What are the main symptoms of ulcerative colitis. How is ulcerative colitis diagnosed. What causes ulcerative colitis. Who is most commonly affected by ulcerative colitis. How is ulcerative colitis treated. What are the potential complications of ulcerative colitis. How can ulcerative colitis impact quality of life.

Understanding Ulcerative Colitis: A Chronic Inflammatory Bowel Disease

Ulcerative colitis is a chronic inflammatory condition affecting the large intestine, specifically the colon and rectum. This long-term illness is characterized by inflammation and the development of small ulcers in the lining of the colon, which can lead to bleeding and the production of pus. As a form of inflammatory bowel disease (IBD), ulcerative colitis can significantly impact a person’s quality of life and requires ongoing management.

Key Characteristics of Ulcerative Colitis

• Chronic inflammation of the colon and rectum
• Development of ulcers in the colon’s lining
• Recurring symptoms with periods of remission and flare-ups
• Potential for extraintestinal manifestations

Recognizing the Symptoms of Ulcerative Colitis

The symptoms of ulcerative colitis can vary in severity and may fluctuate over time. Understanding these symptoms is crucial for early diagnosis and effective management of the condition.

Primary Symptoms

• Recurring diarrhea, often containing blood, mucus, or pus
• Abdominal pain and cramping
• Frequent bowel movements
• Extreme fatigue
• Loss of appetite
• Unintended weight loss

Can ulcerative colitis symptoms vary in intensity? Indeed, the severity of symptoms can differ significantly among individuals. Some people may experience mild discomfort, while others might face severe pain and disruption to their daily lives. The extent and severity of colon inflammation play a crucial role in determining symptom intensity.

Extraintestinal Symptoms During Flare-ups

During periods of increased disease activity, known as flare-ups, some individuals may experience symptoms beyond the digestive system. These extraintestinal manifestations can include:

• Arthritis and joint pain
• Mouth ulcers
• Skin conditions like erythema nodosum
• Eye inflammation
• Bone-related issues, such as osteoporosis

Are there specific triggers for ulcerative colitis flare-ups? While the exact triggers can vary among individuals, some common factors include stress, certain medications, and gut infections. However, in many cases, no specific trigger is identified.

Diagnosing Ulcerative Colitis: When to Seek Medical Attention

Early diagnosis of ulcerative colitis is essential for proper management and prevention of complications. If you experience symptoms suggestive of ulcerative colitis, it’s crucial to consult a healthcare professional promptly.

Steps in the Diagnostic Process

1. Initial consultation with a general practitioner
2. Blood tests and stool sample analysis
3. Referral to a gastroenterologist for specialized evaluation
4. Endoscopic procedures (colonoscopy or sigmoidoscopy)
5. Imaging studies (CT scan or MRI) if necessary

How is ulcerative colitis definitively diagnosed? The gold standard for diagnosing ulcerative colitis is a colonoscopy with biopsy. This procedure allows doctors to visualize the colon’s lining and take small tissue samples for microscopic examination, confirming the presence of inflammation and ruling out other conditions.

Unraveling the Causes of Ulcerative Colitis

The exact cause of ulcerative colitis remains unknown, but researchers believe it results from a complex interplay of genetic, environmental, and immunological factors.

Autoimmune Component

Ulcerative colitis is considered an autoimmune condition, where the body’s immune system mistakenly attacks healthy tissue in the colon. This abnormal immune response leads to chronic inflammation and tissue damage.

Genetic Factors

Studies have identified several genes associated with an increased risk of developing ulcerative colitis. Having a family history of the condition can increase one’s susceptibility.

Environmental Triggers

Various environmental factors may contribute to the development or exacerbation of ulcerative colitis, including:

• Diet high in processed foods
• Stress
• Certain medications
• Changes in gut microbiome

Is ulcerative colitis caused by stress alone? While stress can exacerbate symptoms and trigger flare-ups, it is not considered a sole cause of ulcerative colitis. The condition likely results from a combination of genetic predisposition and environmental factors.

Demographic Insights: Who Is Most Affected by Ulcerative Colitis?

Understanding the demographic patterns of ulcerative colitis can provide valuable insights into risk factors and potential genetic or environmental influences.

Age of Onset

Ulcerative colitis can develop at any age, but it is most commonly diagnosed in individuals between 15 and 25 years old. There is also a smaller peak in diagnosis rates among people in their 50s and 60s.

Ethnic and Geographic Distribution

• Higher prevalence in white people of European descent
• Increased incidence in Ashkenazi Jewish populations
• Lower rates among Asian populations
• Varying prevalence across different geographic regions

Does ulcerative colitis affect men and women equally? Current research suggests that ulcerative colitis affects both men and women at similar rates, with no significant gender predilection observed.

Treatment Approaches for Ulcerative Colitis

The treatment of ulcerative colitis aims to induce and maintain remission, improve quality of life, and prevent complications. Management strategies typically involve a combination of medications and, in some cases, surgical interventions.

