Diagnosis of Colitis
There are several inflammatory bowel conditions called colitis, and the most common is ulcerative
colitis. The major symptom is diarrhea containing blood and mucus, often accompanied by severe abdominal
pain and cramping. Fever, loss of appetite, anemia and weight loss may occur, especially if the atack
is prolonged or recurrent. The entire colon may be involved, but the disease usually begins in the rectum
and lower portion of the colon. Some mild cases may be confined to this area, in which case the stools
may be normal or even hard, but contain blood and mucus.
Ulcerative colitis can be readily diagnosed by sigmoidoscopy, an examination allowing visual inspection
of the lower portion of the colon. A barium enema and X-ray study also may be performed but usually not
during an acute flare-up. Studies also may be indicated to determine whether the colitis is caused by
an infection, such as amebiasis or salmonellosis.
Complications of Colitis
Hemorrhage is the most common complication of ulcerative colitis. In some cases, the bowel also may be
perforated, leading to severe infections. This is always considered a medical emergency requiring immediate surgery.
Colon cancer is much more frequent in patients with ulcerative colitis, especially those with a family
history of the two diseases and in whom the colitis begins in childhood. Cancer is also more common if
the entire colon is involved. Therefore, patients with ulcerative colitis should be closely monitored
for colon cancer.
Treatment of Colitis
Mild to moderate ulcerative colitis usually can be treated with drugs and a special diet. Medications,
such as anticholinergics, may be prescribed to reduce colon motility. A normal diet usually can be consumed,
but foods that cause diarrhea or irritate the colon should be avoided. Some patients may be advised to avoid
raw fruits and vegetables. Antidiarrheal drugs also may be prescribed. More severe disease may require treatment
with corticosteroid drugs. Surgery to remove all or most of the colon may be required in severe cases or those
that are considered very likely to progress to cancer.
Summing Up
Irritable bowel syndrome is a common intestinal disorder characterized by diarrhea and abdominal cramps.
Ulcerative colitis is a less common and more severe inflammatory disease that may involve the entire large
intestine. Colitis tends to recur, but in most cases, a remission can be achieved through drug therapy.
Since colon cancer occurs more frenquently in ulcerative colitis patients, periodic cancer screening is recommended.
