What is chronic colitis? Chronic colitis (ulcerative colitis) is one of the chronic inflammatory bowel diseases (IBD). The condition involves inflammation of the superficial lining of the large intestine and rectum. Over time, the inflammation can gradually spread, causing damage to the intestinal lining, leading to ulcers, bleeding, or other complications.
What causes chronic colitis?
The exact cause is still unknown, but it is presumed to result from combined risk factors, including:
- Genetic factors
- Ethnicity—more common in Europeans than Asians
- Abnormal immune system
- Intestinal viral or bacterial infections
- Diet, such as high-fat foods, caffeine, and alcohol
- Smoking
- Stress
What are the symptoms of chronic colitis?
- Abdominal pain
- Rectal pain and urgency with difficulty holding bowel movements
- Chronic diarrhea or severe diarrhea
- Mucus or fresh blood in the stool
- Fever and fatigue
- Joint pain
- Weight loss
- Anemia
- Hepatitis
How is chronic colitis diagnosed?
Doctors diagnose based on symptoms, medical history, physical examination, and additional tests to support the diagnosis, as follows:
- Blood tests to detect infection or inflammation, anemia, and malnutrition
- Stool tests to check for blood cells and to rule out viral or parasitic infections
- Colonoscopy or flexible sigmoidoscopy with biopsy to confirm the diagnosis
- Abdominal computed tomography (CT scan) or abdominal magnetic resonance imaging (MRI) to aid diagnosis and treatment planning
How is chronic colitis treated?
There is currently no cure. Treatment aims to relieve symptoms, induce and maintain remission, prevent relapses, and reduce complications.
- Medication
- Anti-inflammatory drugs to reduce intestinal inflammation, such as corticosteroids and sulfasalazine
- Immunosuppressants to reduce immune-mediated inflammation, such as azathioprine, methotrexate, and TNF inhibitors
- Antibiotics, such as metronidazole and ciprofloxacin
- Symptomatic relief, such as antispasmodics for abdominal pain and antidiarrheals
- Iron and vitamin B12 for patients with anemia and B12 deficiency
- Medications can cause side effects and must be used strictly under medical supervision
- Surgery for cases uncontrolled by medication or with severe complications
Chronic colitis may flare and subside repeatedly if not properly treated, and patients have a higher risk of colorectal cancer than the general population. Ongoing follow-up and periodic colonoscopy are recommended to monitor for colorectal cancer.
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