What types of colitis are there?
Doctors distinguish between colitis for a reason, because their treatment is fundamentally different. Stool tests, colonoscopy, and biopsy can help determine the type of colitis.
- Infectious - caused by bacteria, viruses, parasites
- Pseudomembranous - associated with antibiotics and Clostridioides difficile
- Inflammatory bowel diseases - ulcerative colitis and Crohn's disease
- Microscopic - changes are visible only under a microscope
- Ischemic - due to impaired blood supply to the intestine in the elderly
- Drug and radiation - after NSAIDs, chemotherapy and radiation therapy
Causes and risk factors
The most common causes of chronic complaints are previous intestinal infections, after which intestinal function is disrupted, long-term use of medications and immune diseases of the intestines. In older people with atherosclerosis, diabetes and heart disease, it is important to think about ischemic colitis.
- Past intestinal infections and parasitoses
- Antibiotic courses
- Regular use of NSAIDs
- Atherosclerosis and heart rhythm disturbances
- Radiation therapy of the pelvic organs
Symptoms
The manifestations are similar for different types of colitis, so it is impossible to make an accurate diagnosis based on complaints. If blood appears in the stool, a person loses weight, or wakes up at night due to diarrhea, we are most likely not talking about a functional disorder, but about an inflammatory or other organic disease.
- Pain or cramps in the abdomen, most often along the colon
- Unstable stool - diarrhea, constipation, or alternation of both
- Mucus, sometimes blood in stool
- Bloating and rumbling in the stomach
- False urges, feeling of incomplete evacuation
Diagnostics
They start with stool tests: coprograms, tests for intestinal infections, parasites and C. difficile toxins, fecal calprotectin. Normal calprotectin speaks against severe inflammation and in favor of irritable bowel syndrome. With increased calprotectin, blood in the stool, weight loss and age over 45–50 years, a colonoscopy with biopsy from different parts of the intestine is indicated - without it microscopic colitis cannot be diagnosed.
- Coprogram and stool tests for infections and parasites
- Fecal calprotectin
- Complete blood count, CRP, iron
- Colonoscopy with biopsy
- Ultrasound or CT scan of the abdominal cavity according to indications
Treatment and prevention
Treatment depends entirely on the identified cause. Infectious colitis is treated with antibacterial or antiparasitic agents, pseudomembranous colitis with special antibiotics, inflammatory bowel diseases with anti-inflammatory and immunosuppressive therapy, and drug withdrawal with drug withdrawal. Diet relieves symptoms of any colitis, but does not eliminate its cause. Probiotics and sorbents are sometimes prescribed as a supplement, but taking them for years instead of examination is dangerous: you can miss a serious disease.
- Regular small meals, enough fluids
- Limiting fatty, spicy foods, alcohol during an exacerbation
- Do not take antibiotics and NSAIDs without a doctor's prescription
- Practice good food hygiene and wash your hands
- Screening colonoscopy after 45–50 years