Colitis: Key Q&A

What is colitis?

Colitis is inflammatory bowel disease that occurs in the large intestine. Inflammatory bowel disease is the chronic inflammation and irritation of tissue in the gastrointestinal tract. It can occur anywhere from the mouth to the anus, although it most often affects the intestines. When inflamed, the intestinal lining can become red, swollen, develop ulcers and bleed.

More than 1 million Americans have been diagnosed with inflammatory bowel disease, according to the American College of Gastroenterology. There are 10 new cases for every 100,000 people each year.

How dangerous is colitis?

In severe cases, colitis can lead to other conditions, including anemia from blood loss, ulcers, blockage or stricture of the intestinal passage and fistulas that can also lead to the formation of abscesses outside the intestine. A condition called toxic megacolon can occur when the large intestine widens and loses muscle tone. Colitis may also increase a patient's risk of developing colon cancer.

What's the difference between Crohn's disease and ulcerative colitis?

The two primary types of inflammatory bowel disease are Crohn's disease and ulcerative colitis. Crohn's disease can occur anywhere along the digestive tract and irritate all layers of tissue in the wall's lining. It occurs most commonly in both the small and large intestines. Ulcerative colitis occurs only in the large intestine, usually starting in the rectum, and affects only the inner intestinal lining.

Are inflammatory bowel disease and irritable bowel syndrome the same thing?

No. Inflammatory bowel disease differs from irritable bowel syndrome in its diagnosis, symptoms and prognosis. Inflammatory bowel disease is intestinal inflammation that can be seen via a barium x-ray or colonoscopy. Irritable bowel syndrome is a functional disorder -- no inflammation is seen, and it cannot be identified by diagnostic tests. Both involve symptoms of abdominal cramping and pain, as well as diarrhea. However, inflammatory bowel disease can include rectal bleeding, fever and an elevated white blood cell count, whereas irritable bowel syndrome does not.

What populations may have a higher risk of colitis?

Colitis occurs primarily in the United States and Europe and among young people between 10 and 35 years old more often than in the elderly. Whites and Jews are at greater risk for colitis than other racial and ethnic groups. Men and women appear to be at equal risk of developing this disease. Cigarette smokers are at higher risk of developing Crohn's disease, but not ulcerative colitis. Colitis also appears to run in families.

How is colitis diagnosed?

Diagnosis begins with a physical examination and medical history that may be accompanied by blood tests and stool tests. There are two primary methods used to diagnosis colitis. A barium x-ray involves ingesting a chalky liquid that helps internal organs show up clearly on x-rays. This can be used for examination of the upper or lower digestive tract.

A colonoscopy involves inserting a small, flexible tube through the anus and into rectum and colon. A light and camera record images for analysis by a physician. Biopsies and color images can be taken during this procedure.

How is colitis treated?

Long-term treatment is often required for people with colitis. Medications such as aminosalicylates, corticosteroids and immunosuppressive therapy can help treat the symptoms of colitis and keep the disease in remission.

Hospitalization may be required to treat those who are severely malnourished, dehydrated or have experienced massive blood loss. Surgery may be necessary to treat cancer, when intestinal obstructions or perforations exist, or when medicines fail to work.