Monday, May 6, 2013

Colitis Explained: Part I What is Colitis?

Colitis is the term for inflammation of the colon or large bowel or intestine. The rectum is the very last part of the colon. When it is inflamed the term proctitis is used. Understanding the causes and treatment of colitis requires a basic understanding of the colon and inflammation.

The beginning of the colon is called the cecum. It begins in the lower right portion of the abdomen where the last part of the small intestine (ileum) empties into the large intestine. This part of the colon is also where the appendix attaches. The segments of the colon in order from the beginning of the colon or cecum going distally are ascending, transverse, descending, sigmoid colon and rectum. One of the major jobs of the colon is to recycle water for the body. When the entire colon is present and healthy the stools have only enough water in them to remain soft and easy to pass, but not so watery or loose that leakage occurs and dehydration ensues. When a large part of the colon is removed or when the colon is significantly injured the stools are very watery and frequent.

Inflammation is the body? response to infection or suspected attack or irritation. Inflammation of a body area is labeled by adding the suffix ??itis??to the body part, hence tonsillitis when tonsils are inflamed and appendicitis when the appendix is inflamed. Recognized since ancient times, inflammation has been classically described by the presence of signs and symptoms of redness (rubor), pain (dolar), heat (calor), swelling (tumor) and impairment of the function of the involved organ or tissue. If you have arthritis, joint inflammation; the joint is red, swollen, painful, warm and is stiff, preventing normal function.

In colitis the colon is usually quite red and swollen appearing when seen by colonoscopy (scope exam of the colon). Abdominal pain and impaired function occurs resulting in diarrhea because the damaged colon loses some of its ability to absorb water. If enough damage occurs to the lining sloughing of the surface cells occurs with passage of bloody stools, mucus, and even the appearance of tissue.

Inflammation has cell and fluid components. The cell component includes various white blood cells. The type of white blood cells found in the lining of the intestine determines the cause and effect on the intestine. Fluids include chemicals secreted to fight infection or presumed infection that can cause damage to the colon lining.

Colitis can be acute (self-limited) like E. coli infection or chronic like in ulcerative colitis. Causes of colitis include infections, ischemia (poor blood flow), food allergies, food protein intolerances, lack of normal bacterial flora or stool (after antibiotics, diversion after a colostomy), radiation injury, chemotherapy induced low white blood cell counts (neutropenic), or idiopathic (unknown cause).

Chronic colitis is one of several types of inflammatory bowel disorders or IBD for short and should not be confused with IBS the term for irritable bowel syndrome. Irritable bowel syndrome (IBS) does not involve any colon inflammation though it was referred to in the past as mucus colitis because of common symptom of excess mucus in stools or spastic colitis because of the common complaint of painful spasms of the colon that commonly occur in IBS. Biopsies of colon tissue in irritable bowel syndrome are normal and do not show signs of inflammation therefore it is not considered an inflammatory bowel disorder.

The food allergy expert-the food doc Dr. Scot Lewey reviews in more detail the various types of colitis, their causes and treatment in part II of this series. In the future href=?ttp://blank?? will offer online help for colitis, Crohn's disease, food allergies, food intolerance, Celiac disease and gluten sensitivity.

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