Definition

Colitis is swelling (inflammation) of the large intestine (colon).

Causes

Most of the time, the cause of colitis is unknown.

Causes of colitis include:

  • Infections caused by a virus or a parasite
  • Food poisoning due to bacteria
  • Crohn disease
  • Lack of blood flow (ischemic colitis)
  • Past radiation to the large bowel (radiation stricture)
  • Necrotizing enterocolitis in newborns
  • Pseudomembranous colitis caused by Clostridia difficile infection

Symptoms

Symptoms can include:

  • Abdominal pain and bloating that may be constant or come and go
  • Bloody stools 
  • Constant urge to have a bowel movement (tenesmus)
  • Dehydration
  • Diarrhea
  • Fever

Exams and Tests

The health care provider will perform a physical exam. You will also be asked questions about your symptoms, such as:

  • How long have you had the symptoms?
  • How severe is your pain?
  • How often do you have pain and how long does it last?
  • How often do you have diarrhea?
  • Have you been traveling?
  • Have you been taking antibiotics recently?

The provider can diagnose colitis by inserting a flexible tube into the rectum (flexible sigmoidoscopy or colonoscopy) and looking at certain areas of the colon. You may have biopsies taken during this exam. Biopsies may show changes related to inflammation. This can help determine the cause of colitis.

Other studies that can identify colitis include:

  • CT scan of the abdomen
  • MRI of the abdomen
  • Barium enema
  • Stool culture
  • Stool examination for ova and parasites

Treatment

Your treatment will depend on the cause of the disease.

Outlook (Prognosis)

The outlook will vary, depending on the cause of the problem.

Possible Complications

Complications may include:

  • Bleeding with bowel movements
  • Perforation of the colon
  • Toxic megacolon
  • Sore (ulceration)

When to Contact a Medical Professional

Call your provider if you have symptoms such as:

  • Abdominal pain that does not get better
  • Blood in the stool or stools that look black
  • Diarrhea or vomiting that does not go away
  • Swollen abdomen

References

Osterman MT, Lichtenstein GR. Ulcerative colitis. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran’s Gastrointestinal and Liver Disease. 10th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 116.

Wald A. Other diseases of the colon and rectum. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran’s Gastrointestinal and Liver Disease. 10th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 128.

Version Info

  • Last reviewed on 7/11/2017
  • Michael M. Phillips, MD, Clinical Professor of Medicine, The George Washington University School of Medicine, Washington, DC. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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