Tuesday, 3 December 2013

Colitis - Types and Symptoms

Colitis is defined as a condition of inflammation of the large intestine, including the colon, caecum and rectum.

I. Types of Colitis
According to the study by Catholic University of the Sacred Heart, types of colitis include
microscopic colitis, ischemic colitis, segmental colitis associated with diverticula, radiation colitis, diversion colitis, eosinophilic colitis and Behcet's colitis(a).

II. Symptoms
1. Adnomial pain and Diarrhea
There is a report of a 25-year-old Iranian gentleman was admitted to hospital with severe bloody diarrhoea and abdominal pain as a result of herbal induced weight loss adversed effects. On flexible sigmoidoscopy, a continuous length of congested mucosa with multiple small ulcers was seen extending up to the mid-transverse colon, in keeping with ulcerative colitis, according to the study by
Homerton University Hospital NHS Foundation Trust(1)

2. Bleeding per rectum
Acute ischaemic colitis (AIC) is being increasingly recognised as an uncommon cause of abdominal pain associated with fresh bleeding per rectum and and diarrhoea,  according to the study by University Central Hospital(2).

3.  Distention with bloody diarrhea
The typical clinical presentation is acute sudden abdominal pain and distention with bloody diarrhea(3).

4. Abdominal bloating and flatulence
In the study to estimate the prevalence of microscopic colitis and SIBO in patients with IBS, to evaluate the symptoms and the efficacy of treatment found that out of the 132 patients initially diagnosed with IBS 3% (n=4) had microscopic colitis and 43.9% (n=58) had SIBO. Diarrhea was the main symptom in patients with microscopic colitis and SIBO (p=0.041), while abdominal painabdominal bloating and flatulence were prominent in IBS patients (p=0.042; p=0.039; p=0.048)(4).

5. Changes in bowel habits
Abdominal pain, bloating, early satiety, and changes in bowel habits are common presenting symptoms in individuals with functional GI disorders(5).

6. Fever and severe dehidration
There is a report of a 19-year-old man with a 1-year history of ulcerative colitis presented with fever, bloody diarrhea and severe dehidration. He was on po.48 mg methylprednisolon and 3 g mesalazine daily, and has recently finished taking chlarythromycin for Campylobacter jejuni infection(6).

7. Urgency
In the study to examine the differing perspectives and perceptual gaps relating to ulcerative colitis (UC) symptoms and their management between patients and healthcare professionals (HCPs), indicated that fifty-five percent of patients stated that UC symptoms over the past year had affected their quality of life, while physicians and nurses estimated that 35% to 37% of patients would have a reduced quality of life over the same period. Patients ranked urgency and pain as the most bothersome symptoms(7)

8. Other symptoms
There is a report of a case of a 51-year-old Caucasian male who was evaluated for abdominal pain, elevated liver enzymes, leukopenia, thrombocytopenia, severe peripheral arthralgias, and chronic watery diarrhea as result of granulomatous enterocolitis. due to Sarcoidosis(8). Other study conducted by Anhui University of Traditional Chinese Medicine, with rats in the model group showed lethargy, poor appetite, loss of energy, diarrhea and bloody stool(9).

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(a) http://www.ncbi.nlm.nih.gov/pubmed/23208963
(1) http://www.ncbi.nlm.nih.gov/pubmed/23291814
(2) http://www.ncbi.nlm.nih.gov/pubmed/1759791
(3) http://www.ncbi.nlm.nih.gov/pubmed/10223095
(4) http://www.ncbi.nlm.nih.gov/pubmed/23272525
(5) http://www.ncbi.nlm.nih.gov/pubmed/22577375
(6) http://www.ncbi.nlm.nih.gov/pubmed/22398071
(7) http://www.ncbi.nlm.nih.gov/pubmed/22894661
(8) http://www.ncbi.nlm.nih.gov/pubmed/23256126
(9) http://www.ncbi.nlm.nih.gov/pubmed/22883409 

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