How Colitis Is Treated

There are various causes of colitis and each has different treatments

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Colitis, which is inflammation in the large intestine, is a symptom of a disease or condition. It can be caused either by conditions that are chronic or those that come on suddenly (which is called acute).

Some of the causes of colitis include inflammatory bowel disease (IBD, which includes Crohn’s disease and ulcerative colitis), microscopic colitis, ischemic colitis, pseudomembranous colitis (sometimes called Clostridium difficile or antibiotic-associated colitis), and allergic colitis.

Treating colitis will mean dealing with the underlying condition that’s causing it. Because the causes are so different, there is no one treatment that will be used for every type of colitis.

This article will discuss how each type of colitis is treated. In most cases, treatments will include medications and/or changes to diet. For some conditions, certain types of surgery might also be used.

Two gastroenterologists discuss images from an endoscopy.

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Home Remedies and Lifestyle

For some of the causes of colitis, part of the treatment plan may include care that can be done at home. Changes to diet might also be used for some conditions, either long-term or for a short period of time.

Diarrhea

Some of the conditions that cause colitis may also cause diarrhea and/or vomiting. Drinking enough fluids to replace those lost through diarrhea is important. People with diarrhea should watch for signs of dehydration. If you have severe diarrhea, check with a healthcare professional about the best ways to replace lost fluids.

Crohn’s Disease and Ulcerative Colitis

Treatment for IBDs includes many different factors. There is no one diet that is recommended for all cases of IBD. It’s recommended that people with IBD work with a registered dietitian to develop an eating plan. 

Some of the diets that may be used as a template include the specific carbohydrate diet (SCD), the Mediterranean diet, and the IBD anti-Inflammatory diet. There has not been enough research to recommend one diet for everyone. Although, one study showed that the SCD and the Mediterranean diet were about the same in helping reduce symptoms.

Stress doesn’t cause colitis or IBD. However, depression, anxiety, or other mental health conditions may lead to a worsening of symptoms for some people. Stress relief and mental health care may be used as part of a treatment plan.

Regular exercise is recommended for most people, including those with colitis caused by IBD. It’s thought that exercise may have benefits in fighting inflammation. Physical activity may be recommended as part of an overall plan to cope with the disease and its symptoms.

Smoking may worsen symptoms of Crohn’s disease. Stopping smoking is recommended for all people who live with a form of IBD, regardless of how it affects the digestive system or other parts of the body.

Microscopic Colitis

There is not enough research available to help guide lifestyle decisions or dietary changes for people living with microscopic colitis. Some people may find it helpful to work with a dietitian in order to develop a healthful eating plan that doesn't worsen symptoms. However, it is recommended that people who live with this condition stop smoking.

Ischemic Colitis

It’s not thought that ischemic colitis can be prevented. There are several risk factors, some of which can’t be changed (such as female sex and being over the age of 65). Preventing constipation and controlling any underlying conditions are important to living a healthy lifestyle.

Allergic Colitis in Infants

In some cases, this type of colitis is thought to be related to a food allergy. For breastfed infants, it might be recommended that the breastfeeding parent take certain foods that commonly cause allergies out of their diet.

In some cases, this may mean first stopping foods containing dairy. Other foods that cause common food allergies might be stopped as well if the colitis doesn’t improve.

Over-the-Counter (OTC) Therapies

There aren't many over-the-counter remedies that may be recommended to treat the cause of colitis. Vitamin and mineral supplements might be recommended in some cases.

Iron

Colitis may cause bleeding from the colon. If there is enough blood loss, it can cause anemia. Iron or other supplements may be recommended. It’s important to check with a physician rather than self-diagnosing and self-treating iron deficiency anemia to ensure iron is needed and that the right type and dose of iron are being used.

Rehydration

Some causes of colitis are also associated with diarrhea and/or vomiting. Self-care for vomiting and diarrhea may include moving to a bland diet or a diet of mostly liquids until food can be kept down.

Taking in enough fluids to replace any that are lost is important in preventing dehydration. This may include water, sports drinks, or store-bought or homemade oral rehydration solution.

C. difficile Colitis

While it is not part of any official treatment guidelines, there is a theory that probiotics may be helpful for preventing Clostridium difficile (C. difficile) infection.

In one study, a yeast called Saccharomyces boulardii helped reduce the risk of infection in hospitalized patients. Patients should always discuss any use of probiotics with their physician to ensure they’re being used properly.

Prescriptions

There are many prescription medications and therapies used to treat colitis. The treatments used will be different based on the cause of colitis. In most cases, therapies are aimed at treating the underlying cause of the inflammation.

Crohn’s Disease and Ulcerative Colitis

There are a variety of prescription medications that might be used to treat IBD. Your gastroenterologist will usually prescribe these medications. Not every drug will work for every patient.

Which medication or combination of medications are used will depend on which form of IBD is causing the colitis (Crohn’s disease or ulcerative colitis), how deep the inflammation is, and if there are other symptoms that need treatment.

Some of the types of drugs used include 5-aminosalicylic acid medications (5-ASA), corticosteroids, immunomodulators, and biologics.

Microscopic Colitis

There aren’t any guidelines on how to treat microscopic colitis. However, some prescription medications may be used, including cholestyramine, 5-ASA drugs, corticosteroids, immunomodulators, and anti-tumor necrosis factor alpha drugs.

Ischemic Colitis

Medications may be used to provide some relief from the signs and symptoms of this condition. Pain relief, antibiotics, and fluids may be given to patients that are hospitalized for ischemic colitis.

C. difficile Colitis

Even though this condition may occur after treatment with antibiotics, that is also the first treatment that might be tried. Antibiotic resistance, where some strains of bacteria have become resistant to antibiotics, can complicate treatment.

Surgeries and Specialist-Driven Procedures

Crohn’s Disease and Ulcerative Colitis

Surgery may be used to treat colitis that’s caused by IBD. This includes either the partial or the total removal of the colon. Surgery might be used when medications have failed to control the disease or there is a risk of colon cancer. 

When the entire colon is removed, there must be another way for stool to leave the body. That could mean placing an ileostomy, in which a piece of the small intestine is brought through the abdomen, which is called a stoma. An appliance is worn on the abdomen over the stoma to collect stool.

In ulcerative colitis, a type of surgery called an ileal pouch-anal anastomosis (IPAA), or commonly, a j-pouch may be performed. In an IPAA, the end of the small intestine is used to create a holding space for stool (much like a rectum). It is then attached to the anus and stool is passed out the bottom.

Ischemic Colitis

In some cases, surgery might be used to treat this potentially life-threatening condition. Damaged parts of the intestine may need to be removed or any affected arteries may need to be repaired.

C. difficile Colitis

Another treatment that’s used under the care of a physician is a fecal microbiota transplant (FMT). Stool from a healthy donor that has been specially treated is put into the colon of the person with C. difficile colitis.

Summary

The treatments for colitis will depend on the underlying cause. For most types, medication and a change in diet are used. For some types, surgery may be needed.

A Word From Verywell

The reasons for the development of colitis are varied, as are the treatments. The key is to get the cause of colitis diagnosed so that it can be treated early and effectively. One of the most important things to know about the early diagnosis and treatment is that bleeding from the rectum is not normal. Blood in or on the stool is a reason to see a doctor, even if it has happened before. 

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