Regional Gastrointestinal Consultants

Colitis

Colitis

Overview

The term “colitis” is a general term, and can apply to infections and any other condition associated with an inflamed colonic lining.

Ulcerative Colitis is a chronic inflammatory bowel disease in which the large intestine (colon) becomes inflamed and ulcerated (pitted or eroded), leading to flare-ups (bouts or attacks). The small intestine is not involved. Ulcerative Colitis (UC) is one form of inflammatory bowel disease (IBD); Crohn’s Disease is another. Ulcerative Colitis is distinct from Crohn’s Disease although in some patients it can be difficult to tell the difference, particularly in the early stages.

The inflammation may involve: the rectum alone (proctitis); the rectum and sigmoid colon (proctosigmoiditis or distal colitis); the rectum and a large part of the colon (sub-total colitis); or the rectum and the entire colon (total or universal colitis). These are descriptive terms - it is the same disease process although for reasons that are not understood, the disease may remain confined to one part of the colon.

There may be an interaction between environmental, genetic, immunological factors, and infectious agents (viruses or bacteria). There is no evidence that a particular diet causes ulcerative colitis, but unidentified dietary factors may make the disease worse. Psychological stress does not cause ulcerative colitis, but may make the symptoms worse. Cigarette smokers have about half the risk of developing ulcerative colitis as non-smokers, and the disease is likely to be more severe if a smoker has recently ceased smoking. In contrast, smokers are twice as likely as non-smokers to develop Crohn’s Disease.

Symptoms

The most common symptoms of Ulcerative Colitis are abdominal pain and diarrhea, which may contain blood, mucous and pus. Patients may suffer fatigue, weight loss, appetite loss, dehydration and malnutrition.

The symptoms of Ulcerative Colitis occur in flare-ups. A flare-up may be sudden and severe, causing violent diarrhea that typically contains mucus and blood, high fever, abdominal pain, joint pain and occasionally peritonitis (inflammation of the lining of the abdominal cavity).

During such flare-ups, the person is profoundly ill. More often, a flare-up begins gradually, and the person has an urgency to have a bowel movement (defecate), mild cramps in the lower abdomen, and visible blood and mucus in the stool. A flare-up can last days or weeks and can recur at any time. Severe bleeding can lead to anaemia.

Treatment

There is no special diet for Ulcerative Colitis, although patients may find it necessary to avoid certain foods (e.g. highly seasoned foods or dairy foods) which worsen their symptoms.

There are 4 classes of medications which are useful in inflammatory bowel disease:

  • Corticosteroids
  • Mesalazine-delivering drugs
  • Immunomodulators
  • Antibiotics

Patients with Ulcerative Colitis occasionally have symptoms severe enough to require admission to hospital. This allows the bowel to be rested by limiting oral intake, the use of intravenous fluids and medications, intravenous feeding, correction of dehydration, and close observation for possible complications.

Most people with Ulcerative Colitis will never need to have surgery. Most patients respond to treatment over a period of a few weeks or months and will eventually be left with only mild bowel symptoms. Some patients have relapses and remissions.

However, a small proportion of patients eventually require surgery for removal of the colon because of chronic debilitating illness not responding to treatment, massive bleeding, perforation of the colon, or risk of cancer.

There are several surgical options, each of which has advantages and disadvantages. The most common operation is removal of the entire colon and rectum (proctocolectomy), with ileostomy. Ileostomy is the creation of a small opening in the abdominal wall where the lower small intestine (ileum) is brought to the skin’s surface to allow drainage of waste. A special appliance is worn over the opening to collect waste and the patient empties this several times each day.

Proctocolectomy with continent ileostomy is an alternative to standard ileostomy. In this operation, the surgeon creates a pouch out of the ileum inside the wall of the lower abdomen. The patient is able to empty the pouch by inserting a tube through a small leak-proof opening in his or her side. Creation of this natural valve eliminates the need for an external appliance. However, the patient must wear an external pouch for the first few months after the operation.

Another operation that avoids the use of a pouch is ileoanal anastomosis. The diseased portion of the colon is removed and the outer muscles of the rectum are preserved. The surgeon attaches the lower small intestine (ileum) inside the rectum, forming a pouch, or reservoir, that holds the waste. This allows the patient to pass stool through the anus in a normal manner, although the bowel movements are usually more frequent and watery.

IMPORTANT HEALTH NOTE

We recommend that people experiencing gastrointestinal symptoms do not attempt self-treatment. With many medications being available over the counter, and numerous do-it-yourself online unqualified remedy recommendation, it is natural to consider treating yourself but we highly recommend against this.

If you are experiencing gastrointestinal symptoms you may have a more significant issue than you would expect from the sometimes muted or infrequent symptom you may be experiencing. It is important to keep in mind that is you are having gastrointestinal symptoms or concerns it is best see a doctor to have those symptoms diagnosed and any conditions treated. Also, it is worth noting, that if health conditions do exist, the earlier they are diagnosed and treated, the greater the probability will be to successfully eliminate or manage a present condition, in fact successful outcomes will increase significantly with early detection.

If you have gastrointestinal concerns or are experiencing any gastrointestinal symptoms, please contact us promptly to schedule a consultation with a physician.


DISCLAIMER: PLEASE READ CAREFULLY

The information on this website is to provide general information. In no way, does any of the information provided reflect definitive medical advice and self-diagnoses should not be made based on information obtained online. It is important to consult a best in class physician regarding ANY and ALL symptoms or signs as it may a sign of a serious illness or condition. A thorough consultation and examination should ALWAYS be performed for an accurate diagnosis and treatment plan. Be sure to call a physician or call our office today at (215) 321-4700 to schedule a consultation.