Colitis is an acute or chronic inflammatory disease of the colon (the terminal part of the intestine) or of the intestine in general.
It is an umbrella term that is used to describe several conditions that cause inflammation of the colon and which depend on the underlying causes. The most common forms are ulcerative colitis, spastic colitis, nervous colitis, irritable bowel syndrome and Crohn’s disease.
They are also defined as Chronic Inflammatory Intestinal Diseases (IBD), which manifest themselves with different symptoms but often characterized by ulcers and erosions of the intestine. According to statistics, they affect one person in every 200-300.
The symptoms of colitis are the “classic” gastrointestinal ones such as bloating, flatulence, pain, constipation or diarrhea. There are several treatments to treat colitis, but it’s also important to know what to eat and what not to eat.
Colitis – what is it
The term colitis is generally used to mean an inflammation that affects the colon, or the second section of the large intestine. It is accompanied by abdominal pain associated with cramps, a feeling of bloating, constipation and/or diarrhea.
The term should be limited to problems specific to the colon, but in the past, the name spastic colitis referred to a wider range of disorders such as irritable bowel syndrome or Crohn’s disease, as well as all those unspecified inflammatory syndromes affecting the large intestine.
In order to speak of colitis, there must therefore be an inflammation of the colon mucosa, which for example we do not find in irritable bowel syndrome, in jargon spastic colitis, in which the symptoms are caused by colon motility problems.
The causes can be different, from infections to inflammations, up to allergies. Colitis is then defined as acute if it occurs rapidly, within a few hours and is typical of infectious ones.
Instead, chronic colitis refers to a subtle and gradual onset, over days or weeks. Among the chronic colitis, the most important are irritable bowel syndrome and inflammatory bowel disease.
Colitis: the symptoms
Symptoms of colitis can vary depending on the specific trigger. However, there are some common symptoms associated with colitis. Here are some of the most frequent:
- Diarrhea: Loose or loose stools are a common symptom of colitis. Diarrhea can be persistent and may contain blood, mucus, or pus.
- Abdominal cramps and pain in the lower abdomen. Cramps can be intermittent or constant and can vary in intensity.
- Defecation urgency: Some people with colitis may experience an urge to go to the bathroom, often accompanied by a feeling that they can’t hold their stools.
- Rectal bleeding or mucus: Some forms, such as ulcerative colitis, can cause rectal bleeding. This can show up as visible blood in the stool or on toilet paper.
- Abdominal swelling with a feeling of abdominal distension.
- Involuntary weight loss due to early satiety and decreased appetite.
- Fatigue.
More serious symptoms may include breathlessness, abnormal heartbeat and fever.
It is important to highlight that these symptoms are similar to other gastrointestinal conditions and that only a doctor can make an accurate diagnosis.
Types of colitis
The different colitis are classified according to the cause of the disease and the duration. They can be divided into:
- Primary (or primitive), if originating from the colon itself.
- Secondary, in the event that they are caused by diseases affecting other organs.
- Acute, i.e. colitis that occurs suddenly with abdominal pain, constipation or diarrhea.
- Chronic, which are often a consequence of the acute forms.
- Infectious, that is, those resulting from infections and bacteria.
- Ischemic, which develop when blood flow to part of the large intestine (the colon) is reduced.
- Pseudomembranous, which result from the abuse of antibiotics.
- Ulcerative, in which the inner wall of the rectum and colon, the “mucosa,” may appear red, bloody, and have widespread ulcers.
Acute inflammations are very frequent and are mainly due to infections, but when diarrhea lasts for more than 4 weeks, after due investigations, we can possibly speak of chronic inflammation.
Furthermore, there are particular entities called IBD (Intestinal Bowel Disease – chronic inflammatory diseases of the intestine), where phases of acute inflammation alternate with phases of remission of the disease.
In this case the inflammation does not always concern the colon, as in the case of Crohn’s disease, which in 50% of cases affects the ileum (the last part of the small intestine that connects to the large intestine) and the large intestine.