Pharmacological Treatments

• Aminosalicylates (5-ASAs): Anti-inflammatory drugs used for mild to moderate cases
• Corticosteroids: Powerful anti-inflammatory medications for acute flare-ups
• Immunosuppressants: Drugs that modulate the immune system to reduce inflammation
• Biologics: Targeted therapies that block specific inflammatory pathways

Surgical Options

In cases where medical management is ineffective or complications arise, surgical intervention may be necessary. Surgical options include:

• Total colectomy with ileostomy
• Proctocolectomy with ileal pouch-anal anastomosis (IPAA)

Can ulcerative colitis be cured with medication alone? While medications can effectively manage symptoms and induce remission, there is currently no medical cure for ulcerative colitis. Some patients may require surgery for long-term symptom relief or to address complications.

Navigating Complications and Long-term Outlook

Ulcerative colitis can lead to various complications that may affect both intestinal and extraintestinal systems. Understanding these potential issues is crucial for comprehensive patient care and early intervention.

Intestinal Complications

• Toxic megacolon: A rare but serious condition involving colon dilation
• Bowel perforation: A life-threatening emergency requiring immediate surgery
• Strictures: Narrowing of the colon due to chronic inflammation
• Increased risk of colorectal cancer

Extraintestinal Complications

• Anemia: Due to chronic blood loss and malabsorption
• Osteoporosis: Reduced bone density, partly due to long-term steroid use
• Liver diseases: Such as primary sclerosing cholangitis
• Delayed growth and development in children

How does ulcerative colitis impact long-term health? While ulcerative colitis is a chronic condition, many individuals can achieve long periods of remission with proper treatment. Regular medical follow-ups, adherence to treatment plans, and lifestyle modifications can help manage the disease and reduce the risk of complications.

Living with Ulcerative Colitis: Strategies for Quality of Life

Managing ulcerative colitis extends beyond medical treatments. Adopting lifestyle strategies and coping mechanisms can significantly improve quality of life for individuals living with this chronic condition.

Dietary Considerations

While there is no one-size-fits-all diet for ulcerative colitis, some dietary adjustments may help manage symptoms:

• Identifying and avoiding trigger foods
• Eating smaller, more frequent meals
• Staying hydrated
• Considering probiotic supplements

Stress Management

Stress can exacerbate symptoms, making stress reduction techniques valuable tools:

• Mindfulness and meditation
• Regular exercise
• Adequate sleep
• Cognitive-behavioral therapy

Support Systems

Building a strong support network can provide emotional and practical assistance:

• Joining support groups
• Open communication with family and friends
• Collaborating closely with healthcare providers

How can individuals with ulcerative colitis maintain a normal lifestyle? With proper management and support, many people with ulcerative colitis lead fulfilling lives. Developing coping strategies, adhering to treatment plans, and maintaining open communication with healthcare providers are key to navigating the challenges of this chronic condition.

Understanding ulcerative colitis, its symptoms, causes, and management strategies is crucial for both patients and healthcare providers. By staying informed and proactive, individuals can work towards better disease control and improved quality of life. Ongoing research continues to uncover new insights into this complex condition, offering hope for more targeted treatments and improved outcomes in the future.

Ulcerative colitis – NHS

Ulcerative colitis is a long-term condition where the colon and rectum become inflamed.

The colon is the large intestine (bowel) and the rectum is the end of the bowel where poo is stored.

Small ulcers can develop on the colon’s lining, and can bleed and produce pus.

Symptoms of ulcerative colitis

The main symptoms of ulcerative colitis are:

• recurring diarrhoea, which may contain blood, mucus or pus
• tummy pain
• needing to poo frequently

You may also experience extreme tiredness (fatigue), loss of appetite and weight loss.

The severity of the symptoms varies, depending on how much of the rectum and colon is inflamed and how severe the inflammation is.

For some people, the condition has a significant impact on their everyday lives.

Symptoms of a flare-up

Some people may go for weeks or months with very mild symptoms, or none at all (remission), followed by periods where the symptoms are particularly troublesome (flare-ups or relapses).

During a flare-up, some people with ulcerative colitis also experience symptoms elsewhere in their body; which are known as extra-intestinal symptoms.

These can include:

• painful and swollen joints (arthritis)
• mouth ulcers
• swollen fat under the skin causing bumps and patches – this is known as erythema nodosum
• irritated and red eyes
• problems with bones, such as osteoporosis

In many people, no specific trigger for flare-ups is identified, although a gut infection can occasionally be the cause.

Stress is also thought to be a potential factor.

When to get medical advice

You should see a GP as soon as possible if you have symptoms of ulcerative colitis and you have not been diagnosed with the condition.

They can arrange blood or poo sample tests to help determine what may be causing your symptoms.

If necessary, they can refer you to hospital for further tests.

Find out more about diagnosing ulcerative colitis

If you have been diagnosed with ulcerative colitis and think you may be having a severe flare-up, contact a GP or your care team for advice.

You may need to be urgently admitted to hospital for immediate care.

If you cannot contact your GP or care team, call NHS 111 or contact your local out-of-hours service.

What causes ulcerative colitis?

Ulcerative colitis is thought to be an autoimmune condition.

This means the immune system, the body’s defence against infection, goes wrong and attacks healthy tissue.

The most popular theory is that the immune system mistakes harmless bacteria inside the colon as a threat and attacks the tissues of the colon, causing it to become inflamed.

Exactly what causes the immune system to behave in this way is unclear.

Many experts think it’s a combination of genetic and environmental factors.

Who’s affected

The UK Crohn’s & Colitis UK charity reports at least 1 in every 227 people in the UK has been diagnosed with ulcerative colitis. This amounts to around 296,000 people.

