Colitis

Colitis refers to inflammation of the inner lining of the colon, or large intestine. It can arise from various underlying causes, ranging from infections and autoimmune diseases to allergic reactions or certain medications. People suffering from colitis often experience abdominal discomfort, persistent diarrhoea, and, in some cases, bleeding.

Understanding colitis is vital for early detection, proper treatment, and management of its chronic symptoms. Timely diagnosis not only improves the quality of life but can also prevent serious complications.

Colitis is the medical term for inflammation of the colon. Depending on the cause and duration, it can be either acute or chronic. Inflammation disrupts the colon's ability to absorb water and salts, leading to symptoms such as diarrhoea and abdominal pain.

There are different forms of colitis, including ulcerative colitis, infectious colitis, ischemic colitis, microscopic colitis, and allergic colitis.

India

Colitis, especially ulcerative colitis and Crohn's disease (forms of Inflammatory Bowel Disease - IBD), is increasingly being diagnosed in India. A 2017 Indian Council of Medical Research (ICMR) study indicated an incidence rate of 9.31 per 100,000 people for ulcerative colitis.

Worldwide

Globally, colitis is more prevalent in developed countries, particularly in North America and Europe. According to the Crohn's and Colitis Foundation, over 3 million Americans are affected by IBD. Incidence is rising in developing countries due to urbanisation and dietary shifts.

• Ulcerative Colitis: Chronic inflammation and ulcers in the colon and rectum.
• Crohn's Colitis: A form of Crohn's disease affecting the colon.
• Microscopic Colitis: Inflammation visible only under a microscope.
• Infectious Colitis: Caused by bacterial, viral, or parasitic infections.
• Ischemic Colitis: Due to reduced blood flow to the colon.
• Allergic Colitis: Typically affects infants and young children due to food allergies.

• Autoimmune Reactions: As in ulcerative colitis and Crohn's disease.
• Infections: From bacteria like E. coli, Salmonella, and viruses like Cytomegalovirus.
• Reduced Blood Flow: Leading to ischemic colitis.
• Radiation Therapy: Used for abdominal cancers.
• Medications: NSAIDs, antibiotics, and chemotherapy agents.
• Allergies: Especially food allergies in infants.

• Abdominal pain and cramping
• Chronic diarrhoea, often with blood or pus
• Urgency to defecate
• Fatigue
• Fever
• Weight loss
• Anaemia due to blood loss
• Bloating and gas

• Medical History and Physical Examination
• Stool Tests: To rule out infections.
• Blood Tests: To check for anaemia and inflammation markers.
• Colonoscopy: Gold standard for visualising inflammation and collecting biopsy samples.
• CT Scan or MRI: For identifying complications like abscesses or fistulas.
• Sigmoidoscopy: For limited inflammation.

Medications

• Aminosalicylates (5-ASAs): Such as mesalazine and sulfasalazine, to reduce inflammation. (Mesagran Sachet)
• Corticosteroids: Prednisone and budesonide, used short-term to control flares. (Predon 20mg Tablet)
• Immunomodulators: Azathioprine and 6-mercaptopurine help maintain remission.
• Biologic Therapies: Like infliximab and adalimumab target specific immune pathways.
• Antibiotics: For infectious colitis.
• Anti-diarrhoeal and pain relief medications: Used cautiously.

Other Treatments

• Surgery: In severe cases, part of the colon may need to be removed.
• Nutritional Support: Supplements for deficiencies (iron, calcium, Vitamin D, B12).

• Probiotics: Help restore healthy gut bacteria.
• Dietary Modifications: Elimination diets, low FODMAP diets.
• Herbal Remedies: Turmeric (curcumin) has anti-inflammatory properties.
• Mind-Body Practices: Yoga, meditation, and cognitive behavioural therapy can help reduce stress-induced flares.

• Family History of IBD
• Autoimmune Diseases
• Age: Most common in people aged 15 to 30 and 50 to 70.
• Diet High in Processed Foods
• Smoking
• Sedentary Lifestyle

• Colon perforation
• Severe bleeding
• Toxic megacolon
• Increased risk of colon cancer
• Malnutrition
• Joint pain and skin problems due to systemic inflammation

• Track Symptoms: Keep a diary to identify flare triggers.
• Follow Medication Schedule: Don’t skip doses.
• Work with a Dietitian: Personalise your meal plan.
• Stay Connected: Join support groups.
• Prioritise Mental Health: Seek therapy if anxiety or depression arises.

• "It’s caused by poor diet alone" – Not always true.
• "It’s just a stomach bug" – Colitis is more complex.
• "You can’t live a normal life" – With management, many do.
• "Surgery cures it permanently" – It depends on the type and severity.

• Persistent or bloody diarrhoea
• Severe abdominal pain
• Fever not improving with time
• Unintended weight loss
• Symptoms not responding to over-the-counter treatments

• What type of colitis do I have?
• What treatment is best suited for me?
• Will I need long-term medication?
• Are there dietary restrictions I should follow?
• What are the risks of complications?
• Is surgery an option for me?

• Listen without judgment
• Help them adhere to dietary or medication routines
• Be patient during flare-ups
• Educate yourself on their condition
• Encourage regular medical check-ups

Colitis is a chronic but manageable condition affecting millions globally. With early diagnosis, lifestyle changes, and appropriate treatments, individuals with colitis can lead fulfilling lives. Raising awareness and debunking myths can help build a more supportive environment for those navigating this challenging condition.