Abdominal pain, digestive disorders, diarrhea… These symptoms may be those of colitis (acute or chronic). Focus on the causes and treatments of this inflammation of the colon.
Colitis means a inflammation of the colon which can be acute or chronic. The symptoms are mainly digestive. Infectious colitis (viral, bacterial or parasitic) are one of the most common causes of colitis. In case of fever or persistent symptoms, you should consult your attending physician or gastroenterologist. What is colitis? When to consult? What treatments treat colitis?
Definition: what is colitis?
The term colitis reflects a inflammation of the colon. A distinction must be made between colitis and functional intestinal disorders also called “functional colopathy” or “irritable bowel”, a disease in which there is no lesion of the colon’s mucosa. Several causes are responsible for colitis as described by Dr. Michael Bismuth, specialist in hepato-gastroenterology at Montpellier University Hospital. Colitis is a frequent reason for consultation in gastroenterology. They can be acute or chronic. The diagnosis of colitis can be made by imaging tests such as ultrasound or CT scan or by colonoscopy.
What are the symptoms of colitis?
“Whatever the cause of colitis or whether it is acute or chronic, it is manifested by digestive symptoms that combine localized or diffuse abdominal pain, transit disorders with daytime and sometimes nighttime liquid stools which may be purulent, mucous or bloody and sometimes nausea and vomiting“ describes Dr. Michael Bsimuth. In more serious forms, the general condition may deteriorate with the appearance of inappetence, fatigue and weight loss or even malnutrition (especially in chronic colitis). Some chronic colitis such as inflammatory diseases of the digestive tract can be associated with rheumatological, dermatological or ophthalmological symptoms.
What are the causes of colitis?
Many etiologies are at the origin of acute or chronic colitis. “The main causes of acute colitis are infectious colitis (viral, bacterial or parasitic), acute diverticulitis, ischemic colitis, the revelation of a chronic inflammatory disease of the digestive tract, colitis secondary to taking certain medications such as nonsteroidal anti-inflammatory drugs or antibiotics”details the specialist.
What is infectious colitis?
Infectious colitis is caused by bacteria (salmonella, clostridium, cholera, staphylococcus, etc.), viruses (rotavirus, etc.) or parasites (amoebas) and are responsible for acute diarrhea associated with abdominal pain. We distinguish choleriform syndrome, dysenteric syndrome with bloody stools associated with fever and gastroenteritis syndrome.
What is pseudomembranous colitis?
Pseudomembranous colitis is a particular form of infectious colitis that occurs after taking antibiotic treatment which is linked to the presence of a bacterium called Clostridium difficile. There are very serious forms which can be life-threatening. The treatment of pseudomembranous colitis is based on certain specific antibiotics.
What is acute diverticulitis?
Acute diverticulitis is a inflammation of a colon diverticulum. The diverticulum is a weakness of the wall of the colon whose frequency increases with age and which is characterized by “a small bursa” hanging from the wall of the colon. It is manifested by left abdominal pain (flank and left iliac fossa in general) associated with fever and transit disorders with sometimes bloody watery stools. The diagnosis is based on the abdominal scanner which will look for complications such as an abdominal abscess. The treatment of acute diverticulitis is well codified and involves treatment with antibiotics and a residue-free diet when diagnosed. A digestive surgery consultation can be discussed from the outset in serious forms or in the event of a recurrence.
What is ischemic colitis?
Ischemic colitis is related to a decrease in blood flow responsible for poor vascularization of the colon. It can be secondary to a state of shock (haemorrhage, allergy, severe infection), heart failure, taking certain medications (antihypertensives, diuretics, pills, anti-inflammatories), blood diseases, diseases of the arteries (atheromatosis, autoimmune diseases, etc.) or to a embolism.
What are the causes of chronic colitis?
The causes of chronic colitis are multiple such as chronic inflammatory diseases of the digestive tract (Crohn’s disease and ulcerative-hemorrgic rectocolitis), radiation colitis secondary to irradiation for cancer, so-called microscopic colitis often caused by taking medication (veinotonics, gastric antisecretory, aspirin, etc.) or the colon mucosa is normal (diagnosis made by colon biopsies). There are many other rarer causes of chronic colitis.
What are the signs of ulcerative colitis?
Crohn’s disease and ulcerative colitis are frequent chronic digestive pathologies which are usually revealed by transit disorders, in particular daytime and nighttime loose stools that may be bloody, chronic abdominal pain, weight loss or malnutrition. Endoscopic examinations such as colonoscopy and oesogastro-duodenal fibroscopy with the realization of biopsies are essential for diagnosis. Therapeutic management of these diseases requires a gastroenterological opinion specialized because the treatments can be complex and associated with several drugs or even a surgical treatment.
When to consult in case of colitis?
The diagnosis of colitis is based on the symptoms described by the patient, doctor’s clinical examination and the results of additional examinations such as stool tests for bacteria or parasites, imaging tests (ultrasound and scanner of the abdomen) and endoscopic examinations such as colonoscopy with biopsies (that is to say a sample of the mucosa of the colon) which can direct the cause of the colitis in particular in the event of chronic colitis. “It is essential to consult your attending physician or possibly a gastroenterologist in the event of serious signs (high fever, mucous or bloody stools, altered general condition, etc.), in the event of persistence or aggravation of the symptoms previously described after 2 to 3 days of evolution despite taking a treatment symptomatic or at extreme ages (elderly, infants)”warns Dr. Michael Bismuth.
What are the treatments for colitis?
Treatment for acute colitis depends on its cause. digestive rest in case of nausea and vomiting or the establishment of a diet low in fiber or residue may help improve symptoms. In case of severe abdominal pain, antispasmodic treatment associated with an analgesic treatment can be proposed.
Antidiarrheals should be handled with caution. especially in cases of infectious colitis (diarrhea being a mode of defense of the body). The treatment of chronic colitis and in particular chronic inflammatory bowel diseases such as ulcerative colitis and Cröhn’s disease requires specialized gastroenterological advice because the treatments can be complex and associated with several drugs (corticotherapy, immunosuppressant, biotherapies) or even treatment. surgical.
Thanks to Dr. Michael Bismuth, specialist in hepato-gastroenterology at Montpellier University Hospital.