The condition can develop at any age, but is most often diagnosed in people between 15 and 25 years old.

It’s more common in white people of European descent, especially those descended from Ashkenazi Jewish communities, and black people.

The condition is rarer in people from Asian backgrounds, although the reasons for this are unclear.

Both men and women seem to be equally affected by ulcerative colitis.

How ulcerative colitis is treated

Treatment for ulcerative [RT1] colitis aims to relieve symptoms during a flare-up and prevent symptoms from returning (maintaining remission).

In most people, this is achieved by taking medicine, such as:

• aminosalicylates (ASAs)
• corticosteroids (steroid medicines)
• immunosuppressants

Mild to moderate flare-ups can usually be treated at home. But more severe flare-ups need to be treated in hospital.

If medicines are not effective at controlling your symptoms or your quality of life is significantly affected by your condition, surgery to remove some or all of your bowel (colon) may be an option.

During surgery, your small intestine can be diverted out of an opening in your abdomen known as a stoma. This type of surgery is known as an ileostomy.

In some cases, the stoma is only temporary and can be closed up once your bowel has healed.

An alternative option is to create an internal pouch that’s connected to your anus called an ileoanal pouch.

Read more about treating ulcerative colitis

Complications of ulcerative colitis

Complications of ulcerative colitis include:

• an increased risk of developing bowel cancer
• poor growth and development in children and young people

Also, the steroid medicines used to treat ulcerative colitis can cause weakening of the bones (osteoporosis) as a side effect.

Read more about the complications of ulcerative colitis

IBD or IBS?

Inflammatory bowel disease (IBD) is a term mainly used to describe 2 conditions that cause inflammation of the gut (gastrointestinal tract).

They are:

• ulcerative colitis
• Crohn’s disease

IBD should not be confused with irritable bowel syndrome (IBS), which is a different condition and requires different treatment.

Information:

Social care and support guide

If you:

• need help with day-to-day living because of illness or disability
• care for someone regularly because they’re ill, elderly or disabled (including family members)

Our guide to care and support explains your options and where you can get support.

Page last reviewed: 01 November 2022
Next review due: 01 November 2025

Colitis Information | Mount Sinai

Colitis is swelling (inflammation) of the large intestine (colon).

Ulcerative colitis is categorized according to location. Proctitis involves only the rectum. Proctosigmoiditis affects the rectum and sigmoid colon. Left-sided colitis encompasses the entire left side of the large intestine. Pancolitis inflames the entire colon.

The large intestine is the portion of the digestive system most responsible for absorption of water from the indigestible residue of food. The ileocecal valve of the ileum (small intestine) passes material into the large intestine at the cecum. Material passes through the ascending, transverse, descending and sigmoid portions of the colon, and finally into the rectum. From the rectum, the waste is expelled from the body.

This lower abdominal X-ray shows narrowing (stenosis) of the end of the small intestine (ileum), caused by Crohn disease. Crohn disease typically affects the small intestine, whereas ulcerative colitis typically affects the large intestine. A solution containing a dye (barium), was swallowed by the patient. When it passed into the small intestines, this X-ray was taken (lower GI series).

Crohn disease, also called regional enteritis, is a chronic inflammation of the intestines which is usually confined to the terminal portion of the small intestine, the ileum. Ulcerative colitis is a similar inflammation of the colon, or large intestine. These and other IBDs (inflammatory bowel disease) have been linked with an increased risk of colorectal cancer.

Causes

Most of the time, the cause of colitis is not known.

Causes of colitis include:

• Infections caused by a virus or a parasite
• Food poisoning due to bacteria
• Crohn disease
• Ulcerative colitis
• Lack of blood flow (ischemic colitis)
• Past radiation to the large bowel (radiation colitis and strictures)
• Necrotizing enterocolitis in newborns
• Pseudomembranous colitis caused by Clostridium difficile infection (now called Clostridiodes difficile)

Symptoms

Symptoms can include:

• Abdominal pain and bloating that may be constant or come and go
• Bloody stools 
• Constant urge to have a bowel movement (tenesmus)
• Dehydration
• Diarrhea
• Fever

Exams and Tests

The health care provider will perform a physical exam. You will also be asked questions about your symptoms, such as:

• How long have you had the symptoms?
• How severe is your pain?
• How often do you have pain and how long does it last?
• How often do you have diarrhea?
• Have you been traveling?
• Have you been taking antibiotics recently?

Your provider may recommend a flexible sigmoidoscopy or colonoscopy. During this test, a flexible tube is inserted through the rectum to examine the colon. You may have biopsies taken during this exam. Biopsies may show changes related to inflammation. This can help determine the cause of colitis.

Other studies that can identify colitis include:

• CT scan of the abdomen
• MRI of the abdomen
• Barium enema
• Stool culture
• Stool examination for ova and parasites

Treatment

Your treatment will depend on the cause of the disease.

Outlook (Prognosis)

The outlook depends on the cause of the problem.

• Crohn disease is a chronic condition which has no cure but can be controlled.
• Ulcerative colitis can usually be controlled with medicines. If not controlled, it can be cured by surgically removing the colon.
• Viral, bacterial and parasitic colitis can be cured with appropriate medicines.
• Pseudomembranous colitis can usually be cured with appropriate antibiotics.

