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Colitis

Colitis Therapy

Featured colitis therapy including diet

  • Diet: Diet is the mainstay therapy for most causes of colitis. A clear fluid diet allows the colon to rest, since the fluid is absorbed in the stomach and none is passed into the colon to be processed as stool.
  • Hydration: Adequate hydration is important because an individual can lose a significant amount of fluid with each diarrheal bowel movement. Aside from the daily fluid requirements, this excess loss needs to be replaced, otherwise dehydration will occur and potentially worsen the symptoms of abdominal pain and cramping.
  • IV fluids: Intravenous (IV) fluid may be required, especially if the patient cannot drink enough fluids by mouth. For some illnesses like ischemic colitis, in which blood flow to the bowel is already compromised, adequate hydration is a key element in treatment.
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Colitis Overview

Colitis is the term used to described inflammation of the colon There are a variety of causes of colitis including infections, poor blood supply, and autoimmune reactions.

The colon (large bowel or large intestine) is responsible for collecting and storing the waste products of digestion. It is a long muscular tube that pushes undigested food towards the anus for eventual elimination as a bowel movement. As the liquid mixture of undigested food makes its journey, it mixes with mucus and normal bacteria residing in the colon. As well, water is reabsorbed into the bloodstream, and the feces start to solidify.

The colon is located in the abdominal cavity and is divided into the following parts: the cecum, the ascending colon, the transverse, the descending colon, the sigmoid, the rectum, and the anus. The right colon includes the cecum and ascending colon. The left colon includes the transverse segment to the sigmoid.

The wall of the colon has numerous layers. There is a smooth muscle layer that wraps the outside and is responsible for squeezing the undigested food through the length of the colon. The inner layers, or mucosa, come into contact with the fluid and allow water and electrolyte absorption to help solidify the feces. The mucosal layer is where the colon inflammation occurs and is responsible for the symptoms of colitis.

As with any other organ, the colon has a blood supply with arteries delivering oxygen rich blood and nutrients to it, and veins that drain carbon dioxide and lactic acid from it.

Colitis Causes

Inflammation of the colon can be caused by a variety of illnesses and infections. Some of the most common causes are discussed below.

Infectious Colitis

Viruses and bacteria can cause colon infections. Most are food-borne illnesses or "food poisoning." Common bacterial causes include Shigella, E.Coli, Salmonella and Campylobacter. These infections often present with bloody diarrhea and can cause significant dehydration.

Pseudomembranous colitis is caused by the bacteria Clostridium difficile (C. difficile). This disorder is often seen in patients who have recently been taking antibiotics for an infection. The antibiotic alters the normal bacteria present in the colon and allows an overgrowth of the Clostridium bacteria. Clostridium bacteria produce a toxin that causes diarrhea. This is an infection, and often there is a fever present. The diarrhea is usually not bloody.

Ischemic Colitis

The arteries that supply blood to the colon are like any other artery in the body. They have the potential to narrow due to atherosclerosis (just like blood vessels in the heart, which can cause angina, or narrowed vessels in the brain can cause a stroke). When these arteries narrow, the colon loses it's blood supply and becomes inflamed.

The colon can also lose its blood supply for mechanical reasons. A couple of examples include volvulus, in which the bowel twists on itself, or an incarcerated hernia in which a portion of the colon gets stuck in an outpouching of the abdominal wall.

In patients who are at risk for decreased blood flow to the colon, ischemic colitis can occur if the blood pressure falls. This may occur with dehydration, anemia, or shock.

Ischemia or lack of blood supply causes significant pain, fever, and bloody bowel movements.

Inflammatory Bowel Disease

There ate two types of inflammatory bowel disease. The first, ulcerative colitis, is thought to be an autoimmune illness in which the body's immune system attacks the colon and causes inflammation. Ulcerative colitis begins in the rectum and may gradually spread throughout the colon. The signs and symptoms are generally abdominal pain and bloody bowel movements.

Crohn's disease is the second type of inflammatory bowel disease, and may involve any part of the digestive tract from the esophagus and stomach to both the small and large intestine. It often has skip lesions, that is diseased areas are interspersed with healthy areas of tissue.

Microscopic Colitis

Two diseases make up this group of colon inflammation, collagenous colitis and lymphocytic colitis. In these diseases, the inflammation is caused by some layers of the colon wall becoming engorged with either collagen or lymphocytes. Watery, non-bloody diarrhea is the most common symptom.

This is an uncommon illness that is seen more frequently in older women. The cause is unknown but an auto-immune potential may exist.

Chemical Colitis

If chemicals are instilled into the colon, inflammation and damage can occur. One of the complications of an enema is the inflammation of the mucosal lining of the colon caused by harsh chemicals.



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Colitis

Why is good nutrition such a challenge for people with Crohn disease?

Most of us know that good nutrition is essential to good health. Good nutrition is even more important to people whose health is compromised by a chronic disease. When you have Crohn disease, maintaining good nutrition can be a real challenge.

Several factors contribute to nutritional problems in people with Crohn disease. When inflamed, the small intestine is not able to do its main job, which is absorbing nutrients from food. The degree of this impairment, called malabsorption, depends on the extent of inflammation and damage in the intestine.
 
To make matters worse, the intestinal inflammation and pain of the disease reduce your appetite, so you probably do not eat enough to supply your nutritional needs. Diarrhea further depletes important nutrients. Compounding the problem is the fact that people with a chronic illness such as Crohn disease require more calories and certain o...

Read the Diet and Nutrition in Crohn Disease article »



Read What Your Physician is Reading on eMedicine

Colitis »

Colitis is an inflammation of the colon. It may be associated with enteritis (inflammation of the intestine) and/or proctitis (inflammation of the rectum).

Read More on eMedicine »

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