Colitis

Colitis
Classification and external resources

A micrograph demonstrating cryptitis, a microscopic correlate of colitis. H&E stain.
ICD-10 K50 - K52
ICD-9 556.9
OMIM 191390
DiseasesDB 31340
MedlinePlus 001125
eMedicine ped/435
MeSH C06.405.205.265

In medicine, colitis (pl. colitides) refers to an inflammation of the colon and is often used to describe an inflammation of the large intestine (colon, caecum and rectum).

Colitides may be acute and self-limited or chronic, i.e. persistent, and broadly fit into the category of digestive diseases.

In a medical context, the label colitis (without qualification) is used if:

  1. The aetiology of the inflammation in the colon is undetermined; for example, colitis may be applied to Crohn's disease at a time when the diagnosis has not declared itself.
  2. The context is clear; for example, an individual with ulcerative colitis is talking about their disease with a physician that knows the diagnosis.

Contents

Signs and symptoms

The signs and symptoms of colitides are quite variable and dependent on the etiology (or cause) of the given colitis and factors that modify its course and severity.

Symptoms of colitis may include: abdominal pain, loss of appetite, fatigue, diarrhea, cramping, urgency and bloating.

Signs may include: abdominal tenderness, weight loss, changes in bowel habits (increased frequency), fever, bleeding (overt or occult)/bloody stools, diarrhea and distension.

Signs seen on colonoscopy include: colonic mucosal erythema (redness of the inner surface of the colon), ulcers, bleeding.

Diagnosis

Symptoms suggestive of colitis are worked-up by obtaining the medical history, a physical examination and laboratory tests (CBC, electrolytes, stool culture and sensitivity, stool ova and parasites et cetera). Additional tests may include medical imaging (e.g. abdominal computed tomography, abdominal X-rays) and an examination with a camera inserted into the rectum (sigmoidoscopy, colonoscopy).

Types

There are many types of colitis. They are usually classified by the etiology.

Types of colitis include:

Micrograph showing intestinal crypt branching, a histopathological finding of chronic colitis. H&E stain.
Micrograph of a colonic pseudomembrane, as may be seen in in Clostridium difficile colitis, a type of infectious colitis.

Autoimmune

  • Inflammatory bowel disease (IBD) - a group of chronic colitides.
    • Ulcerative colitis - a chronic colitis that affects the large intestine.
    • Crohn's disease - a type of IBD often leads to a colitis.

Idiopathic

Iatrogenic

Vascular disease

Infectious

  • Infectious colitis.

A well-known subtype of infectious colitis is Clostridium difficile colitis,[1] which is informally abbreviated as "c diff colitis". It classically forms pseudomembranes and is often referred to as pseudomembranous colitis, which is its (non-specific) histomorphologic description.

Enterohemorrhagic colitis may be caused by Shiga toxin in Shigella dysenteriae or Shigatoxigenic group of Escherichia coli (STEC), which includes serotype O157:H7 and other enterohemorrhagic E. coli.[2]

Parasitic infections, like those caused by Entamoeba histolytica, can also cause colitis.

Unclassifiable colitides

Indeterminate colitis is a term used for a colitis that has features of both Crohn's disease and ulcerative colitis.[3] Indeterminate colitis' behaviour is usually closer to ulcerative colitis than Crohn's disease.[4]

Atypical colitis is a phrase that is occasionally used by physicians for a colitis that does not conform to criteria for accepted types of colitis. It is not an accepted diagnosis per se and, as such, a colitis that cannot be definitively classified.

Severity of colitides

Fulminant colitis is any colitis that becomes worse rapidly. In addition to the diarrhea, fever, and anemia seen in colitis, the patient has severe abdominal pain and presents a clinical picture similar to that of septicemia, where shock is present. About half of human patients require surgery. In horses, the fulminant colitis known as colitis X usually results in death within 24 hours.