Possible Complications

Complications may include:

When to Contact a Medical Professional

Contact your provider if you have symptoms such as:

• Abdominal pain that does not get better

• Blood in the stool or stools that look black

• Diarrhea or vomiting that does not go away

• Swollen abdomen

Ananthakrishnan AN, Regueiro MD. Management of inflammatory bowel diseases. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran’s Gastrointestinal and Liver Disease. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 116.

Lichtenstein GR. Inflammatory bowel disease. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 132.

Pardi DS, Cotter TG. Other diseases of the colon. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran’s Gastrointestinal and Liver Disease. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 128.

Last reviewed on: 7/1/2021

Reviewed by: Michael M. Phillips, MD, Emeritus Professor of Medicine, The George Washington University School of Medicine, Washington, DC. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

symptoms and diagnosis, prices for the treatment of colitis in Moscow at the Hadassah clinic

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At the Hadassah clinic, the treatment of chronic digestive diseases is approached in a complex manner. Leading gastroenterologists will help identify inflammatory triggers of colitis and reduce their impact. An individual treatment program will be selected for your case, including a special diet, anti-inflammatory and antimicrobial drugs, and intestinal support drugs.

In some cases (with severe ulcerative colitis), patients undergo surgical treatment. We adhere to world standards of medical care, which allows us to guarantee quality and safety.

Colitis is a prolonged inflammation of the colon or rectum, which usually occurs with ulceration of the mucosa. It can lead to recurrent diarrhea, bloody and mucous fecal excretion, abdominal pain, a strong feeling of weakness, decreased appetite and weight loss. The disease can occur in acute or chronic form – with occasional exacerbations. What is intestinal colitis and what are its symptoms, you will learn on this page.

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PECULIARITIES OF COLITIS TREATMENT IN HADASSAH

International treatment protocols

Doctors of the Hadassah gastroenterology department in Moscow carry out treatment measures in accordance with modern international protocols, which guarantees the maximum therapeutic effect.

Individual approach

Together with you, the gastroenterologist will consider the risks and benefits of all treatment options and help you make an informed decision.

Innovative drugs

The Hadassah clinic is located on the territory of the Moscow International Medical Cluster and operates within the framework of Federal Law-160. According to the law, we can use the latest equipment and drugs of the latest generation that have not yet been registered in Russia.

Solving problems of any complexity

A strong team of specialists from the surgical division and advanced operating rooms equipped with unique equipment provide a solution to a problem of any complexity.

Department doctors

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Buchina
Anaida Valerievna

General practitioner, gastroenterologist, Ph.D.

Work experience: 24 years

Cost of admission: from 9000 ₽

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Dobritsyn
Igor Aleksandrovich

Gastroenterologist

Work experience: 28 years

Admission fee: from 6500 ₽

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Zavarzina
Natalya Pavlovna

Gastroenterologist-nutritionist

Work experience: 14 years

Appointment fee: from 6500 ₽

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Kanshina
Antonina Aleksandrovna

Pediatric gastroenterologist, pediatrician, Ph. D.

Work experience: 11 years

Cost of admission: from 9000 ₽

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Nikolaeva
Natalia Petrovna

Gastroenterologist

Work experience: 12 years

Appointment fee: from 6500 ₽

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Petrachenkova
Maria Yurievna

Hepatologist, gastroenterologist

Work experience: 12 years

Appointment fee: from 6500 ₽

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Drunk
Olga Pavlovna

Endocrinologist, dietitian, Ph.D.

Work experience: 11 years

Cost of admission: from 9000 ₽

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Fedulenkova
Lyudmila Viktorovna

Nephrologist, gastroenterologist-hepatologist, Ph.D.

Work experience: 25 years

Cost of admission: from 9000 ₽

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Yakushev
Andrey Alexandrovich

Gastroenterologist, hepatologist, therapist

Work experience: 5 years

Admission fee: from 6500 ₽

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MAIN SYMPTOMS OF ACUTE AND CHRONIC INTESTINAL COLITIS

• diarrhea;
• mucus and/or blood in feces;
• left abdominal pain;
• feeling of weakness;
• fever;
• loss of appetite and weight;
• frequent need to have a bowel movement;
• unexplained weight loss;
• discomfort during defecation.

In rare cases, there is a rash on the body, irritation of the conjunctiva of the eyes and arthralgia (joint pain).

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Causes of colitis

Cause unknown. Colitis is believed to be autoimmune, in which the body’s defense system attacks healthy tissue. Presumably this is due to genetic predisposition and exposure to environmental factors:

• penetration into the intestines of pathogenic microorganisms;
• long-term use of non-steroidal anti-inflammatory drugs, antibacterial drugs, etc.;
• partial or complete blockage of the arteries, leading to disruption of the blood supply to the colon.

Also, colitis can develop against the background of other diseases of the digestive system in the absence of timely treatment.

TYPES OF DISEASE

They directly depend on the cause of the disease. The most common colitis is infectious, ischemic, medicinal, microscopic, radiation, ulcerative.

Infectious colitis

Both adults and children who have encountered it at an early age know about it. This common disease occurs due to the ingestion of harmful microorganisms from the outside or the activation of opportunistic microflora in the intestine itself. The development of inflammation is largely facilitated by unsanitary conditions and a hot climate. This form of colitis is treated by infectious disease doctors. Self-medication is unacceptable, since inflammation can provoke atrophic colitis, which is even more dangerous. It is characterized by attacks of acute pain in the abdomen, problems with defecation, significant weight loss. This condition is dangerous in itself and can provoke an exacerbation of other diseases of the patient.

