Colitis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: M.Umer Tariq [2]; Maham Khan [3]; Rim Halaby, M.D. [4]
Synonyms and keywords: autoimmune colitis, ulcerative colitis, Crohn's colitis, infectious colitis, pseudomembranous colitis, enterohemorrhagic colitis, microscopic colitis, lymphocytic colitis, collagenous colitis, diversion colitis, chemical colitis, ischemic colitis, indeterminate colitis, atypical colitis, fulminant colitis, immune mediated colitis, immune colitis
Overview
Colitis is the inflammation of the colon, that can be either acute or chronic.
Classification
Classes of Colitis | Disorders |
Autoimmune colitis | |
Infectious colitis |
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Microscopic colitis | |
Iatrogenic | |
Vacular disease | |
Unclassifiable |
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Notes:
- Fulminant colitis is any colitis with a rapid downhill clinical course; 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.
- 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.
- Immune mediated colitis is the experimental name in animal studies of ulcerative colitis. It is a synonym of ulcerative colitis, but it should not be used as a synonym when referring to ulcerative colitis.
Causes
Causes by Organ System
Causes by Alphabetical Order
- Aganglionic megacolon
- Albinism
- Alosetron (patient information)
- Ampicillin Oral (patient information)
- Ankylosing Spondylitis
- Auranofin
- Autistic enterocolitis
- Azithromycin
- Aztreonam Injection (patient information)
- Bacillary dysentery
- Bacterial gastroenteritis
- Behcet disease
- Campylobacter jejuni
- Cefaclor
- Cefadroxil (patient information)
- Cefamandole Nafate Injection (patient information)
- Cefazolin Sodium Injection (patient information)
- Cefepime
- Cefepime Injection (patient information)
- Cefoperazone Sodium Injection (patient information)
- Cefotaxime Sodium Injection (patient information)
- Cefotetan Disodium Injection (patient information)
- Cefoxitin Sodium Injection (patient information)
- Cefpodoxime (patient information)
- Ceftazidime Injection (patient information)
- Ceftazidime
- Ceftizoxime Sodium Injection (patient information)
- Ceftriaxone Sodium Injection (patient information)
- Cefuroxime Sodium Injection (patient information)
- Cephalexin (patient information)
- Cephalosporin
- Cephradine Oral (patient information)
- Chemical colitis
- Chlamydia trachomatis
- Cidofovir
- Clindamycin
- Clostridium difficile
- Co-amoxiclav
- Colitis ulcerosa
- Collagenous colitis
- Corticosteroid
- Crohn disease
- Cryptosporidiosis
- Cytomegalovirus
- Cytomegalovirus
- Darifenacin (patient information)
- Dental braces
- Desogestrel and Ethinyl Estradiol
- Dicloxacillin (patient information)
- Dirithromycin (patient information)
- Diversion colitis
- Enoxacin (patient information)
- Entamoeba histolytica
- Ertapenem
- Erythromycin and Sulfisoxazole (patient information)
- Escherichia coli O157:H7
- EVAR
- Flucytosine
- Gerson diet
- Glycopyrrolate (patient information)
- Hyoscyamine (patient information)
- Imipenem and Cilastatin Sodium Injection (patient information)
- Infectious colitis
- Inflammatory bowel disease
- Irritable bowel syndrome
- Ischemic colitis
- Isosporiasis
- Ixabepilone
- Lanthanum (patient information)
- Levofloxacin Oral (patient information)
- Lincomycin Hydrochloride
- Linezolid
- Lomefloxacin (patient information)
- Loracarbef (patient information)
- Lymphocytic colitis
- Methotrexate (patient information)
- Miconazole Injection (patient information)
- Microscopic colitis
- Milk allergy
- Moxifloxacin
- Multiple organ dysfunction syndrome
- Nafcillin Sodium Injection (patient information)
- Neisseria gonorrhoeae
- Neonatal necrotizing enterocolitis
- Norfloxacin (patient information)
- Ofloxacin injection (patient information)
- Oxacillin Sodium Injection (patient information)
- Oxcarbazepine
- Oxybutynin (patient information)
- Peginterferon alfa-2a (patient information)
- Peginterferon alfa-2b (patient information)
- Penicillin
- Pergolide
- Piperacillin sodium injection (patient information)
- Pramipexole
- Prednisolone
- Procyclidine (patient information)
- Propantheline
- Pseudoephedrine
- Pseudomembranous colitis
- Quinolone
- Radiation colitis
- Reserpine
- Scleroderma
- Sepsis
- Solifenacin
- Sparfloxacin
- Syphilis
- [[Tegaserod]
- Treponema pallidum
- Typhilitis
- Ulcerative colitis
- Yersinia enterocolitica
Diagnosis
Symptoms
Physical Examination
Diagnostic Tests
Colitis is associated with the following findings:
- Swelling of the colon tissue
- Bleeding
- Erythema (redness) of the surface of the colon
- Ulcerations of the colon
Common tests which reveal these signs include:
- X-rays of the colon
- Testing the stool for blood and pus
- Sigmoidoscopy
- 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.
Treatment
Medical Therapy
Treatment of colitis may include the administration of antibiotics and general anti-inflammatory medications such as Mesalamine or its derivatives, steroids, or one of a number of other drugs that ameliorate inflammation.
Changes in diet can be effective at treating the symptoms of colitis and easing the side effects. These can include reducing the intake of carbohydrates, lactose products, soft drinks, and caffeine. This approach has been championed by Elaine Gottschall.
Hygienic and naturopathic doctors have taken the diet approach further, attributing bowel inflammation to toxemia stemming from high-protein, fatty diets and other dietary irritants. Changing to a low-fat, minimally-processed, whole-foods diet per the Natural Hygiene self-healing system has been effective in eliminating symptoms and rebuilding health. Dr. Zarin Azar, MD,, is one advocate of this healing system.
Infliximab (or REMICADE) - a drug originally produced to treat Rheumatoid Arthritis - has recently been approved for the treatment of Colitis where traditional treatments have failed. REMICADE is a biologic therapy that recognizes, attaches to, and blocks the action of a protein in your body called tumor necrosis factor alpha (TNF-alpha). TNF-alpha is made by certain blood cells in your body. It is administered through a series of infusions.
Surgery
Approximately half of patients with fulminant colitis require surgery. Surgery usually entails removing the colon and bowel and creating a "pouch" with portions of the small intestine.