Colitis: Causes, Symptoms, Diagnosis, and Treatment

Disease Insights: colitis

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Welcome to the ultimate guide on colitis. Here, you'll find answers to the most common questions to help you or your loved ones understand and manage this condition better.

Description for colitis

Inflammation of the colon, which can cause diarrhea, abdominal pain, and bleeding.

Symptoms of colitis

abdominal pain, blood in stool, diarrhea, fever, weight loss

Precautions for colitis

Follow a low-residue diet, Take prescribed anti-inflammatory , Avoid trigger foods, Stay hydrated

Questions Covered:

what is colitis?
What are the usual symptoms of colitis?
causes of colitis?
How do doctors usually figure out if someone has colitis, diagnosis?
How do doctors usually treat colitis?
What are the possible complications that could arise from colitis?
What are the potential risk factors associated with colitis?
What are the ways to prevent colitis?

Answers:

Question: what is colitis?

Ulcerative colitis (UC) is a type of inflammatory bowel disease (IBD). Symptoms can range from mild to severe. In some cases, you may not have any symptoms. Treatment focuses on managing or reducing symptoms.
Ulcerative colitis (UC) is a type of inflammatory bowel disease (IBD). IBD comprises a group of diseases that affect the gastrointestinal (GI) tract.
UC occurs when the lining of your large intestine (also called the colon), rectum, or both become inflamed.
This inflammation produces tiny sores called ulcers on the lining of your colon. Inflammation usually begins in the rectum and spreads upward. It can involve your entire colon.
The inflammation causes your bowel to move its contents rapidly and empty frequently. As cells on the surface of the lining of your bowel die, ulcers form. The ulcers may cause bleeding and discharge of mucus and pus.
While this condition affects people of all ages, most people develop UC between ages 15 and 30 years old, according to the American Gastroenterological Association. After 50 years old, there's another small increase in diagnosis of IBD, usually in men.

Question: What are the usual symptoms of colitis?

The seriousness of UC symptoms varies among people who have the condition. The symptoms can also change over time.
People diagnosed with UC may experience periods of mild symptoms or no symptoms at all. This is called remission. However, symptoms can return and become severe. This is called a flare-up.
Common symptoms of UC include:
abdominal pain
increased abdominal sounds
bloody stools
diarrhea
fever
rectal pain
weight loss
malnutrition
UC may cause additional symptoms, such as:
joint pain
joint swelling
nausea and decreased appetite
skin problems
mouth sores
eye inflammation

Question: causes of colitis?

Researchers believe that UC may be the result of an overactive immune system. However, it's unclear why some immune systems respond by attacking the large intestines, and others don't.
Factors that may play a role in who develops UC include:
Genes. You may inherit a gene from a parent that increases your chance of having UC.
Other immune disorders. If you have one type of immune disorder, your chance of developing a second is higher.
Environmental factors. Bacteria, viruses, and antigens may trigger your immune system.

Question: How do doctors usually figure out if someone has colitis, diagnosis?

Different tests can help a doctor diagnose UC. UC mimics other bowel diseases such as Crohn's disease. A doctor will order multiple tests to rule out other conditions.
Tests to diagnose UC often include:
Blood tests. Blood tests are often useful in the diagnosis of UC. A complete blood count looks for signs of anemia (a low red blood cell count). Other tests indicate inflammation, such as a high level of C-reactive protein and a high sedimentation rate. A doctor may also order specialized antibody tests.
Stool test. A doctor examines your stool for certain inflammatory markers, blood, bacteria, and parasites.
CT scan. This is a specialized X-ray of your abdomen and pelvis.
Endoscopy. A doctor uses a flexible tube to examine your stomach, esophagus, and small intestine.
Biopsy. A surgeon removes a tissue sample from your colon for analysis.
Flexible sigmoidoscopy. Flexible sigmoidoscopy is a type of endoscopy. During this test, a doctor inserts a long, flexible tube into your rectum so that they can examine it, the sigmoid colon, and part of the descending colon. Flexible sigmoidoscopy is also known as sigmoidoscopy.
Colonoscopy. During a colonoscopy, a doctor inserts a lighted scope called a colonoscope into your rectum to examine the inside of your colon. It's also a type of endoscopy.
Were you recently diagnosed? Here's what you need to know about treating and living with UC.

Question: How do doctors usually treat colitis?