Ischemic colitis

Symptoms occur predominantly in adults (over 45 years of age). The disease is provoked by violations of the normal functioning of the circulatory system. Insufficient blood supply to the intestinal walls causes local inflammation, which can become protracted and even accompany the patient for the rest of his life. With the most pessimistic forecasts, it can turn into necrosis, so it is very important to undergo the necessary examinations in a timely manner and be regularly observed by a specialized specialist. Ischemic colitis is treated by coloproctologists. In addition, the removal of symptoms and therapy of this disease are within the competence of gastroenterologists and surgeons.

Drug-induced colitis

May be triggered by regular use of strong drugs: long-term use of non-steroidal anti-inflammatory drugs, antibacterial drugs, etc. The doctor must warn the patient about the risks of such drug therapy, the same information should be contained in the instructions for the drug. It is fundamentally important to tell your doctor about the ailment that has appeared, so that the specialist can adjust the treatment plan as soon as possible.

Microscopic colitis

Carriers of autoimmune diseases may encounter it. The risk group includes patients with dysfunction of various organs and systems. Their weakened bodies do not always cope well with common diseases, and acute colitis, which is usually easily managed with diet and standard drug therapy, can become another long-term comorbidity.

Radiation colitis

May occur as a reaction to topical cancer treatments. Aggressive impact on the pelvic organs can negatively affect the functioning of the intestines. As a result, undesirable consequences may occur, a person who has not previously encountered gastrointestinal diseases is at risk. Radiation colitis is completely impossible to cure, but it is possible to stabilize the patient’s condition. Competent recommendations will be given by a coloproctologist.

Ulcerative colitis

Can develop at any age, but most often between 15 and 25 years of age. This disease occurs in both men and women. Its cause is unknown. It is believed that such colitis is autoimmune. This is a series of diseases in which the body’s defense system attacks healthy tissues. This is presumably due to a genetic predisposition. Therapy is more focused on alleviating the phenomena that cause inflammation. The most common method of treatment is medical, in a few patients there may be a need for surgery. Treatment of ulcerative and nonspecific ulcerative colitis of the intestine is within the competence of gastroenterologists.

FORMS OF COLITIS

There are two of them: acute and chronic. The latter can proceed:

• In a continuous form, with persistent relapses.
• Paroxysmal (affects the patient’s lifestyle, the extent to which he complies with medical recommendations).
• At rest, that is, remission. But even in this case, the patient cannot be considered fully recovered. The diagnosis remains in the anamnesis for life.

Please note that other medical terms can be seen on the patient card. The fact is that colitis is rather a collective name for acute and chronic inflammatory processes in the large intestine. And there are details.

So, if the inflammation is localized in the caecum, then typhlitis will be mentioned in the diagnosis.

Pathology may affect the transverse colon. In this case, in the conclusion they will write “trasversit” or “angular colitis”, depending on its affected bend. If the lesion of the intestine is bilateral, they will write “proctosigmoiditis” in the extract.

The sigmoid colon often becomes inflamed. In this case, the doctor will talk about sigmoiditis.

If the rectum is affected, the specialist will diagnose proctitis.

If the entire large intestine is affected, they will write “pancloit” in the conclusion.

DIAGNOSIS OF COLITIS

If signs of colitis appear, it is recommended to consult a proctologist, gastroenterologist or surgeon. The doctor will examine you and take a medical history. If necessary, the following tests may be required:

• blood tests;
• diagnosis of anemia or inflammation;
• faecal tests;
• exclusion of infection, internal bleeding, or colonic parasitic infestation;
• barium enema;
• examination of the structural features of the intestine;
• colonoscopy;
• whole colon imaging;
• differential diagnosis of colitis to exclude diseases that have a similar clinical picture.

TREATMENTS FOR COLITIS

The choice of treatment for colitis in men and women is based on the degree of activity, course and symptoms of the disease, the density of relapses, the findings of inflammation outside the intestine, previous treatment and side effects of these drugs. The goal of therapy is to relieve symptoms and achieve remission.

To prevent/suppress the final inflammatory activity in relation to the mucous membrane of the colon, drug treatment is used, depending on the severity of the course of colitis, one type of drug or a combination of drugs is prescribed:

• Corticosteroids stool regulation and appetite restoration.
• Antibiotics Infection control (destruction of the pathogen).
• Anthelmintics (for helminthic invasions). Destruction of parasites that provoke the inflammatory process in the intestines.
• Immunosuppressants Used only in case of confirmed immune disease to restore the protective functions of the body.
• Symptomatic therapy Used to restore bowel function. For this, antidiarrheal drugs, antispasmodics and iron supplements are used.
• Surgical intervention The need for intervention arises only in advanced cases, when conservative therapy is no longer effective.

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Possible complications of the disease

Both acute and chronic colitis can not only reduce the quality of life, but also lead to borderline conditions. Inflammation can provoke erosion, ulcers and necrosis of the intestinal mucosa. This is how catarrhal and erosive-ulcerative colitis manifests itself. In advanced cases, possible:

• internal bleeding;
• tissue atrophy leading to peritonitis;
• intestinal rupture;
• obstruction of the stool due to the formation of adhesions;
• scarring of the mucous tissue, due to which the lumen of the large intestine narrows.

