Colitis

Colitis is inflammation in your colon, which is the main part of your large intestine. Your colon is the last leg of the journey your food takes through your digestive system. Inflammation makes the tissues in your colon swell and cause discomfort. This can affect the way the journey ends, causing pain, diarrhea and, sometimes, blood in your poop. Colitis can also affect your quality of life and make it difficult to do your normal activities.

There are different types of colitis. Some are short-lived and easy to treat, like when you have food poisoning. Other types — like inflammatory bowel diseases — are longer-lasting and difficult to treat. Colitis is more serious when it doesn’t go away. A severe case can damage your colon over time.

Symptoms of colitis

Common symptoms include:

• Abdominal pain
• Bloating
• Feeling like you need to poop
• Watery diarrhea
• Mucus or blood in your poop
• Loss of appetite
• Fever
• Fatigue

Colitis causes

The causes can vary depending on the type of colitis you have:

• Infectious colitis is caused by a viral, parasitic or bacterial infection. Salmonella and E. coli are common causes. Most people get it from eating or drinking contaminated food or water.
• Pseudomembranous colitis is the result of a specific bacterium known as C. diff (clostridioides difficile). C. diff already lives in your intestines, but certain antibiotics can cause C. diff to overgrow.
• Allergic colitis primarily affects babies who drink breastmilk. An allergy to the protein in cow’s milk (lactose intolerance) causes it.
• Ischemic colitis is when your intestines aren’t getting enough blood. A blockage in your blood vessels, like a blood clot or atherosclerosis, causes it.
• Inflammatory bowel diseases (IBD) are a group of conditions that cause chronic inflammation in your colon. They include ulcerative colitis, microscopic colitis and Crohn’s disease. Experts believe they’re a type of autoimmune disease, which means they cause your immune system to malfunction and attack its own tissue.
• Radiation colitis is a side effect of radiation therapy, which is a treatment for certain types of cancer.
• Diversion colitis is a side effect that can occur in people who’ve had a colostomy. Experts believe it happens when the part of your colon that’s not being used is deprived of certain nutrients.

Complications of colitis

Complications usually result from severe, long-term colitis. They can include:

• Perforation: Chronic inflammation weakens your colon walls, making them more likely to rupture. An ulcer in your colon may wear a hole all the way through the lining of the colon. This can cause bacteria from your colon to infect your abdominal cavity or bloodstream.
• Toxic megacolon: Severe inflammation causes the muscles in your colon to stop working. Food and gas build up in your colon and make it widen or stretch.
• Increased risk of colon cancer: Long-term inflammation in your colon can sometimes lead to changes in your colon wall that become cancerous.

How doctors diagnose colitis

Your healthcare provider will begin by asking you about your symptoms, when they began and what you were eating and drinking at the time. They’ll ask you about your current medications and any health conditions that you have. After a physical examination, they may recommend medical tests. These are likely to include blood tests, stool tests and imaging tests to look at your colon.

Tests for colitis

Endoscopic tests that check the inside of your colon with a lighted camera can be helpful in diagnosing the type of colitis you have. Colonoscopy and flexible sigmoidoscopy also allow your provider to take tissue samples from the inside of your colon (biopsy). Analyzing the tissue sample can help them figure out the cause of your symptoms.

CT scans can also help diagnose colitis and determine if the condition affects more than just the colon.

What is the treatment for colitis?

Treatment for colitis depends on the type and the cause. It may include:

• Medications: Your provider may prescribe antibiotics to treat infections, corticosteroids to treat inflammation, immunomodulators to help your immune system, biologic (intravenous or subcutaneous) medications and mucosal agents like mesalamine to treat IBD.
• Food changes: If you have temporary colitis, you may benefit from foods that are low in fiber and easy to digest. If you have chronic colitis, you may need a personalized eating plan that avoids trigger foods and ensures you’re getting the right nutrients.
• Surgery: People with certain types of colitis may require surgery to treat complications. Surgery doesn’t always cure these conditions, but it may be necessary to stop bleeding, repair a perforation or remove a blockage.

What kind of diet is helpful for colitis?

Your healthcare provider may suggest following a:

• Soft diet: A soft food diet refers to food that’s soft in texture, low in fiber and easy to digest. This way of eating is sometimes called a gastrointestinal (GI) soft diet.
• Anti-inflammatory diet: To keep chronic inflammation low, your healthcare provider might recommend you avoid highly inflammatory foods, especially fast and processed foods high in sugar and fat.
• Elimination diet: If you have an inflammatory bowel disease, your healthcare provider will likely recommend an elimination diet to figure out which foods cause your symptoms to flare up. An elimination diet eliminates certain types of foods and then adds them back in a systematic way so that you can observe how your gut responds to them.

When should I see my healthcare provider?

Contact your provider if you have symptoms of colitis, like:

• Abdominal pain that doesn’t get better
• Blood in your poop
• Diarrhea that doesn’t go away

What’s the outlook for people with colitis?

Colitis can be challenging, but it’s manageable with help from a healthcare provider. Your exact outlook also depends on what type of colitis you have.

Sometimes, colitis is acute and temporary. There are fixes that are easier to incorporate. For example, avoiding specific foods or taking antibiotics is all you need for certain types of colitis.

But people with chronic, long-term colitis work closely with their provider on a treatment that gives them the most relief. This could include medication or changes to your eating habits. It can be a lifelong condition that comes and goes. You may try several treatments or have to adjust your treatment every so often. This can make managing the condition challenging, but your provider can help find a way to ease your symptoms.