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Colitis: Types, Symptoms, Causes, Treatment and Diet

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Colitis: Types, Symptoms, Causes, Treatment and Diet

What is colitis?

Colitis is defined as an inflammatory bowel disorder and is characterised by inflammation in the inner lining of the colon (large intestine) and rectum. The inflammation generally begins in the rectum and the lower part of the large intestine and gradually spreads upward to the entire colon. Colitis hardly affects the small intestine except for the lower part, which is known as the ileum.

For a person suffering from colitis, with time as the cells on the surface of the lining of the large intestine die and slough off, ulcers develop resulting in pus, mucous and bleeding. The inflammation of the inner lining of the colon may cause diarrhoea and/or frequent urge for emptying of the colon.

What are the types of colitis?

Broadly, colitis is classified into four major types. These include:

  1. Ulcerative colitis:

    This is the most common type of colitis. Along with Crohn's disease, Ulcerative colitis (UC) is classified as inflammatory bowel disease. UC usually occurs when the immune system of the body becomes overactive against certain microbes like bacteria present in the digestive tract. It starts in the rectum and eventually spreads to the colon. The condition causes inflammation and painful ulcers within the large intestine's inner tissue lining.

  2. Ischemic colitis:

    Ischemic colitis (IC) is a type of colitis that occurs when the colon experiences restricted flow of blood. The flow of blood can be obstructed by blood clots that can result in sudden blockage. Atherosclerosis, a condition that involves the build-up of fatty deposits in the blood vessels, is one of the major culprits that restrict the flow of blood to the colon.

  3. Microscopic colitis:

    This condition is diagnosed by a physician after carefully examining a tissue sample of the colon under a microscope. Lymphocytic colitis and collagenous colitis are the two types of microscopic colitis. Lymphocytic colitis is diagnosed if there are too many lymphocytes in the tissue sample. Collagenous colitis is diagnosed when the lining of the colon becomes thick owing to the accumulation of collagen beneath the outermost layer of tissue.

  4. Allergic colitis in infants:

    As the name suggests, the condition affects infants. It generally happens within 1 to 2 months after birth. Symptoms of this condition include excessive spitting up, reflux, fussiness, and possible flecks of blood in a baby’s stool. The cause of this condition is not known.

What are the symptoms of colitis?

The symptoms of a person having colitis may vary depending upon how severe the inflammations are and where the inflammation occurs. Some of the common symptoms of such a disorder include:

  • Diarrhoea along with blood or pus
  • Abdominal pain or Cramping
  • Loss of appetite
  • Rectal pain
  • Bleeding of rectum
  • Anaemia due to excess bleeding
  • Urgency to defecate
  • Inability to defecate despite urgency
  • Fever
  • Weight loss
  • Weakness and lack of growth in children.

A few patients may also experience some indirect symptoms such as:

A patient having such symptoms should immediately consult a doctor for proper diagnosis and treatment.

How is colitis diagnosed?

The diagnosis of patients suffering from colitis involves obtaining the medical history of the patient, physical examinations and a few laboratory tests. A few popular ways of diagnosis are laboratory examination of stool sample, abdominal computed tomography, abdominal X-rays and colonoscopy.

Once the severity of the condition and the area of inflammation within the colon is accurately diagnosed, the treatment begins and it includes both either by drug therapy or by surgery (if found necessary by the doctor).

How is colitis treated?

The problem of colitis is usually treated either by drug therapy or by surgery. There are several categories of drugs that may prove effective in the treatment of colitis. The type of drug prescribed by the doctor mainly depends on the severity of the condition that a patient suffers from. Moreover, the response of patients to various drugs may also be different and hence it might take some time for the doctor to find out the appropriate medicine that would be effective for a particular patient.

In addition to this, it is important for physicians to weigh out the benefits as well as the side effects of various medicines before prescribing them to their patient.

