Colitis (Symptoms, Types, and Treatments)
Benjamin Wedro, MD, FACEP, FAAEM
Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen’s University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.
Bhupinder S. Anand, MBBS, MD, DPHIL (OXON)
Dr. Anand received MBBS degree from Medical College Amritsar, University of Punjab. He completed his Internal Medicine residency at the Postgraduate Institute of medical Education and Research, Chandigarh, India. He was trained in the field of Gastroenterology and obtained the DPhil degree. Dr. Anand is board-certified in Internal Medicine and Gastroenterology.
Jay W. Marks, MD
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
Colitis definition and facts
- Colitis refers to inflammation of the inner lining of the colon. There are numerous causes of colitis including infection, inflammatory bowel disease (Crohn’s disease, ulcerative colitis), ischemic colitis, allergic reactions, and microscopic colitis.
- Symptoms of colitis depend upon the cause and may include
- abdominal pain,
- diarrhea, with or without blood in the stool (one of the hallmark symptoms of colitis).
- Associated symptoms depend upon the cause of colitis and may include
- eye inflammation,
- joint swelling,
- canker sores,
- skin inflammation.
- Blood in the stool is never normal and medical care should be sought for evaluation of the cause.
- Depending upon the history and physical examination, further testing may be necessary to find the cause of colitis and may include blood tests (complete blood count, electrolytes, k >
What are the symptoms of colitis?
Colitis can be caused by infections, loss of blood supply, or chronic diseases. Despite the cause, people suffering from colitis may have typical symptoms that include
- abdominal pain,
- bloating, and
- diarrhea (bloody diarrhea with some types of colitis).
What is colitis?
Colitis describes inflammation of the inner lining of the colon and can be associated with diarrhea, abdominal pain, bloating, and blood in the stool. This inflammation may be due to a variety of reasons, including the following:
- Loss of blood supply to the colon (ischemia)
- Inflammatory bowel disease (Crohn’s disease, ulcerative colitis)
- Allergic reactions
- Invasion of the colon wall with lymphocytic white blood cells or collagen
Colitis and the anatomy of the colon
The colon, or large intestine, is a hollow, muscular tube that processes waste products of digestion from the small intestine, removes water, and ultimately eliminates the remnants as feces (stool) through the anus. The colon is located within the peritoneum, the sac that contains the intestine, located in the abdominal cavity.
The colon is surrounded by many layers of tissue. The innermost layer of the colon is the mucosa that comes into contact with the waste products of digestion. The mucosa absorbs water and electrolytes back into the blood vessels that are located just below the surface in the submucosa. This is surrounded by a circular layer of muscles and then another outer layer of longitudinal muscles that run along the length of the colon. The muscles work together to rhythmically squeeze liquid waste from the cecum through the entire length of the colon. Water is gradually removed, turning the waste into formed stool, so that it is excreted out of the anus in solid form.
The colon frames the organs within the peritoneum, and its segments are named based on their location.
- The colon usually begins in the right lower quadrant of the abdomen, where the terminal ileum, the last part of the small intestine, attaches to the cecum, the first segment of the colon. The appendix is attached to the cecum.
- The ascending colon begins at the cecum and arises from the right lower abdomen to the right upper abdomen near the liver.
- The colon then makes a sharp left turn called the hepatic flexure (hepatic=liver), and is referred to as the transverse colon, as it makes its way to the left upper quadrant of the abdomen near the spleen.
- There is a sharp downward turn called the splenic flexure, and it is referred to as the descending colon as it runs from the left upper quadrant to the left lower quadrant of the abdomen.
- When it descends into the pelvis, it is referred to as the sigmo >
What are the causes (types) of colitis?
Colitis describes inflammation of the colon (col=colon + itis=inflammation). Examples of causes of colitis include
- infection, for example, caused by bacteria like C. difficile, viruses, and parasites;
- inflammatory bowel disease like Crohn’s disease and ulcerative colitis,
- ischemic colitis caused by decreased blood supply;
- microscopic colitis (lymphocytic/collagenous colitis);
- allergic reactions.
Infectious causes of colitis
Many bacteria reside in the colon; they live in harmony with the body and cause no symptoms. However, some infections can result if a virus, bacteria, or parasite invade the small and/or large intestine.
Common bacteria that cause colitis include
These infections usually occur because the patient has eaten contaminated food. Symptoms can include diarrhea with or without blood, abdominal cramps, and dehydration from water loss because of numerous watery, bowel movements. Other organs can also be affected by the infection or the toxins that the bacteria can produce.
Clostridium difficile, commonly referred to as C. diff, is a bacterial cause of colitis that often occurs after a person has been prescribed an antibiotic or has been hospitalized. C. diff is found in the colon of healthy people and coexists with other “normal” bacteria. But when antibiotics are prescribed, susceptible bacteria in the colon can be destroyed, allowing the clostridia to grow unchecked, causing colitis. Patchy membranes form over the colon mucosa and some health-care professionals refer to C. diff colitis as pseudomembranous colitis. The bacteria also may be found on many surfaces in the hospital (for example, bedrails, toilets, and stethoscopes), and the infection may spread from person to person (it is highly contagious). Unfortunately, this infection is becoming more common outside the hospital environment, and people can develop community acquired C. diff colitis without exposure to antibiotics or a medical facility.