Colitis

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Overview

Colitis is a digestive disease characterized by inflammation of the colon.

Signs and symptoms

Signs and symptoms of colitis include pain, tenderness in the abdomen, fever, swelling of the colon tissue, bleeding, erythema (redness) of the surface of the colon, rectal bleeding, and ulcerations of the colon. Common tests which reveal these signs include X-rays of the colon, testing the stool for blood and pus, sigmoidoscopy, and 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.

Types

Types of colitis include ulcerative colitis, Crohn's colitis, diversion colitis, ischemic colitis, infectious colitis, fulminant colitis, chemical colitis, microscopic colitis, lymphocytic colitis, and atypical colitis.

A well-known subtype of infectious colitis is pseudomembranous colitis, which results from infection by a toxigenic strain of Clostridium difficile. Parasitic infections can also cause colitis.

Any colitis with a rapid downhill clinical course is known as fulminant colitis. 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. Approximately half of these patients require surgery.

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.

Complete Differential Diagnosis of the causes of Colitis

(In alphabetical order)

Complete Differential Diagnosis of the Causes of Colitis

(By organ system)

Cardiovascular No underlying causes
Chemical / poisoning

Chemical colitis,

Dermatologic No underlying causes
Drug Side Effect

Alosetron (patient information), Ampicillin Oral (patient information), Auranofin, Aztreonam Injection (patient information), Azithromycin, Cefadroxil (patient information), Cefaclor, Cefamandole Nafate Injection (patient information), Cefazolin Sodium Injection (patient information), 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), Ceftizoxime Sodium Injection (patient information), Ceftriaxone Sodium Injection (patient information), Cefuroxime Sodium Injection (patient information), Cephalexin (patient information), Cephalosporin, Cephradine Oral (patient information), Clindamycin, Co-amoxiclav, Corticosteroid, Darifenacin (patient information), Dicloxacillin (patient information), Dirithromycin (patient information), Enoxacin (patient information), Ertapenem, Erythromycin and Sulfisoxazole (patient information), Flucytosine, Glycopyrrolate (patient information), Hyoscyamine (patient information), Imipenem and Cilastatin Sodium Injection (patient information), Lanthanum (patient information), Levofloxacin Oral (patient information), Linezolid, Lomefloxacin (patient information), Loracarbef (patient information), Methotrexate (patient information), Miconazole Injection (patient information), Moxifloxacin, Nafcillin Sodium Injection (patient information), Norfloxacin (patient information), Ofloxacin injection (patient information), Oxacillin Sodium Injection (patient information), Oxybutynin (patient information), Peginterferon alfa-2a (patient information), Peginterferon alfa-2b (patient information), Penicillin, Piperacillin sodium injection (patient information), Prednisolone, Procyclidine (patient information), Propantheline (patient information), Reserpine (patient information), Solifenacin (patient information), Sparfloxacin (patient information), Tegaserod (patient information),

Ear Nose Throat No underlying causes
Endocrine No underlying causes
Environmental No underlying causes
Gastroenterologic

Aganglionic Megacolon, Irritable bowel syndrome, Ischemic colitis, Inflammatory bowel disease, Lymphocytic colitis, Microscopic colitis, Crohn disease,

Genetic

Albinism,

Hematologic No underlying causes
Iatrogenic

Diversion colitis, EVAR,

Infectious Disease

Bacterial gastroenteritis, Bacillary dysentery, Campylobacter jejuni, Chlamydia trachomatis, Clostridium difficile, Cryptosporidiosis, Cytomegalovirus, Escherichia coli O157:H7, Entamoeba histolytica, Isosporiasis, Neisseria gonorrhoeae, Treponema pallidum, Typhlitis, Yersinia enterocolitica,

Musculoskeletal / Ortho

Ankylosing Spondylitis,

Neurologic No underlying causes
Nutritional / Metabolic

Gerson diet, Milk allergy,

Obstetric/Gynecologic No underlying causes
Oncologic No underlying causes
Opthalmologic No underlying causes
Overdose / Toxicity No underlying causes
Psychiatric

Autistic enterocolitis,

Pulmonary No underlying causes
Renal / Electrolyte No underlying causes
Rheum / Immune / Allergy

Behcet disease, Collagenous colitis, Dental braces, Inflammatory bowel disease,

Sexual No underlying causes
Trauma No underlying causes
Urologic No underlying causes
Miscellaneous

Multiple organ dysfunction syndrome,

Treatment

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. Surgery is sometimes needed, especially in cases of fulminant colitis. Surgery usually entails removing the colon and bowel and creating a "pouch" with portions of the small intestine.

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.

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