However, in severe cases of colitis, where medical treatment has no effect, the doctors may recommend for surgical treatment. The surgical treatment involves the removal of the entire colon and rectum (proctocolectomy) of the patient.

This surgical method is followed by another process known as ileoanal anastomosis where the surgeon constructs a pouch from the end of the patient’s small intestine and attaches it to the anus. This pouch functions similar to the rectum and collects the stool of the patient and helps in excreting them out normally.

Who needed treatment for colitis ?

Any person irrespective of their age and having symptoms such as diarrhoea along with blood or pus, abdominal pain or cramping, loss of appetite, rectal pain, bleeding of rectum, anaemia due to excess bleeding, urgency to defecate, inability to defecate despite urgency, fever, weight loss, weakness due to inflammation of the inner lining of the large intestine or rectum is said to be suffering from colitis and is eligible for this treatment.

Who is not eligible for the treatment?

People who do not suffer from the symptoms of colitis are considered as not having this disease and are not eligible for such treatment. Moreover, if a patient suffers from serious side effects of a particular treatment of colitis, then the doctor may recommend switching to some other effective form of treatment of the disease.

What is the best medication for colitis?

The drugs prescribed by the doctor for the treatment of colitis mainly include anti-inflammatory drugs, immune system suppressors, antibiotics, anti-diarrhoeal medications, pain relievers (except ibuprofen, naproxen sodium and diclofenac sodium as they tend to worsen the symptoms and increase the severity of the disease) and iron supplements.

The common anti-inflammatory drugs used in the treatment of colitis include amino-salicylates and corticosteroids. The immune system suppressors used for treatment are azathioprine, mercaptopurine, cyclosporine, infliximab, adalimumab, golimumab and vedolizumab.

What foods help soothe colitis flares?

Colitis and diarrhoea are often associated with each other. This is because just like diarrhoea, the body loses significant amounts of fluid with each flare-up of colitis. When the colon is inflamed, it is important to ensure that the organ gets proper rest. Reduce the consumption of solid foods and intake of fluid diet All these steps not only assist in rehydrating the body but also ensure that the colon get enough rest.

While making the aforementioned changes to your diet may provide soothing effects and reduce the likelihood of colitis flare-ups, it is important to note that this is no cure for colitis.

What foods trigger colitis?

Depending on the cause of the condition, there are certain foods that are associated with worsening of colitis in some people. There are some foods that trigger colitis flare-ups or aggravate the symptoms. It is recommended that people with colitis should make a list of foods that have caused flare-ups in the past.

As per the recommendations of the Crohn's & Colitis Foundation of America, people with colitis should consider avoiding the following foods:

  • Oily or fried foods
  • Dairy products
  • High-fibre foods

Are there any side effects?

Like most other treatments, medications used for treating colitis also have some side effects. It is important for a patient to know how to differentiate between the symptoms of colitis and the possible side effects that may arise from its medications. A doctor, who prescribes the medicines for a patient of colitis, must always weigh out the benefits as well as the possible adverse side effects of the medication.

Some of the common side effects of the treatment of colitis include headache, nausea, vomiting, fever, rash, loss of appetite, decreased white blood cells, decreased sperm production in males, diarrhoea, abdominal pain and cramps, gas, hair loss, dizziness, kidney problems, weakness, pericarditis, pancreatitis, high blood pressure, weight gain, mood swings, acne, osteoporosis, cataracts, high blood sugar levels, insomnia, lymphoma and others. In case a patient suffers from some serious side effects then he/she must immediately consult a doctor for remedial measures.

What are the post-treatment guidelines?

The treatment of colitis involves a number of medications and proper diet (mainly fluids and excluding any type of spicy food). Even after the patient recovers from this problem, he/she needs to follow some guidelines given by the doctor in order to stay healthy.

The post treatment guidelines to be followed by a patient include taking the medicines regularly on time, having a healthy diet, taking plenty of fluids to avoid dehydration and practising regular exercises to facilitate proper bowel movements.

