Colitis is an inflammation of the colon. Colitis may be acute and self-limited or long-term. It broadly fits into the category of digestive diseases. In a medical context, the label colitis is used if:
The cause of the inflammation in the colon is undetermined; for example, colitis may be applied to Crohn's disease at a time when the diagnosis is unknown, or
The context is clear; for example, an individual with ulcerative colitis is talking about their disease with a physician who knows the diagnosis.
Symptoms suggestive of colitis are worked-up by obtaining the medical history, a physical examination and laboratory tests. Additional tests may include medical imaging and an examination with a camera inserted into the rectum. An important investigation in the assessment of colitis is biopsy. A very small piece of tissue is removed from the bowel mucosa during endoscopy and examined under the microscope by a histopathologist. It can provide important information regarding the cause of the disease and the extent of bowel damage.
Types
There are many types of colitis. They are usually classified by the cause. Types of colitis include: showing intestinal crypt branching, a histopathological finding of chronic colitis. H&E stain. of collagenous colitis. H&E stain. of a colonic pseudomembrane, as may be seen in Clostridium difficile colitis, a type of infectious colitis.
A subtype of infectious colitis is Clostridium difficile colitis, which is informally abbreviated as "C-diff colitis". It classically forms and is often referred to as pseudomembranous colitis, which is its histomorphologic description. Enterohemorrhagic colitis may be caused by Shiga toxin in Shigella dysenteriae or Shigatoxigenic group of Escherichia coli, which includes serotype and other enterohemorrhagic E. coli. Parasitic infections, like those caused by Entamoeba histolytica, can also cause colitis.
Unclassifiable colitides
Indeterminate colitis is the classification for colitis that has features of both Crohn's disease and ulcerative colitis. Indeterminate colitis' behaviour is usually closer to ulcerative colitis than Crohn's disease. 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 and, as such, a colitis that cannot be definitively classified.
Treatment
Some people may be admitted into the hospital following the colonoscopy depending on results. It is sometimes necessary to get the patient started on a steroid to speed up the healing of the colon. It may also be necessary to get the patient hydrated from the fluid loss and iron replaced from the loss of blood. After a hospital stay, the patient may be put on a daily medication to manage their chronic colitis. The medication can be an anti-inflammatory or an immunosuppressant. There are many different types of medication used and the doctor will prescribe the one they see fit. If the patient doesn't respond, new medications will be tried until there is a good fit. Moreover, several studies recently have found significant relationship between colitis and dairy allergy, suggesting some patients may benefit from an elimination diet.
Research
In the lab, the CRISPR-Cas systems effectively killed C. difficile bacteria. Researchers tested this approach in mice infected with C. difficile. Two days after the CRISPR treatment, the mice showed reduced C. difficile levels. Next steps include retooling the phage to prevent C. difficile from returning after the initial effective killing.
