Colitis is an inflammatory bowel disease (IBD) affecting the colon (large intestine). There are several types of colitis: ulcerative colitis, ischemic colitis, pseudomembranous colitis, and microscopic colitis.
Ulcerative colitis causes long-lasting inflammation and ulcers (sores) in the digestive tract. It affects the innermost lining of the large intestine (colon) and rectum. Symptoms typically develop over time. Ulcerative colitis can be debilitating and may have life-threatening complications. There is no known cure, but treatment can greatly reduce symptoms of the disease, with potential for long-term remission.
Ulcerative colitis symptoms include:
- Diarrhea (often with blood or pus)
- Abdominal pain and cramping
- Rectal pain
- Rectal bleeding (passing small amount of blood with stool)
- Urgency to defecate
- Inability to defecate despite urgency
- Weight loss
The exact cause of ulcerative colitis is unknown, but it may be caused by an abnormal immune system reaction. Diet and stress may trigger “flare-ups” of ulcerative colitis, but are not the root cause.
Ischemic colitis occurs when blood flow to a section of the large intestine (colon) is reduced due to narrowed or blocked blood vessels. This diminished blood flow provides insufficient oxygen for digestive system cells, causing painful damage to the colon. Ischemic colitis can affect any part of the colon, but most often causes pain on the left side of the abdomen.
Ischemic colitis is most common among those over age 60. Symptoms include:
- Abdominal pain, tenderness, or cramping
- Rectal bleeding (bright red or maroon-colored blood in stool, or passing of blood without stool)
- Urgency to defecate
The precise cause of ischemic colitis is unknown, but there are several risk factors:
- Buildup of fatty deposits on artery walls (atherosclerosis)
- Dangerously low blood pressure (hypotension) associated with heart failure, major surgery, trauma, or shock
- A blood clot in an artery supplying the colon or, less commonly, in a vein (venous thrombosis)
- Bowel obstruction caused by a hernia, scar tissue, or a tumor
- Surgery involving the heart or blood vessels, the digestive system, or female reproductive system
- Blood disorders, like inflammation of the blood vessels (vasculitis), lupus, or sickle cell anemia
- Cocaine or methamphetamine use
- Colon cancer (rare)
Pseudomembranous colitis occurs when harmful bacteria in the colon release strong toxins. Such bacteria are normally regulated by healthy bacteria in the digestive system, but this balance can be upset by antibiotics and other medications. It may also be referred to as antibiotic-associated colitis or C. difficile colitis. Severe pseudomembranous colitis can be life-threatening, however treatment is typically successful
Pseudomembranous colitis symptoms include:
- Diarrhea (potentially bloody)
- Abdominal cramps and pain
- Pus or mucus in the stool
Virtually any antibiotic can cause pseudomembranous colitis. Antibiotics most commonly associated with pseudomembranous colitis include:
Microscopic colitis is an inflammation of the large intestine that causes persistent diarrhea.
Symptoms may be sporadic, and include:
- Chronic diarrhea
- Abdominal pain or cramps
- Weight loss
- Fecal incontinence
Suspected causes include:
- Medications that can irritate the lining of the colon
- Bacteria that produce toxins that irritate the lining of the colon
- Viruses that trigger inflammation
- Other immune system disorders, such as rheumatoid arthritis or celiac disease.
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