What is Colitis?

    Colitis refers to inflammation occurring in the colon, the primary segment of the large intestine. Serving as the final portion of the digestive tract, the colon plays a crucial role in processing food. Inflammation within the colon can disrupt this digestive process, leading to symptoms such as abdominal pain, diarrhoea, and, occasionally, blood in the stool. Inflammation represents the body's reaction to infection or injury, eliciting swelling and tenderness within the affected tissues.

    What are the different types of colitis?

    The various types of colitis are classified based on their underlying causes:

    1. Ulcerative colitis:

    Ulcerative colitis (UC) is a type of inflammatory bowel disease (IBD), along with Crohn’s disease. It is characterized by inflammation and ulceration of the inner lining of the large intestine. UC typically starts in the rectum and extends to the colon.

    2. Pseudomembranous colitis:

    Pseudomembranous colitis (PC) results from an overgrowth of the bacterium Clostridium difficile (C. diff) in the intestine. This occurs when antibiotics disrupt the balance of bacteria in the gut, allowing C. diff to increase and release toxins that cause inflammation.

    3. Ischemic colitis:

    Ischemic colitis (IC) occurs when blood flow to the colon is reduced or blocked, leading to tissue damage.

    4. Microscopic colitis:

    Microscopic colitis is diagnosed by examining colon tissue under a microscope. It includes two subtypes: lymphocytic colitis and collagenous colitis.

    5. Allergic colitis in infants:

    Allergic colitis is seen in infants and is characterized by symptoms like reflux, spitting up, fussiness, and blood in the stool. It is believed to result from an allergic reaction to breast milk or formula components. Eosinophilic colitis is a similar condition related to protein allergies.

What are the causes of Colitis?

    Colitis, inflammation of the colon, can have various causes, including:

    Inflammatory bowel diseases (IBD): Conditions like ulcerative colitis and Crohn's disease involve chronic digestive tract inflammation, leading to colitis symptoms.

    Infections: Bacterial, viral, or parasitic infections can cause infectious colitis. Examples include Clostridium difficile (C. diff), Salmonella, Campylobacter, and parasitic infections like giardiasis and amebiasis.

    Ischemia: Reduced blood flow to the colon due to conditions like atherosclerosis, blood clots, or vasculitis can lead to ischemic colitis, causing inflammation and damage to the colon.

    Allergic reactions: Allergic colitis, especially seen in infants, can result from allergic reactions to specific components in breast milk or formula, leading to colon inflammation.

    Autoimmune reactions: Conditions like microscopic colitis involve autoimmune reactions, where the immune system mistakenly attacks the colon's lining, leading to inflammation.

    Radiation therapy: Radiation treatment for cancer, especially in the abdominal area, can cause inflammation and damage to the colon, known as radiation colitis.

    Medications: Certain medications, particularly nonsteroidal anti-inflammatory drugs (NSAIDs), antibiotics, and proton pump inhibitors (PPIs), can irritate the lining of the colon and lead to drug-induced colitis.

    Inflammatory disorders: Conditions such as diverticulitis, collagenous colitis, and eosinophilic colitis involve colon inflammation due to various underlying factors.

    Other factors: Chronic stress, dietary factors (such as high-fat or low-fibre diets), and environmental factors may also contribute to colitis in some individuals.

What are the risk factors of Colitis?

    Different types of colitis have distinct risk factors associated with them.

  • For ulcerative colitis (UC), you're more susceptible if you:

    1. Fall within the age range of 15 to 30 (most common) or 60 to 80

    2. Are of white or Ashkenazi Jewish descent

    3. Have a family history of UC

  • For pseudomembranous colitis (PC), the risk factors include:

    1. Long-term antibiotic use

    2. Hospitalization

    3. Chemotherapy treatment

    4. Use of immunosuppressant medications

    5. Older age

    6. History of previous episodes of PC

  • For ischemic colitis (IC), the risk factors involve:

    1. Age over 50

    2. Presence of heart disease or being at risk of it

    3. History of heart failure

    4. Low blood pressure

    5. Previous abdominal surgery

    Understanding these risk factors can help healthcare providers assess the likelihood of developing colitis and implement appropriate preventive measures or treatment strategies.

What are the symptoms of colitis?

    The symptoms you may experience depending on your condition include:

  • Abdominal pain or cramping
  • Bloating in the abdomen
  • Unexpected weight loss
  • Diarrhoea with or without blood
  • Presence of blood in your stool
  • Urgent need to move your bowels
  • Chills or fever
  • Vomiting

What are the complications of Colitis?

    Complications typically arise from severe and chronic colitis, leading to various potential issues:

    1. Perforation: Prolonged inflammation weakens the walls of the colon, increasing the risk of rupture. Ulcers formed in the colon might penetrate through its walls, potentially causing bacterial infection in the abdominal cavity (peritonitis) and bloodstream (septicaemia). Septicaemia can escalate into sepsis, posing a significant health threat.

    2. Toxic megacolon: Intense inflammation can dilate the colon walls, disrupting its natural muscle contractions. This condition, known as toxic megacolon, can impede the passage of food and gas through the colon, causing abdominal distension and heightening the risk of rupture.

    3. Elevated risk of colon cancer: Prolonged inflammation can induce cellular alterations in the colon lining, predisposing individuals to cancerous changes. The likelihood of developing colon cancer significantly increases after prolonged exposure to chronic colitis.

    4. Increased susceptibility to other inflammatory diseases: Individuals with inflammatory bowel diseases are more likely to develop additional inflammatory conditions elsewhere in their bodies. For instance, conditions like osteoarthritis (inflammation of the joints) and primary sclerosing cholangitis (inflammation affecting the liver and bile ducts) might occur. It is believed that uncontrolled inflammation in one area of the body may trigger a similar inflammatory process in another location.

When to see the doctor?

    Suppose you experience abdominal pain or cramping, bloating in the abdomen, unexpected weight loss, diarrhoea with or without blood, blood in your stool, urgent need to move your bowels, chills or fever, or vomiting. In that case, it's important to consult a doctor. These symptoms could indicate various types of colitis, ranging from inflammatory bowel diseases like ulcerative colitis to infections or other underlying conditions. Seeking medical advice promptly is crucial if you notice any of these symptoms persisting or worsening, as proper diagnosis and treatment are essential for managing colitis effectively.

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