Even after recovery the patient needs to go for follow-up check-ups on a regular basis as instructed by their doctor. In case, a patient suffers from any side effects during the time of medication then he/she should consult a doctor for its remedy

How long does it take to recover?

The time taken for a patient of colitis to recover from this problem usually varies depending on the seriousness of the condition and the physiological response of the patient to the prescribed medications. Usually cases of mild colitis may take about 3 to 4 days to recover for children and about one week for adults. However, patients suffering from severe colitis may even take 3 to 4 weeks to recover from this condition.

What is the price of colitis treatment in India?

The price of the treatment of colitis in India varies depending upon the seriousness of the condition of the patient and the medication that his/her doctor prescribes. Usually mild colitis can be treated with medicines that can cost as low as Rs. 1300 (for full treatment).

However, patients suffering from severe colitis may require costly medications and even surgical treatment (if necessary) and for such treatments, the price range can be between Rs. 57,400 to Rs. 7,87,500 in India. This treatment is available in almost all leading hospitals in India.

Are the results of the treatment permanent?

It should be remembered that colitis, being an auto-immune disease characteristically has a relapsing-remitting course and this means that there are periods of flare-ups which are then followed by a period of remission. Presently there are no medical treatments for the complete cure of colitis.

The medical treatments only tend to lessen the severity of the condition. However, conditions such as inflammation of the bowel, bloody diarrhoea and abdominal cramping can be stopped with surgical treatments.

How to cure colitis permanently?

A variety of treatment options exist for ulcerative colitis. These include medicine and dietary changes. It must be noted that these are not curative treatments. However, you can opt for surgery to get your colon and rectum removed.

There are natural remedies that are believed to cure colitis. Some of them are:

  • Avoiding foods that lead to flare-ups
  • Regular exercise
  • Stress reduction
  • Cognitive behaviour therapy
  • Consuming omega 3 rich foods
  • Intake of herbs like turmeric, ashwagandha etc.

How do you stop a colitis flare-up?

There are certain simple measures that you can take to stop or reduce the frequency and intensity of colitis flare-ups. These measures include:

  1. Keep a food journal: Kindly ensure that you have a record of everything you eat and drink. This will help identify the foods that trigger flare-ups. You can then avoid those foods and reduce your risk of flare-ups.
  2. Limit your fibre intake: Too much fibre is associated with colitis flare-ups. Do not consume foods that offer more than 1 gram of fibre per serving. Such foods include white rice, white pasta, eggs, butter, fish etc.
  3. Exercise:Regular physical activity can help reduce the risk of colitis flare-ups. Exercise is known to reduce inflammation in the body. However, it is recommended that you opt for low-intensity exercises like walking and swimming.
  4. Reduce stress:Reducing stress can reduce the inflammatory response of the body and help overcome flare-up faster. Activities such as meditation, deep breathing exercises, etc can provide relief from stress. Also, ensure that you get adequate rest and sleep every day.
  5. Eat smaller meals:Reducing meal size can help people with a history of colitis flare-ups. However, you can increase the frequency of meals but ensure that the meals are smaller than usual.

What are the alternatives to the treatment?

Although medical and surgical treatments are considered as the best ways to control the conditions of colitis, there are a few alternative treatments as well. The alternative treatments for the conditions of colitis include taking of herbal and nutritional supplements, probiotics, fish oil (although excess consumption of fish oil can cause diarrhoea), Aloe Vera gel, acupuncture therapy and/or turmeric.

In addition to this, the patient should avoid consumption of spicy food, dairy products, alcohol, beverages and fibres in their diet. Eating of small light nutrition-rich meals at regular intervals throughout the day, plenty of water and multivitamin supplement helps to recover from this condition.