It is essential to start treatment immediately and, at the first symptoms of intestinal colitis, contact a pediatric or adult specialist for referrals for the necessary tests and examinations.

PREVENTIVE MEASURES TO PREVENT PROGRESSION OF THE DISEASE

Knowing how to correctly build a diet and daily routine, you can, if not cure intestinal colitis forever, then significantly reduce the risk of its recurrence.

Diet prescription. Refusal of spicy, fatty and smoked foods. Including more fruits and vegetables in your diet.

• Your task is to help the body get the maximum of nutrients from food. Meals should be easily digestible. With an exacerbation of the disease, it is rational to puree food with a blender to minimize the burden on the gastrointestinal tract.
• Eat often, once every 2-3 hours, in small portions.
• Try to minimize the use of flour, in particular fresh pastries. Bread, crackers, biscuits can become an alternative.
• For fried dishes, prefer steamed, stewed, baked, but without the formation of a crust. Make casseroles, cereals on the water, cook light low-fat soups from chicken, beef, veal, turkey.
• Focus on lean food: during the period of exacerbation, spices, vinegar, excessive salt intake are undesirable.
• Avoid stool-thinning foods, including fresh fruits and vegetables, and juices. Strong tea, coffee is also temporarily banned.
• Products designed to help the intestines get rid of constipation are harmful for colitis. Their use further injures the mucosa. Thus, with a healing diet, you need to give up legumes, bran and other products from this list.
• During an exacerbation, it is not recommended to consume milk. Dairy products can be used in doses. Try to control your condition, and if you feel that dairy products are negatively affecting, adjust your diet.
• There are no restrictions on fluid intake – water, weak tea and herbal decoctions, compotes, fruit drinks.

At the acute stage, following a strict diet is just as important as taking medication. It is necessary to spend at least 3-5 days on such a diet, and it is possible to expand the diet only in agreement with the doctor. The specialist will draw conclusions based on the results of the tests and your well-being.

If intestinal colitis is chronic, the diet should always be followed – this is an important component of treatment. Light relaxations are possible at the stage of remission, while you need to control your well-being. Flatulence, loss of appetite and weight, the appearance of pus and blood in the stool – all this indicates the beginning of the inflammatory process. It is important to prevent its development.

Preventive examinations

If you have a predisposition to colitis, it is recommended to visit a gastroenterologist and a proctologist every year. Regular follow-up with a doctor, timely delivery of tests and examinations will allow you not to miss the borderline condition and start treatment at an early stage.

Chronic colitis requires lifelong follow-up with a specialist. Inflammation may not appear outwardly for a long time, and only laboratory tests and examinations will allow you to see what is happening in the large intestine. Thus, the patient will be spared from unexpected threatening consequences of the disease.

Compliance with the regime

Both physical and mental stress can provoke an aggravation, so pay attention to your lifestyle. Intense workouts, high power loads, stress at work, experiences in your personal life – if you can minimize this, try.

Chronic care

If you have other diagnoses besides colitis, remember to follow your doctor’s instructions.

Important!

When prescribing treatment, check the compatibility of drugs. Your task is to cope with one disease and not provoke the development of another. That is, the list of drugs for the underlying disease should not include those that provoke the development of intestinal colitis.

PROGNOSIS AND PREVENTION OF INFECTIOUS COLITIS

This disease has a favorable prognosis. Russian doctors have sufficient information about how to treat colitis, and with timely treatment and an unaggravated form of the disease, recovery will be complete.

Prevention:

Follow basic hygiene rules to avoid relapses. Wash your hands regularly and thoroughly, eat foods that have undergone sufficient heat treatment. Pay special attention to the freshness of products, the purity of the water used.

PREDICTION AND PREVENTION OF ISCHEMIC COLITIS

Ischemic colitis is not an independent disease. It is provoked by problems with the circulatory system. The prognosis for the treatment of the disease directly depends on the treatment of the underlying disease, but in general it is favorable. For the prevention of ischemic colitis, it is important to follow the basic rules of nutrition. It should be full-fledged, saturated with substances useful for the body.

PROGNOSIS OF RADIATION COLITIS

This disease causes irreversible changes in the walls of the large intestine. As a result, ulcers and strictures can appear on them, which can only be corrected with a surgical method. The prognosis will be favorable if the treatment was carried out on time and chosen correctly.

Radiation colitis is not preventable.

PROGNOSIS AND PREVENTION OF ULCERATIVE COLITIS

Prognosis in the treatment of ulcerative colitis directly depends on the severity of the disease. In a severe form of the disease, the patient needs to stay in the hospital.

In the treatment of chronic ulcerative colitis of the intestine, modern medicine cannot give a 100% relief from the problem, only the removal of exacerbation symptoms is possible. The patient’s task is to avoid relapses by following the diet (No. 4, 4B, 4C according to Pevzner), constantly taking maintenance drugs, regularly taking tests and undergoing examinations.

In rare cases (11-22%), surgery is possible. In such a situation, the patient is prescribed a colproctectomy, that is, the removal of the colon.