Irritable bowel syndrome, a separate disease, has been called spastic colitis. This name may lead to confusion, since colitis is not always a feature of irritable bowel syndrome. Since the etiology of IBS is currently unknown and possibly multifactorial, there may be some overlap in symptoms between IBS and the various forms of colitis.

Treatment

How a given colitis is treated is dependent on its etiology, e.g. infectious colitis are usually treated with antimicrobial agents (e.g. antibiotics); autoimmune mediated colitis is treated with immune modulators/immune suppressants. Severe colitis can be life-threatening and may require surgery.

See also

Interleukin-37

Notes

  1. ^ "Clostridium Difficile Colitis - Overview". WebMD, LLC. http://www.webmd.com/digestive-disorders/tc/clostridium-difficile-colitis-overview. Retrieved 2006-09-15. 
  2. ^ Beutin L (2006). "Emerging enterohaemorrhagic Escherichia coli, causes and effects of the rise of a human pathogen". J Vet Med B Infect Dis Vet Public Health 53 (7): 299–305. doi:10.1111/j.1439-0450.2006.00968.x. PMID 16930272. 
  3. ^ Romano, C.; Famiani, A.; Gallizzi, R.; Comito, D.; Ferrau', V.; Rossi, P. (Dec 2008). "Indeterminate colitis: a distinctive clinical pattern of inflammatory bowel disease in children.". Pediatrics 122 (6): e1278–81. doi:10.1542/peds.2008-2306. PMID 19047226. 
  4. ^ Melton, GB.; Kiran, RP.; Fazio, VW.; He, J.; Shen, B.; Goldblum, JR.; Achkar, JP.; Lavery, IC. et al. (Jul 2009). "Do preoperative factors predict subsequent diagnosis of Crohn's disease after ileal pouch-anal anastomosis for ulcerative or indeterminate colitis?". Colorectal Dis 12 (10): 1026–32. doi:10.1111/j.1463-1318.2009.02014.x. PMID 19624520. 

External links


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Look at other dictionaries:

  • Colitis-X — Colitis X, equine colitis X or peracute toxemic colitis is a catchall term for various fatal forms of acute or peracute colitis found in horses, but particularly a fulminant colitis where clinical signs include sudden onset of severe diarrhea,… …   Wikipedia

  • colitis — f. gastrol. Inflamación del colon que puede presentarse de forma aguda o crónica. Clínicamente se traduce por diarrea más o menos profusa que en ocasiones puede ir acompañada de deposiciones líquidas con sangre y pus, dolores abdominales y fiebre …   Diccionario médico

  • colitis — (plural colitis) sustantivo femenino 1. Área: medicina Inflamación del colon. 2. Uso/registro: coloquial. Diarrea causada por la inflamación del colon: Me he agarrado una colitis este verano …   Diccionario Salamanca de la Lengua Española

  • Colitis — Co*li tis, n. [NL., fr. Gr. ? + itis.] (Med.) An inflammation of the large intestine, esp. of its mucous membrane; colonitis. [1913 Webster] …   The Collaborative International Dictionary of English

  • Colītis — (gr., Med.), Dickdarmentzündung …   Pierer's Universal-Lexikon

  • Colitis — vgl. Kolitis …   Das Wörterbuch medizinischer Fachausdrücke

  • colitis — 1860, from comb. form of COLON (Cf. colon) (2) + ITIS (Cf. itis) …   Etymology dictionary

  • colitis — f. Med. Inflamación del colon …   Diccionario de la lengua española

  • colitis — [kō līt′is, kəlīt′is] n. [ModL < Gr kolon, colon, large intestine + ITIS] inflammation of the large intestine …   English World dictionary

  • Colitis — Kolitis (auch Colitis) ist in der Medizin ein Oberbegriff für verschiedene akut oder chronisch verlaufende Entzündungen des Dick oder Grimmdarmes (Colon), die meist mit Durchfall einhergehen. Hierzu zählen: Chronisch entzündliche Darmerkrankungen …   Deutsch Wikipedia


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