Colitis Symptoms

If you want to learn about inflammatory colitis symptoms, look no further. I am going to help steer you through the subject of inflammatory bowel disease (also known as IBD), the investigations and the management of this group of conditions.

So the first thing to know is…

What is Colitis and How It Differs From IBS?

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A lot of people get mixed up between IBS and IBD. Irritable Bowel Syndrome is a functional digestive disorder, a problem with the way the bowel works where as IBD or Inflammatory Bowel Disease causes inflammation within the bowel wall.

Both conditions can cause diarrhea and abdominal pain symptoms and this is why the two conditions can sometimes be muddled up.

Inflammatory colitis is a condition that affects the large bowel. There are two main forms of the condition, Crohns disease and Ulcerative colitis.

I will explain more about these later and also other forms of colitis too.

Both these conditions cause the bowel to become inflamed to varying degrees.

The main Crohns and Ulcerative colitis symptoms include abdominal pain, diarrhea, bleeding, weight loss and extra intestinal features such as tiredness, mouth ulcers, anemia, joint pains and rashes, eye problems (iritis and uveitis) and in some cases a liver disease called sclerosing cholangitis.

Who Gets Symptoms?

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Inflammatory colitis can affect both men and women equally and can occur at any age, but most commonly occurs between the ages of 15 to 40 years of age with a prevalence between 100 to 150 per 100, 000 population.

Crohns and Ulcerative Colitis Difference

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Symptoms of crohns and ulcerative colitis can be very similar. However, there are some differences as Crohns can affect anywhere from the mouth to the anus whereas ulcerative colitis only affects the colon.

Often Crohns disease sufferers have issues with their weight and are often, although not exclusively, are of low body weight.

Crohns disease can also cause what’s known as perianal disease in about 20% of cases. Perianal disease causes abscesses in and around the buttock and anal area.

Abnormal tracts occur and are known as fistulas, with communication between the skin and the internal area of the pelvis.

The opening “sinuses” can discharge pus and sometimes blood. Fistulas can also occur internally between the bowel and other organs such as the bladder.They can also connect two pieces of bowel.

Investigation of Crohns and Ulcerative Colitis

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There are many colitis symptoms investigations that can be done. These can include blood tests to check for anemia and evidence of liver involvement.

Other blood tests known as inflammatory markers including the CRP or c-reactive protein and ESR or erythrocyte sedimentation rate are used as indicators of inflammation.

They can be used to guide treatment progress, but they are not always raised in either condition.

There is a stool test called a fecal calprotectin test that is often raised in bowel inflammation and a stool should always be sent to exclude an infective cause.

The main investigation to diagnose colitis is through passing a flexible camera in to the large bowel. These investigations include a flexible sigmoidoscopy and colonoscopy.

The latter is most common as it investigates the whole of your large bowel and biopsies (little pieces of tissue) can be taken during the test to be analyzed in the laboratory.

Less commonly, x-ray investigations with a barium enema and CT colon are used in the investigation of your bowel symptoms.

Other Conditions That Can Cause Symptoms

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I have discussed Crohns and Ulcerative colitis symptoms, but there are other conditions that can give rise to similar features. The most common of these are infections of the colon.

There’s a curious condition called microscopic colitis. This is diagnosed on biopsy and produces symptoms similar to other forms of IBD.

It can occur in some people that take proton pump inhibitors such as Omeprazole or Losec for their indigestion and it is also more common in people with celiac disease.

In the elderly, poor blood supply to the gut can cause a condition called ischemic colitis. This can be a very difficult condition to treat as it doesn’t respond to the usual treatments for inflammatory colitis.

Prevention in this case is better than cure, so those at risk include people with blood pressure issues; diabetes, smoking, high cholesterol levels and obesity are all at risk. Addressing these risk factors may help reduce the risk.

Treatment

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There are many treatments of inflammatory colitis symptoms ranging from tablets to enemas and suppositories and lastly injections and infusions.

The most common treatment is with the anti-inflammatory drugs known as 5-ASA’s or aminosalicylic acid treatments. These are commonly used to not only treat inflammation, but can also be used to help prevent bowel symptoms occurring. This is known as a prophylactic drug.

Steroids are commonly used if the symptoms are acute and usually work well. If symptoms are really bad, they can be given in an injectable form too.

There are many side effects to steroids, particularly in long-term use which makes them less attractive. These include thinning of the bones (osteoporosis), high blood pressure, diabetes, redistribution of fat, bruising and thinning of the skin.

When someone is steroid dependent, other drugs known as immunosuppressants are often used. These can be very effective and include such drugs as Azathioprine, 6-Mercaptopurine and Cyclosporine.

Whilst these drugs are good, they do have potential long term issues such as increased risk of infections and effects on your bone marrow where your blood cells are produced. They need to be monitored carefully by your doctor.

Newer drugs called anti-TNF drugs are sometimes used when colitis symptoms are evident. The common ones are Infliximab which is given as a drip infusion and Adalimumab (Humira) which is given as a subcutaneous injection. Again, these drugs have potential side effects and need to be supervised by a specialist.