Living with colitis
Colitis is a chronic inflammatory bowel disease (IBD) which causes an inflammation of the colon. There are several types of colitis, including ulcerative colitis, infectious colitis, Crohn's colitis and many others.
A colitis patient may show some of the following symptoms that may be categorized as common or severe. Common symptoms include diarrhea, slight pain and tenderness in the lower abdomen, loss of appetite and emotional stress. More severe symptoms include loss of blood with stool, excessive weight loss, anemia, severe pain in the lower abdomen and an increased urgency to defecate. Colitis can also leave patients for months or years at a time, and then suddenly reoccur.
The causes of colitis are not yet fully known. Most doctors and researchers feel that it is caused by an abnormality in the immune system itself, rather than any external cause. Normally, our immune system fights harmful foreign bodies, but in a colitis patient, the immune system is somehow altered to treat digestive salts, food particles and enzymes in the large intestine as dangerous. It combats this perceived danger by sending white blood cells to the inner walls of the colon. This excess of white blood cells causes an inflammation of the inner lining of the colon, leading to the formation of ulcers. In acute cases, this results in excessive bleeding coupled with small perforations in the walls of the lower abdomen, in which case surgery might be needed.
Diagnosing colitis involves taking blood and stool samples, followed by imaging and internal inspection. A blood report is used to rule out the infectious and parasitic causes of diarrhea, such as those caused by food poisoning. It is also used to detect whether or not the patient has developed anemia due to the passing of blood through the stool. Stool samples are examined for presence of blood cells.
If these initial tests indicate colitis, most doctors will suggest doing some imaging before taking a patient for an internal inspection. This involves taking an X-ray or an ultrasound scan of the lower abdomen. Images will show the inflamed area quite well and can partially confirm the presence of colitis.
Doctors may then refer patients to for a specialist for internal inspection procedures, such as a sigmoidoscopy or a total colonoscopy. These procedures involve an inspection probe inserted in the patient's anus. The external screen shows the inflamed areas of the colon. A total colonoscopy involves inspection of entire colon with some sample cutting from the inner walls for biopsy purposes.
Treatment depends on the acuteness of the disease. For less severe cases, a 5-ASA line of treatment is recommended. 5-ASA is also known as an aminosalicylate, which is an anti-inflammatory medication. This helps to treat mild and moderate cases of colitis and also helps prevent a relapse of the disease. For acute patients, corticosteroids and immune modifiers are suggested.
For a few patients, colitis can become so severe that the only option is surgery. During surgery, part of the colon is removed and small intestine is made to excrete through a small opening crafted in the lower abdomen, called the stoma. An external pouch then needs to be attached to collect and remove waste. Another approach has the colon removed and a pouch created internally that connects the small intestine with the muscles in the anus. This way, patients can pass stool normally and bowel integrity is preserved as well.
It is very important for all patients to remain mentally positive during treatment for it to be more effective. A proper, nutritious diet is also helpful during treatment. Avoid spicy and irritable foods and drink lots of water. If you have any questions about what foods to avoid in order to maintain a good colitis diet, don't hesitate to ask your doctor.
By Anusheel Tandon
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