Medical Treatment

The definitive treatment of colitis is dependent upon the cause. Many cases require little more than symptomatic care, including clear fluids to rest the bowel and medications to control pain. Some patients become acutely ill and will need intravenous fluids and other interventions to treat their illness.

• Infections: Infections that cause diarrhea and colitis may or may not require antibiotics, depending upon the cause. Viral infections resolve with the supportive care of fluids and time. Some bacterial infections like Salmonella also do not need antibiotic therapy; the body is able to get rid of the infection on its own. Other bacterial infections like Clostridium difficile always require treatment with antibiotics.
  
  
• IBD: The inflammatory bowel diseases (IBDs), ulcerative colitis and Crohn's disease, are often controlled by a combination of medications that are used in a step-wise approach. Initially, anti-inflammatory medications are used, and if these are less than successful, medications that suppress the immune system can be added. In the most severe cases, surgery may be required to remove all or parts of the colon and small intestine.
  
  
• Ischemic colitis: Treatment for ischemic colitis is initially supportive, using intravenous fluids to rest the bowel and prevent dehydration. If adequate blood supply to the bowel isn't restored, surgery may be required to remove parts of the bowel that have lost blood supply.
  
  
• Diarrhea and abdominal pain: Most causes of colitis present with diarrhea and crampy abdominal pain. These symptoms are also found with mild illnesses like viral enteritis (inflammation of the colon). Initial treatment at home may include a clear fluid diet for 24 hours, rest, and acetaminophen (Tylenol) as needed for pain. Often symptoms resolve quickly and no further care is needed.

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