Indications for surgery:

• Conservative treatment does not give a positive response, the situation worsens. At the same time, various schemes of drug therapy have been tried.
• The patient’s condition is severe, almost critical. Ulcerative colitis progresses, manifested by internal bleeding, penetrating damage to the wall of the large intestine and its toxic dilatation.

Lifetime risk of severe exacerbation after treatment is 15%. With adequate drug treatment, it is possible to avoid relapses within 5 years in 50% of patients, within 10 years – in 20%.

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Egorova
Olga Nikolaevna

Gastroenterologist

Work experience: 17 years

Published: 26. 06.2023

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what is it, symptoms and treatment of intestinal inflammation

Disease definition

Colitis is an acute or chronic inflammation of the lining of the large intestine.

The acute form of the disease passes after a while. Chronic is not fully cured, proceeds with periodic exacerbations.

Anatomy of the intestine

Causes of colitis

As a rule, colitis develops on the background of a bacterial or viral infection. But in some cases, its cause is not so easy to establish. The fact is that pathology can occur due to a malfunction in the immune system, anomalies in the structure of the organs of the gastrointestinal tract, or due to allergies. Each individual case of colitis requires careful examination.

Most common causes of colitis:

• viral and bacterial infections;
• infections caused by protozoa and parasites;
• autoimmune diseases in which the body mistakenly attacks its own tissues and organs;
• violation of the blood supply to the colon due to partial or complete blockage of the arteries;
• food poisoning;
• severe allergic reaction;
• immunocompromised;
• uncontrolled intake of antibiotics, non-steroidal anti-inflammatory drugs;
• abuse of spicy, spicy food, alcohol.

Infectious colitis often develops due to infection with bacteria – Campylobacter, Escherichia coli, Salmonella, Staphylococcus, Shigella

Types of colitis

Depending on the course of the disease, acute and chronic colitis are distinguished.

Acute colitis is characterized by vivid symptoms: severe pain and bloating, diarrhea, streaks of blood in the stool, nausea, frequent urge to empty the intestines.

Excruciating pain in the abdomen is one of the symptoms of acute colitis

The symptoms of chronic colitis are almost the same. The difference is in the course of the disease. Acute colitis goes away with time. Chronic – not curable.

According to the prevalence of the pathological process, colitis is diffuse and segmental.

Diffuse colitis involves two or more parts of the colon.

Main types of diffuse colitis:

• proctosigmoiditis – affects the sigmoid and rectum;
• pancolitis – all parts of the large intestine are involved.

Segmental colitis is an inflammation of the mucous membrane of one section of the large intestine.

Main types of segmental colitis:

• typhlitis – the caecum is affected;
• proctitis – rectum;
• sigmoiditis – sigmoid colon;
• transverse colon.

There are also types of colitis depending on the changes that occur in the mucous membrane of the colon.

Types of colitis by mucosal changes:

• erosive – superficial lesions form on the mucous membrane;
• ulcerative – the mucous membrane of the large intestine swells, ulcers appear on it;
• hemorrhagic – there are foci of hemorrhage;
• atrophic – the mucous membrane of the colon becomes thinner.

Characteristic symptoms of hemorrhagic colitis are abdominal cramps and bloody diarrhea

Infectious colitis

One of the most common types of colitis is infectious. According to statistics, every person has been ill at least once in their life. Usually such colitis proceeds in an acute form.

The causative agents of infectious colitis are bacteria (most often campylobacter, E. coli, salmonella, staphylococcus, shigella), viruses (cytomegalovirus, rotavirus), protozoa (dysentery amoeba). Sometimes the disease develops when infected with helminths – pinworms, roundworms, whipworm.

Clostridial colitis is also common in practice. Its causative agent – the bacterium Clostridioides difficile (Cl. difficile) – produces toxic substances that provoke inflammation of the colon mucosa. Often this happens after taking antibiotics, which allow these bacteria to live in the intestines.

Amoeba is a microscopic unicellular organism, one of the causative agents of infectious colitis

In addition, infectious colitis often occurs as a complication of syphilis, tuberculosis, or AIDS.

Symptoms common to infectious colitis are diarrhea, fever, feeling unwell, weakness. If the small intestine is also involved in the process, then the amount of feces increases. At the same time, due to diarrhea, a person loses a large amount of fluid – there is a risk of dehydration.

In dysentery, the sigmoid colon most often becomes inflamed. The disease is acute: diarrhea develops (defecation occurs up to 20 times a day), mucus and blood appear in the feces. Patients complain of severe abdominal pain and high fever.

Similar signs are found in amoebiasis, a type of infectious colitis caused by amoeba, a single-celled protozoan.

Ischemic colitis

This is an acute inflammation of the large intestine, caused by a violation of the blood supply to its walls. Approximately 80% of cases occur in people over 55 years of age.

Most often, the blood supply is disturbed in atherosclerosis, embolism or thromboembolism of the vessels of the mesentery Mesentery A double sheet of peritoneum (a thin film that covers all organs of the abdominal cavity). Thanks to the mesentery, all intestinal loops are attached to the posterior wall of the abdominal cavity and do not intertwine with each other, allergies, injuries, postoperative complications.

In addition, ischemic colitis can develop against the background of arterial hypotension, severe anemia, dehydration, and abdominal aortic aneurysm.

A specific symptom of ischemic colitis is acute severe abdominal pain. Also, patients complain of stool disorder (alternating constipation and diarrhea), recurrent intestinal bleeding.