UC is a chronic condition. The goal of treatment is to reduce the inflammation that causes your symptoms to prevent flare-ups and have longer periods of remission.
Medication
Which medication you'll take will depend on your specific situation, including how severe your symptoms are.
For mild symptoms, your doctor may prescribe a medication to reduce inflammation and swelling. This will help alleviate many symptoms.
These types of medications include 5-aminosalicylates (5-ASA drugs) such as:
mesalamine (Asacol HD, Lialda)
sulfasalazine (Azulfidine)
balsalazide (Colazal)
olsalazine (Dipentum)
Some people may need corticosteroids to help reduce inflammation, but these can have adverse effects, so doctors try to limit their use. If an infection is present, you may need antibiotics.
If you have moderate to severe symptoms, a doctor may prescribe a type of medication known as a biologic. Biologics are made from antibodies and help block inflammation. Taking these can help prevent a symptom flare-up.
Effective options for most people include:
adalimumab (Humira)
golimumab (Simponi)
infliximab (Remicade)
tofacitinib (Xeljanz)
ustekinumab (Stelara)
vedolizumab (Entyvio)
A doctor may also prescribe an immunomodulator. These change the way the immune system works. Examples include methotrexate, 5-ASA drugs, and thiopurine drugs. However, current guidelines don't recommend these as standalone treatments.
In 2018, the Food and Drug Administration (FDA)
approved the use of tofacitinib (Xeljanz) as a treatment for UC. Initially used to treat rheumatoid arthritis, this medication targets cells responsible for inflammation. It's the first oral medication approved for the long-term treatment of UC.
Hospitalization
If your symptoms are severe, you'll need to be hospitalized to correct the effects of dehydration and loss of electrolytes that diarrhea causes. You may also need to replace blood and to treat any other complications.
Researchers continue to look for new treatments each year. Learn more about the newest UC treatments.
Ulcerative colitis surgery
Surgery is necessary if you experience:
substantial blood loss
chronic and debilitating symptoms
perforation of your colon
a severe blockage
A CT scan or colonoscopy can detect these serious problems.
Surgery typically involves removing your entire colon and rectum as well as creating a new pathway for waste. This pathway can be out through a small opening in your abdominal wall.
To redirect waste through your abdominal wall, the surgeon will make a small opening in the wall. The tip of your lower small intestine, or the ileum, is then brought to the skin's surface. Waste will drain through the opening into a bag.
In other types of surgery, the surgeon removes the diseased part of your colon and rectum but retains the outer muscles of your rectum. The surgeon then attaches your small intestine to the rectum to form a small pouch. After this surgery, you're able to pass stool through your rectum. Bowel movements will be more frequent and watery than normal.
In certain procedures, the anus is also removed. Read more about each of the surgical options and their long-term effects.

Question: What are the possible complications that could arise from colitis?

UC increases your risk of developing colon cancer. The longer you have the disease, the higher your risk of this cancer.
Because of this increased risk, your doctor will perform a colonoscopy and check for cancer when you receive your diagnosis.
Repeat screenings every 1 to 3 years
are recommended thereafter, according to the American Cancer Society. Regular screenings help lower your risk of colon cancer. Follow-up screenings can detect precancerous cells early.
Other complications of UC include:
thickening of the intestinal wall
intestinal bleeding
sepsis, or blood infection
severe dehydration
toxic megacolon, or a rapidly swelling colon
rupture of your colon
inflammation of your skin, joints, and eyes
ankylosing spondylitis, which involves inflammation of joints between your spinal bones
kidney stones
liver disease, which is rare
Complications of UC are worse if the condition isn't properly treated. Learn more about the complications of unmanaged UC.

Question: What are the potential risk factors associated with colitis?

Most people with UC don't have a family history of the condition. However, about 12 percent of people with UC do have a family member with IBD, according to research from 2014.
UC can develop in a person of any race, but it's more common in white people. If you're of Ashkenazi Jewish descent, you have a greater chance of developing the condition than most other groups.
Young people with IBD may also be dealing with acne at the same time. Some older studies have suggested a possible link between the use of the cystic acne medication isotretinoin (Absorbica, Amnesteem, Claravis) and UC. However, newer research has yet to find a definitive causal relationship.

Question: What are the ways to prevent colitis?

There's no solid evidence indicating that your diet affects whether you develop UC. You may find that certain foods and drinks aggravate your symptoms when you have a flare-up, though.
Practices that may help include:
drinking small amounts of water throughout the day
eating smaller meals throughout the day
limiting your intake of high fiber foods
avoiding fatty foods
lowering your intake of milk if you're lactose intolerant
Also, ask a doctor if you should take a multivitamin.

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Conclusion & Takeaways

Learning about colitis is the first step toward taking control of your health. By understanding its causes, symptoms, and treatments, you empower yourself to make informed decisions. Remember to consult healthcare professionals for personalized advice and support.