Frequent bathroom trips, abdominal pain, and blood in your stool are signs that something's wrong with your colon. Your doctor might say you have colitis. But colitis isn't just one thing; it could be an autoimmune disease, an infection, or a circulation problem. The treatment depends entirely on which one it is, so getting the right diagnosis matters.

At Summit Health, our gastroenterology team works with patients daily to diagnose colitis accurately and develop personalized treatment plans. We believe informed patients make better health decisions.

What is Colitis? Understanding Colon Inflammation

Colitis means your colon's lining is inflamed. Normally, your colon absorbs water from waste before it leaves your body. When it's inflamed, that doesn't happen, so you get diarrhea, urgency, and pain.

• The key point: colitis isn't one disease. It's a symptom that different conditions trigger. Knowing which type of colitis you have determines your treatment.

Types of Colitis: Ulcerative Colitis vs. Infectious vs. Ischemic

Ulcerative Colitis (UC): Inflammatory Bowel Disease

Ulcerative colitis is a chronic autoimmune condition where your immune system attacks the lining of your colon and rectum, creating open sores called ulcers that bleed and produce mucus.

UC is one of two main types of inflammatory bowel disease (IBD). It's characterized by periods of flare-ups (when symptoms worsen) and remission (when symptoms improve).

Approximately 263 per 100,000 people in the U.S. have IBD, with UC being increasingly common.

What you need to know about colitis:

• Colitis is a long-term condition you'll manage for years
• It only affects the colon and rectum
• The inflammation is constant, not just flare-ups
• You'll likely experience bloody diarrhea, cramping, and urgency

Infectious Colitis: Bacteria, Viruses, and Parasites

When bacteria, viruses, or parasites get into your colon, they cause inflammation.

The most common causes of infectious colitis are:

• Campylobacter jejuni: The most common bacterial cause. Usually comes from contaminated food.
• Salmonella and Shigella: Bacteria spread through contaminated food or water.
• E. coli O157:H7: A dangerous strain that causes severe bleeding and serious complications.
• Clostridium difficile: Develops after antibiotics kill your normal gut bacteria, allowing C. difficile to overgrow.
• Viruses: Like cytomegalovirus. More common in people with weak immune systems.
• Parasites: Like Entamoeba histolytica. Rare in developed countries. 

Infectious colitis typically comes on suddenly and clears up on its own within days to weeks as your body fights off the infection.

Ischemic Colitis: Blood Flow Problems

Ischemic colitis happens when the colon doesn't get enough blood flow. Without an adequate blood supply, colon tissue gets damaged.

It's the most common type of bowel ischemia and usually affects people over 60, particularly women.

What to know:

• About 80-85% of cases are mild.
• Around 50% resolve without complications.
• Most improve within 24-48 hours.
• Often misdiagnosed as ulcerative colitis or infectious colitis because symptoms look similar.
• Risk factors: Heart disease, diabetes, high blood pressure, irregular heartbeat, and recent surgery.

Colitis Symptoms and Diagnosis

Common Symptoms 

Symptoms vary by type and severity, but generally include:

• Persistent diarrhea (watery or bloody)
• Abdominal pain and cramping
• Urgency to have bowel movements
• Rectal bleeding or blood in stool
• Fever
• Fatigue and weight loss
• Constant urge to go even when your bowels are empty

Getting Diagnosed

Diagnosis involves several steps:

• Clinical evaluation: Your doctor takes a detailed history about your symptoms, diet, medications, and family history, asking specific questions about bowel habits and what triggers symptoms.
• Blood and stool tests: These check for anemia, infection, inflammation markers, bacteria, parasites, or toxins like C. difficile.
• Colonoscopy: This is the best way to see what's happening. A doctor uses a flexible tube with a camera to look at your colon directly, taking tissue samples to confirm what type of colitis you have.
• Imaging studies: CT scans help see how widespread the inflammation is and check for any complications.

Colitis Treatment Plans: Medications, Diet, and Management

Treatment for Ulcerative Colitis

Most UC patients start with reducing inflammation in the colon:

• Anti-inflammatories: Medications that reduce colon swelling. Taken daily as pills or enemas.
• Corticosteroids: Strong anti-inflammatory drugs for active flare-ups. Used short-term because long-term use causes side effects.
• Immunosuppressants: Dial down immune system activity when standard treatments fail.
• Biologic medications: Target specific immune proteins causing inflammation. Given as injections or infusions.
• Surgery: Colon removal when medications don't work or serious complications develop. Stops symptoms completely.
• Diet changes: Most people discover trigger foods (like dairy). During flare-ups, stick to low-fiber foods like rice, plain chicken, and toast. 

Treatment for Infectious Colitis

What works depends on what's causing it:

• Bacterial infections: Your doctor prescribes antibiotics based on which bacteria are causing the problem.
• Viral infections: These usually go away on their own. Treatment means resting, drinking fluids, and managing pain until it passes.
• Parasitic infections: Your doctor prescribes antiparasitic medication based on which parasite you have.

Most cases resolve completely within days to weeks.

Treatment for Ischemic Colitis

Conservative management works for most cases:

• Supportive care: Your colon rests (no food temporarily), you get IV fluids, and antibiotics if infection develops.
• Monitoring: Follow-up colonoscopies track healing. Most people improve within a few weeks.
• Surgery: Sometimes necessary, usually when tissue dies.

General Management

No matter which type of colitis you have:

• Stay hydrated: Drink plenty of water, especially during diarrhea.
• Work with a dietitian: Identify which foods trigger your symptoms and tailor your diet to your condition.
• Manage stress: Try yoga, meditation, or therapy.
• Keep seeing your doctor: Regular check-ins help catch problems early.
• Take medications as prescribed: Don't skip doses or stop without talking to your doctor.

When to Seek Care at Summit Health

Contact your doctor immediately if you have:

• Severe abdominal pain
• Bloody diarrhea with fever
• Signs of dehydration
• Unexplained weight loss
• Symptoms not improving after treatment

Go to the emergency room if you experience:

• Severe abdominal pain with fever above 103°F
• Severe cramping with blood in stool
• Signs of sepsis (confusion, rapid heartbeat, low blood pressure)

Next Steps Towards Treating Colitis

If you think you have colitis or want a second opinion on your diagnosis, talk to your doctor. Summit Health's gastroenterologists can help you figure out what's happening and create a treatment plan that works for you, whether that's in-person appointments, virtual visits, or home-based care.

Contact your nearest Summit Health practice to get started.