Colitis is an inflammation of the large intestine, or colon. There are many causes of colitis, but the symptoms can be similar. The main symptom of colitis is diarrhea. This results from the inflammation in the lining of the intestine, which causes sloughing off of cells and mucous. This is then expelled from the body as bloody diarrhea.
Types
Infections are a common cause of colitis, especially bacteria like E. coli, Salmonella and Shigella. Children become infected with these bacteria by ingesting uncooked or poorly handled food products, contaminated water, or animals that are carriers of the bacteria, like turtles and lizards. Inflammatory bowel disease is another cause of colitis. There are two types of inflammatory bowel disease, Crohn’s disease and ulcerative colitis. According to the Children’s Hospital of Boston, these conditions cause inflammation of the intestines and can also affects other organs, like the eyes, joints and the skin.
Symptoms
The symptoms of colitis may vary depending on its cause, but in general children with colitis have abdominal pain, bloating and blood in the stools. Other symptoms of colitis include fevers, vomiting, weight loss, loss of appetite, and a feeling of having to constantly have bowel movements. Vomiting and diarrhea can lead to dehydration and electrolyte imbalances, like low or high sodium. In severe cases, rectal bleeding can lead to anemia.
Significance
Children with inflammatory bowel disease have chronic inflammation of the intestines. This puts them at risk for nutritional deficiencies and poor growth and development. They may experience fatigue, loss of energy and unintentional weight loss. One of the differences between Crohn’s disease and ulcerative colitis is that the inflammation of Crohn’s can occur anywhere in the gastrointestinal tract while ulcerative colitis is limited to the large intestine. Because of this, children with Crohn’s disease can have other symptoms, like fistulas (an abnormal connection between organs or tissues), mouth ulcers and swollen gums. Other symptoms of Crohn’s disease include liver inflammation, joint pain, eye inflammation, and skin rashes
Considerations
Diarrhea is a common symptom in children who are taking antibiotics, but it could also result from pseudomembranous colitis. When a child takes common antibiotics, the medicine wipes out all the normally occurring gut bacteria, except a resistant bug called C. difficile. When this happens, C. difficile secretes a toxin that causes an inflammation of the intestine called pseudomembranous colitis, which manifests itself as copious watery diarrhea.
Identification
The diagnosis of colitis relies on the presence of symptoms and on several laboratory tests. Stool cultures are important to determine if bacteria are the cause of the colitis. If inflammatory bowel disease is suspected, an endoscopy with direct visualization of the intestines and sampling of the tissue for biopsy may be necessary. Other important tests measure the level of anemia and the degree of inflammation in the body.
Therapy
The treatment for colitis depends on the cause. Infectious colitis is usually self-limited, and care involves maintenance of hydration with oral solutions or intravenous fluids. Pain medications are usually necessary. Treatment of inflammatory bowel disease is a multidisciplinary endeavor, in which physicians, nurses, nutritionists and mental health experts try to diminish the inflammation in the intestines while maintaining an appropriate diet and nutrition to allow normal growth and development.
