What is colitis?

Colitis is a bowel condition where there is inflammation in the lining of the large intestine (colon) resulting in diarrhea, blood in the stool, abdominal pain, and bloating. It has numerous possible causes, such as inflammatory bowel disease (ulcerative colitis and Crohn’s disease), infections, ischemia (lack of blood flow), and microscopic damage to the colon from chemicals or radiation.

How is colitis diagnosed?

Normally colitis is diagnosed endoscopically, either using flexible sigmoidoscopy or colonoscopy. The flexible sigmoidoscope is a short, bendable tube that is passed into the left side of the colon from the rectum. Colonoscopy is usually performed on a sedated patient in which the scope is passed the full length of the colon and into the distal small bowel.

Biopsies and stool samples are usually taken at the time of endoscopy to facilitate finding out the cause of the colitis. X-rays, such as CT scans, are also beneficial in diagnosing colitis; however, their inability to obtain tissue samples makes the finding of the cause of colitis somewhat problematic.

How is colitis treated?

Once the cause of the colitis is identified, the appropriate therapy is implemented. Antibiotics or anti-inflammatory agents are often used to treat colitis. Ischemic colitis is treated with antibiotics and by evaluating for hypercoagulable states.

Surgery is rarely needed for ischemic colitis. Inflammatory bowel conditions, such as ulcerative colitis and Crohn’s disease, are aggressively treated through medicines and sometimes may require surgical intervention.

If surgery is required for colitis, there are several options:

Total proctocolectomy with end ileostomy

Total proctocolectomy removes the anus as well as the rectum and colon. If you no longer have these parts of the digestive tract, you’ll require an ileostomy at the same time to create a stoma, which is a hole in the abdomen. The fecal matter then passes through the hole into a bag which you empty when necessary.

Proctocolectomy with ilea pouch-anal anastomosis (IPAA)

This form of proctocolectomy removes the colon and rectum but leaves the anus and anal sphincter in place. The advantage of this procedure compared with total proctocolectomy is that you don’t need to have a permanent external bag for the collection of fecal matter.

Find out more about the most effective way to deal with colitis by calling our office today.