Severe abdominal pain, blood in the stool and false urge to defecate are possible signs of ischemic colitis

Radiation colitis

Radiation colitis is an inflammation of the colonic mucosa caused by exposure to radiation. It usually develops in patients with malignant tumors of the abdominal cavity, pelvis and genitals. Such neoplasms are treated by directing ionizing radiation to the affected organs and tissues.

The risk of developing radiation colitis increases if the patient has comorbidities – inflammatory bowel disease, diabetes mellitus.

During radiotherapy, the patient is exposed to x-rays

Symptoms of radiation and infectious colitis are similar. Patients develop nausea and vomiting, diarrhea, and abdominal pain.

Symptoms of acute and chronic colitis

Acute colitis develops suddenly and is accompanied by unbearable pain in the abdomen, diarrhea with streaks of blood in the stool. Exacerbation of chronic colitis has similar symptoms.

The main signs of acute and chronic colitis in the acute stage:

• severe abdominal pain,
• bloating,
• diarrhea,
• streaks of blood in feces,
• nausea,
• frequent urge to defecate.

Complications of colitis

If treatment is not started, colitis can lead to serious complications, up to necrosis, that is, tissue death.

Major complications of colitis:

• scar formation, which will lead to narrowing of the lumen of the colon;
• intestinal obstruction;
• internal bleeding;
• intestinal rupture;
• tissue necrosis (death);
• peritonitis – inflammation of the peritoneum;
• colon cancer.

Colitis diagnostics

If symptoms of colitis appear, you need to make an appointment with a doctor – a general practitioner or a gastroenterologist. The doctor will clarify with the patient the nature and localization of abdominal pain. He will take an interest in other symptoms – are there stool disorders, nausea and vomiting, fever.

If the pain in the abdomen is unbearable, and there is blood in the stool, you should immediately call an ambulance.

Then the doctor will palpate the abdomen. He will ask if pains appear when pressing on a particular area. Also, the doctor can listen to the stomach: noises, rumbling and gurgling, along with the symptoms indicated by the patient, will help complete the picture of the disease.

Palpation of the abdomen

Laboratory diagnostics

If colitis is suspected, the doctor will refer the patient for a complete blood count. Hemoglobin deficiency will indicate anemia due to internal bleeding. An increase in the level of leukocytes will detect the inflammatory process.

CBC with leukocyte formula and ESR (with microscopy of a blood smear in case of pathological changes) (venous blood) as well as help in the diagnosis of anemia, diseases of the hematopoietic organs, allergic reactions and autoimmune diseases.

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An analysis of calprotectin in feces will help detect inflammation in the colon.

Calprotectin in feces

Calprotectin in feces test allows you to find the cause of abdominal pain and gastrointestinal bleeding, distinguish inflammatory bowel diseases (ulcerative colitis and Crohn’s disease) from non-inflammatory and monitor the effectiveness of treatment.

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If a bacterial infection is suspected, stool culture for intestinal infections will be useful.

Stool culture for microflora

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Targeted studies help to exclude or confirm helminthic invasion and infection with protozoa.

Differential diagnosis of helminthiases IgG (n/col)

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Protozoa

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If you suspect Clostridial colitis, your doctor may order a targeted test for Clostridium difficile.

Clostridium difficile culture

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Instrumental diagnostics

Colonoscopy is an informative endoscopic examination of the colon. A thin flexible tube is inserted through the anus into the large intestine, equipped with a video camera with a backlight at the end. An image of the mucous membrane of the organ is displayed on the monitor. If necessary, during a colonoscopy, a biopsy is taken in order to then examine the tissue under a microscope.

CT scan of the abdomen with double contrast helps to suspect neoplasms of the intestine, inflammation, blood flow disorders, and also to detect fluid in the abdominal cavity.

Treatment of colitis

Mild colitis is treated on an outpatient basis – a special diet is prescribed, and if an infection is detected, antibiotics and anti-inflammatory drugs. In severe acute colitis and exacerbation of a chronic patient, it is necessary to be hospitalized. In autoimmune colitis, special anti-inflammatory drugs are used.

Diet therapy

In the acute phase of the disease, all indigestible foods should be excluded from the diet.

Prohibited foods for colitis:

• smoked products;
• meat, meat broths;
• salt;
• vinegar;
• legumes;
• fruits and vegetables;
• fatty food.

The amount of salt per day should not exceed 8-10 g – this is about one teaspoon without a slide. Dishes can be stewed or boiled without adding fat.

Usually such a diet is prescribed for a week. As a rule, this is enough to relieve acute symptoms.

Conservative treatment

Treatment of colitis depends on the cause of the disease. If a patient has an infection, they will be prescribed antibiotics. Methods of treatment of concomitant diseases of the digestive tract are determined by the doctor. To protect the intestinal microflora, he may also prescribe probiotics and prebiotics to the patient.

If test results show helminthic invasion, a course of antiparasitic therapy is given.

Inflammation in the lower parts of the large intestine is well stopped by local remedies – anal suppositories. They not only regulate intestinal motility, but also have an anti-inflammatory effect.

Surgical treatment

Operation is indicated only if there is a risk to the life of the patient. This usually happens with complications of colitis – massive bleeding, intestinal rupture.

Relative indication for surgery – partial intestinal obstruction.

Ulcerative colitis in severe cases is also treated surgically.