Popular Questions & Answers

28 year old male from england. One night in the middle of january I suddenly woke up in what I can only describe as a state of panic. My heart was racing I was heavy breathing and my body went really stiff, this lasted for no more than 5-10 seconds it has only happened once but since then I have had a pain in the left hand side of my stomach it feels like a knot like something is in there that shouldn't be, pain in my back the lower and upper parts the pain in my back started on my left side but is now on both sides. I've noticed 2 squishy lumps at the bottom left and side of my back. I notice the discomfort in my stomach more when i'm sat down as to when stood up or laying down. I notice when I urinate a lot of urine comes out but no pain or burning sensation or no more frequent than normal. I have suffered with diarrhea for many years now sometimes I have to use the toilet right after eating. But some days I feel constipated. I can see undigested food sometimes in my stool. I'm sleeping well and haven't noticed any weight loss. I sometimes feel sick but haven't been sick since this started. I have had blood tests done and they have all come back normal. I also did a urine sample and that came back normal. I am currently waiting for an ultrasound scan on the 26th of april. I had the lumps looked at on my back by 2 different doctors and they both said they didn't think they were of any concern. I have recently become a father for the first time, my son is 6 months old and he is my absolute world. I have suffered with anxiety for many years and I am now back on 50 mg of sertraline daily, because of my anxiety I have convinced myself that I have kidney or stomach cancer I spent a lot of time googling my symptoms. I spend most of my time worrying and crying that my son is going to grow up without me. My family history that I know of is diabetes runs on the female side (grandmother, mum, sister) my sister and father both have ibs. In 2019 my mum had stage 2 uterus cancer but has recovered well after surgery. My grandfather died of a stomach aneurysm in 2001 he also had stomach cancer at the time of his death. I've tried to be as detailed as possible with this and any help would be really appreciated i'm just so scared I don't want to leave my son.

MBBS, DPM (Psychiatry)
Psychiatrist, Thrissur
Dear stress patients worry too much. Stress in today’s day & age where stress is high, feelings of frustration can emerge. It is our perception that can change our current negative situation into a healthy & positive one. Another way of perceiving...

For the past 4 months i've suffered with back, stomach and neck discomfort and sometimes get a sore throat. I feel like I have a knot in my stomach that feeling comes and goes I think it feels a bit worse when i've eaten but is worse when sat down. I don't struggle with sleeping I sleep really well. I sometimes feel sick but haven't been sick since this all started. I get pains in what feels like my bowl area. I've noticed when I urinate its a lot of urine but it doesn't hurt or burn and I don't go frequently I sometimes get indigestion. All blood test i've had done have come back normal and I am currently waiting for an ultrasound scan. I've noticed a small squishy bulge at the bottom of my back on the left hand side its painless doctors have checked it and seem to think it's of no concern. I suffer with diarrhea regularly and have done for many years sometimes I need to use the toilet right after eating and I find undigested food in my stool. Irritable bowel syndrome dose run in my family as my sister and father both have it. I suffer with health anxiety very badly and i've convinced myself that I have kidney, stomach or lymphoma cancer. I've just started taking 50 mg of sertraline i'm 8 days into taking them. I'm 28 years old and have a 6 month old son and i'm scared i'm going to die and leave him to grow up without me.

Homeopathy Doctor, Noida
Follow this 1. Don't take tea empty stomach. Eat something like a banana (if you are not diabetic) or any seasonal fruit or soaked almonds and a glass of water first thing in the morning (within 10 mins of waking up). No only biscuits or rusk will...

I'm suffering from skin rash on my both hand, thighs and on back it is itching it started suddenly i'm on medication for piles the medicine which I took was oxerute cd tablet for treating piles after taking the medicine two days later I suddenly got skin rash what should I do.

bachelor of homeopathic medicine and surgery
Homeopathy Doctor, Yamunanagar
it may be tenia take homeopathic medicine sepia 30 tds acid chyro 30 tds bacillinum 200 weekly 2 dose apply coconut oil only it will be cure maintain persona hygienic also

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