Colitis is an inflammatory bowel disease which causes the lining of the colon (part of the large intestine) to become swollen, inflamed and ulcerated.It can occur at any age but is usually diagnosed between the ages of 15 and 40 years.The signs and symptoms of colitis can vary from one person to another. Common symptoms include abdominal pain, weight loss, tiredness, fever and diarrhoea (often accompanied by blood and mucus). The disease can also be associated with mouth ulcers, inflamed eyes, a skin rash, fever, ulcerated legs, swollen joints, pain and swelling of the lower back, stiffening of the spine and inflammation of the liver or bile ducts. Children suffering from colitis may experience slowed growth.Symptoms can flare up during a relapse but die down if the disease goes into remission (when the disease is inactive).

Causes

The cause of colitis is not fully understood. Scientists have suggested that it could be caused by viruses, bacteria, diet, stress or smoking but there is little evidence to support any of these theories.

Diagnosis

To properly diagnose your symptoms, your doctor may use one or more of the following techniques:

  • blood tests cannot be used to diagnose colitis but they can be used to test for anaemia (a deficiency in the blood which can cause a pale complexion and extreme tiredness), to check for vitamin or mineral deficiencies and to evaluate how severe the inflammation is a stool sample may be taken and then sent off to a laboratory for testingyour doctor may want you to have a sigmoidoscopy or a colonoscopy. Both procedures involve an illuminated viewing instrument being passed into your rectum and bowel via your anus. This allows the doctor to inspect the lining of your bowel and if necessary take a small sample of tissue for analysis (a biopsy). These procedures are often carried out while you are under sedation but sometimes a general anaesthetic is used
  • your doctor may send you for an X-ray. Beforehand you may be given a barium enema. This involves delivering a solution of barium sulphate into the rectum. The solution shows up clearly on an X-ray and enables the doctor to get a better look at the condition of your intestine

Treatment

There are many different ways of treating colitis.

  • steroids such as prednisolone are used to reduce inflammation and to ease the symptoms of ulcerative colitis. They work by blocking the action of prostaglandins, which are chemicals in the body responsible for triggering inflammatory reactions. They are available in oral and rectal forms. Severe relapses may need to be treated in hospital with steroids delivered directly into a veinaminosalicylates such as sulfasalazine, mesalazine, olsalazine and balsalazide are also used to reduce inflammation. They are available in oral and rectal formslaxatives are often used to ease painful constipationantidiarrhoeal medicines can be used to treat diarrhoeapainkillers may be used to relieve painazathioprine is an anti-inflammatory medicine. It is often used when other anti-inflammatory medicines have failedif blood loss causes anaemia, iron supplements may be needed. In rare cases a blood transfusion may be necessary
  • in some cases surgery may be performed to remove part of, or the whole of, the colon

Avoiding Relapses

It is not fully understood what causes relapses but they have been linked to stress, diet, taking certain medicines (particularly antibiotics, aspirin or medicines for arthritis) and common infections such as colds and flu. To avoid a relapse it may be worth trying the following:

  • eat a healthy, well-balanced diet. Avoid foods which are known to aggravate your condition. Some people find that milk products, cereals, fruit, nuts, spicy foods and fatty foods can make symptoms worse.Drink plenty of water.Eat small, regular meals instead of large meals and do not rush or skip meals
  • avoid stress or stressful situations. Relaxation techniques such as yoga or meditation may help

Additional Information

For more information about colitis, contact….

  • the Digestive Disorders Foundation, 3 St Andrews Place, London, NW1 4LB. Tel: 0171 486 0341. Or visit their website at www.digestivedisorders.org.uk
  • the National Association for Colitis and Crohn's Disease (NACC), 4 Beaumont House, Sutton Road, St Albans, Hertfordshire AL1 5HH. Tel: 01727 844296. Fax: 01727 862550. Or visit their website at www.nacc.org.uk

If you are a woman taking a contraceptive pill, please remember that diarrhoea and sickness can stop the pill working properly. Extra contraceptive precautions must be taken during a bout of diarrhoea and for seven days afterwards. In the case of a combined pill, should the seven days finish during the pill-free week, the next packet should be started without a break. A doctor or pharmacist will be able to explain this in more detail.