Ulcerative colitis, on the other hand, always affects the colon and rectum.
Ulcerative colitis
Ulcerative colitis is a chronic inflammatory bowel disease that primarily affects the inner lining of the colon and rectum. It is part of a group of diseases known as inflammatory bowel diseases (IBD), along with Crohn’s disease.
It is characterized by episodes of inflammation and superficial ulcers that develop in the lining of the colon and rectum. This inflammation causes symptoms such as bloody diarrhea, abdominal cramps, an urgent need to have a bowel movement, and weight loss.
The exact causes of ulcerative colitis are still unclear but are believed to depend on a combination of factors, including genetic predisposition, an overactive immune system, and environmental factors.
The severity of ulcerative colitis can range from mild to severe, and treatment may include the use of anti-inflammatory drugs, immunosuppressants, corticosteroids, and dietary modifications. In severe cases, surgery may be required.
If you want to know more, read our insight into ulcerative colitis.
Spastic colitis or nervous colitis
Spastic or nervous colitis, also known as irritable bowel syndrome (IBS), is a common gut disorder that causes gastrointestinal symptoms but is not associated with inflammation or structural damage to the intestines. It is characterized by an alteration in intestinal motility and sensitivity of the intestine. Symptoms can vary from person to person and can include:
- Abdominal pain or cramps.
- Intestinal transit alterations.
- Abdominal swelling.
- Feeling of incomplete evacuation.
- Change in stool consistency.
Symptoms of spastic or nervous colitis can be triggered by a variety of factors, including stress, diet, hormones, and food sensitivities. Diagnosis is based primarily on the presence of characteristic symptoms and the exclusion of other gastrointestinal conditions.
While there is no definitive cure for spastic colitis, symptoms can be managed through a combination of lifestyle changes, diet, stress management, and, in some cases, medications to relieve specific symptoms.
Causes and complications
The most common causes of colitis are:
- Bacterial/virus/parasitic infections (the classic viral “intestinal flu”, the famous Clostridium Difficile pseudomembranous colitis, etc.).
- Autoimmune diseases.
- In the case of ischemic colitis, vascular diseases such as atherosclerosis and diabetes can contribute to creating intestinal circulation problems, which cause no more blood to arrive and the mucosa to go into necrosis.
- Complications of chemotherapy/radiation treatment.
- Medications (e.g. NSAID or PPI microscopic colitis) and food allergies.
- Stress and bad eating habits.
According to some studies, ulcerative colitis may increase the risk of colon cancer due to chronic intestinal inflammation, toxic megacolon (abnormal dilatation of the colon, often surgical emergency) and bleeding. In general, all colitis that is not self-limited can have fistulas, perforations, stenosis, abscesses, tumors, bleeding as complications.
Colitis: diagnosis
In the presence of symptoms that suggest colitis, it is advisable to contact your family doctor. He will first of all conduct an interview with the patient about the symptoms and will also inquire about the subject’s lifestyle and eating habits. After that he will be able to prescribe some tests such as:
- Blood tests to rule out any AGA antibodies, which are indicative of gluten intolerance (a condition that can cause similar symptoms).
- Breath test or Breath Test to detect a gastric infection or lactose intolerance.
- CDSA, a bowel function test that also looks for the presence of parasites.
- Stool exam, which allows you to discover a possible colonization by fungi such as Candida Albicans, parasites or occult blood.
- Colonoscopy.
- Abdominal ultrasound.
Following the results, he will judge your colitis as passing or he will take care to send you to a gastroenterologist specialist who will guide you in the best therapy.
Cures and treatments for colitis
Most colitis is self-limiting (disease with a mild course that tends to resolve spontaneously) and does not require specific therapy. In general, it may be necessary to compensate for potentially dangerous loss of fluid and electrolytes in severe cases. Furthermore:
- In case of high blood loss, iron should also be supplemented to prevent anemia.
- If the colitis is caused by an infection that is not viral, antimicrobial therapy is needed to eliminate the agent…
