidoscopy — A test that uses a lighted tube with a camera on the end to examine your rectum and lower colon.
• Colonoscopy — A test that uses a lighted tube with a camera on the end to examine the lining of your entire colon.
• Biopsy — A procedure that involves taking a small sample of colon tissue (2-4 mm) for examination in a lab. A biopsy may be performed during a colonoscopy or flexible sigmoidoscopy exam.

Colitis prognosis

Some types of colitis, such as infectious, ischemic, and allergic colitis, cause short-term symptoms that improve after treatment. Other types, such as ulcerative and microscopic colitis, are chronic, lifelong conditions that require ongoing treatment.

Many people who are diagnosed with colitis have mild symptoms that can be controlled with medication. More severe symptoms may require surgery to provide a cure.

People with colitis will need ongoing follow-up care to manage symptoms and colonoscopies to look for signs of colon cancer.

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How Do You Treat Colitis?

The goals of colitis treatment are to reduce flare-ups, control symptoms, help your colon heal, and reduce long-term damage to your colon. Your doctor may recommend treatment options including:

Dietary changes

Avoiding certain foods may help ease colitis symptoms. Although food triggers can be different for each person, everyday items to avoid may include:

• Dairy (due to lactose intolerance).
• Highly seasoned foods.
• High-fiber foods.

Medication to treat colitis

Many types of medicines are available to treat colitis. Your doctor will recommend the best medication for you based on your condition and symptoms.

Medications to treat colitis include:

• Aminosalicylates — To treat inflammation.
• Antibiotics — To treat or prevent infections.
• Corticosteroids — To suppress the immune system and reduce inflammation.
• Immunomodulators — To suppress the immune system and reduce inflammation.
• TNF-inhibitors — To prevent inflammation by blocking a protein called TNF-alpha.
• Probiotics — Increase healthy bacteria in your gut.

Surgery for colitis

If your colitis does not respond to medicine, or if you develop cancer, you may need colitis surgery to remove your colon. In most cases, your surgeon will remove your entire colon and rectum, which will cure your colitis and eliminate your colon cancer risk.

After your colon is removed, you may have a permanent end ileostomy (stoma bag) to collect stool outside your body or an ileal pouch anal anastomosis (no external bag) to allow for normal bowel function. Your doctor will let you know which option is right for you.

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