In medicine, colitis (pl. colitides) refers to an inflammation of the colon and is often used to describe an inflammation of the large intestine (colon, caecum and rectum).
Colitis may be acute and self-limited or chronic, i.e. persistent, and broadly fits into the category of digestive diseases.
In a medical context, the label colitis (without qualification) is used if:
- The aetiology of the inflammation in the colon is undetermined; for example, colitis may be applied to Crohn's disease at a time when the diagnosis is unknown, or
- The context is clear; for example, an individual with ulcerative colitis is talking about their disease with a physician who knows the diagnosis.
§Signs and symptoms
The signs and symptoms of colitides are quite variable and dependent on the etiology (or cause) of the given colitis and factors that modify its course and severity.
Symptoms of colitis may include: abdominal pain, loss of appetite, fatigue, bloody diarrhea, mucus in the stool, cramping, urgency and bloating.
Signs may include: abdominal tenderness, weight loss, changes in bowel habits (increased frequency), fever, bleeding (overt or occult)/bloody stools, diarrhea, and distension.
Signs seen on colonoscopy include: colonic mucosal erythema (redness of the inner surface of the colon), ulcers, bleeding.
§Treatment
Some patients may be admitted into the hospital following the colonoscopy depending on results. It is sometimes necessary to get the patient started on a steroid to speed up the healing of the colon. It may also be necessary to get the patient hydrated from the fluid loss and iron replaced from the loss of blood. Beyond a hospital stay, the patient will be put on a daily medication which they will continuously take since this is a chronic yet manageable condition. The medication can be an anti-inflammatory or an immunosuppressant. There are many different types of medication used and the doctor will prescribe the one they see fit. If the patient doesn't respond, new medications will be tried until there is a good fit.
§Diagnosis
Symptoms suggestive of colitis are worked-up by obtaining the medical history, a physical examination and laboratory tests (CBC, electrolytes, stool culture and sensitivity, stool ova and parasites et cetera). Additional tests may include medical imaging (e.g. abdominal computed tomography, abdominal X-rays) and an examination with a camera inserted into the rectum (sigmoidoscopy, colonoscopy).
§Types
There are many types of colitis. They are usually classified by the etiology.
Types of colitis include:
§Autoimmune
- Inflammatory bowel disease (IBD) - a group of chronic colitides.
- Ulcerative colitis - a chronic colitis that affects the large intestine.
**Crohn's disease - a type of IBD often leads to a colitis.
§Idiopathic
- Microscopic colitis - a colitis is diagnosed by microscopic examination of colonic tissue; macroscopically it is normal appearing.
- Lymphocytic colitis.
- Collagenous colitis.
§Iatrogenic
- Diversion colitis.
- Chemical colitis.
§Vascular disease
- Ischemic colitis.
§Infectious
- Infectious colitis.
A well-known subtype of infectious colitis is Clostridium difficile colitis, which is informally abbreviated as "c diff colitis". It classically forms pseudomembranes and is often referred to as pseudomembranous colitis, which is its (non-specific) histomorphologic description.
Enterohemorrhagic colitis may be caused by Shiga toxin in Shigella dysenteriae or Shigatoxigenic group of Escherichia coli (STEC), which includes serotype O157:H7 and other enterohemorrhagic E. coli.
Parasitic infections, like those caused by Entamoeba histolytica, can also cause colitis.
§Unclassifiable colitides
Indeterminate colitis is the classification for colitis that has features of both Crohn's disease and ulcerative colitis. Indeterminate colitis' behaviour is usually closer to ulcerative colitis than Crohn's disease.
Atypical colitis is a phrase that is occasionally used by physicians for a colitis that does not conform to criteria for accepted types of colitis. It is not an accepted diagnosis per se and, as such, a colitis that cannot be definitively classified.
§See also
- Gastroenterology
§Notes
§External links
- Colitis at GPnotebook