The non-specific medical term for inflammation of the colon is "colitis." Inflammation of the large intestine may be due to one of several underlying abnormal processes. While signs and symptoms may suggest the cause, there is considerable overlap among them. Any form of colitis should be evaluated by your physician. Accurate diagnosis and appropriate therapy are necessary to prevent progression and complications.
Inflammatory Bowel Disease
The two major forms of inflammatory bowel disease are ulcerative colitis and Crohn's disease. Ulcerative colitis affects only the large intestine and typically causes abdominal cramping and diarrhea, which may be bloody. Abdominal bloating may also occur, and colon rupture in extreme cases causes severe pain and tenderness and hardness of the abdomen. Crohn's disease can affect any portion of the intestinal tract. It is associated with cramping and diarrhea -- which may or may not be bloody -- and cracks and tears around the anus. Crohn's disease may also cause arthritis, scaliness and ulceration of the skin and changes in vision with wateriness and itching of the eyes.
Diverticulitis of the Colon
Diverticula are weak spots in the muscle wall of the large intestine, through which little sacs of colon's lining protrude, producing bubbles much like those on an old-fashioned inner tube. Those sacs may become infected and inflame the colon surrounding them. Signs and symptoms of diverticulitis include abdominal pain; tenderness, usually on the left side; and fever. The inflamed colon may stick to and erode into other organs, producing fecal discharge from the bladder or vagina.
Antibiotic Associated Colitis
Antibiotic Associated Colitis (AAC) occurs when an antibiotic wipes out most of the healthy bacteria that normally live in the colon and leaves only those resistant to the drug. The most common resistant bug is Clostridium difficile, which produces a watery diarrhea. Abdominal pain, fever and increases in white blood cell counts may occur. AAC results in dangerous enlargement of the colon in some people, at which stage the bowel may rupture and cause signs of peritonitis: bloating, tenderness and hardness of the abdomen.
When the blood supply to the colon is compromised by low blood pressure, dehydration, abnormal heart rhythms or blockage of blood vessels, pain and tenderness develop over the part of the affected bowel. The left colon is the side most commonly damaged. Bright red bleeding from the rectum usually occurs in small amounts. Gangrene of the colon with severe pain develop in approximately 15 percent of cases, according to a report in the July 2009 issue of "Cleveland Clinic Journal of Medicine." The result is peritonitis, an infection of the abdominal cavity that is potentially lethal.
Is This an Emergency?
- The American College of Gastroenterology Guideline: Ulcerative Colitis in Adults
- The American College of Gastroenterology Guideline: Management of Crohn's Disease in Adults
- The Merck Manual for Health Care Professionals: Diverticulitis
- The Cleveland Clinic Journal of Medicine: Clinical Approach to Ischemic Colitis