Acute colitis (infectious, viral, etc.) occurs suddenly and is accompanied by symptoms such as fever and intense pain. In France, it represents nearly 10% of annual cases of acute diarrhea. Is that bad ? What treatment?
Colitis is an inflammation of part or all of the lining of the colon. It is said that the crisis of colitis is “acute” if it occurs suddenly, that it is accompanied by fever or severe pain, which appear within a few hours. What are the symptoms of a colitis attack? Is that bad ? What causes acute colitis? How to relieve it?
What is the definition of acute colitis?
A colitis East inflammation of all or part of the colorectal mucosa, caused by an infectious agent or an inflammatory disease. It can be chronic (evolving for several weeks) or acute. Acute colitis is colitis occurring brutallyoften accompanied by fever and intense pain, appearing in a few hours.
What are the causes of acute colitis?
Acute colitis can have several origins:
- A viral, bacterial, or parasitic infection
- A medicinal origin: cthey are generally laxatives or antibiotics that can generate this type of colitis.
- A radiotherapy treatment (when cancer is treated with radiation), we then speak of radiation colitis.
- ischemiathat is to say a decrease in the vascularization of the intestinal wall.
- In some cases it is inflammatoryespecially in case of MICI (Chronic Inflammatory Bowel Disease) or vasculitis.
What are the symptoms of acute colitis?
Several symptoms are likely to suggest acute colitis, in particular:
- a fever of more than 38.5°C,
- diarrhea which may be accompanied by blood with sometimes difficulty defecating,
- severe stomach aches (local or generalized),
- marked weight loss,
- tiredness.
In the event of intense pain in the stomach, especially if it is associated with a fever, do not wait to consult your doctor or the emergency room in order to quickly carry out additional examinations (coproculture, ASP, colonoscopy) and start treatment without delay.
The diagnosis is based on theanamnesis, that is, the questioning of the patient. The symptoms described will guide the practitioner towards the diagnosis of acute colitis. This hypothesis will be confirmed by carrying out a colonoscopy. This examination can be supplemented by a biopsy (a sample of the mucosa in order to analyze it), a blood test which will make it possible to find a number of white blood cells, a sedimentation rate and a high C-reactive protein level, as well as a stool analysis (coproculture or parasitological examination of the stool). An abdominal X-ray, called ASP (for Abdomen Without Preparation), may also be prescribed.
How long does acute colitis last?
In the absence of rapid treatment, acute colitis can last several days or several weeks, sometimes endangering the patient’s life. If medical treatment is offered quickly, symptoms usually improve within a few days.
What treatment to treat acute colitis?
The treatment of acute colitis is essentially medicated. The doctor usually prescribes antibiotics or antiparasitics intended to fight against colitis of infectious origin. On the other hand, colitis due to radiotherapy treatment will have to be managed surgically by removal of part of the colon. Similarly, when the medical treatment has failed or complications appear, only colectomy is considered.
What is the treatment for severe acute colitis?
Severe acute colitis requires medical supervision in a specialized environment with daily ASP, 48 hour fast, and infusion for hydration. There intravenous corticosteroid therapy is the first-line medical treatment. However, it is ineffective in one out of three patients. Infliximab and ciclosporin are possible in 2nd line with comparable efficiency and job security. The choice between the two molecules must be made on a case-by-case basis. There colectomy must be proposed from the outset in the event of complicated forms and be discussed at each stage of the therapeutic management, as an alternative to medical treatment.
What to eat in case of colitis?
The diet must be adapted with a residue-free diet which makes it possible to reduce or eliminate from the diet vegetable dietary fibers but also the residues that can be found in meat (tendons, keratin). We generally recommend 2 to 3 weeks of a strict residue-free diet then 2 weeks of an extended diet. This diet leads to a decrease in stool volume, a decrease in intestinal transit and avoids irritating the intestinal mucosa. We must avoid:
- all raw and cooked vegetables,
- all raw and cooked fruits,
- all whole grains,
- all fibrous or sinewy meats.
The main preventive advice that is given to limit acute colitis attacks is first of all food. It is indeed recommended to limit the consumption of spicy dishes and spices in general (mustard, curry…), chew food diligently and of drink in quantity. It is also advisable to‘avoid stress as much as possible, to eat at a fixed time and to avoid irritating drugs such as laxatives.