Colitis

Exam Cram

• Colitis is inflammation of the large colon, caused by included infection, inflammatory and infarction

• Presentation: diarrhoea (can be bloody), abdominal pains, feverish; raised lactate

• Diagnosis: imaging on CT

• Management: IVF & treat underlying cause

Colitis is a sign and its underlying cause is required for a diagnosis. 

Outline

Assessment

History

• Acute history < 7d

• Abdominal pain, diarrhoea +- blood

• Dehydration

• Recent drug change/ radiotherapy

• PMH- vasculopath

Examination

• Abdominal tenderness +- guarding

• Worst on left side

• Hypotensive, tachycardia

Investigations

• Raised lactated

• Can have raised creatinine

• CTAP: showing colitis

• Stool/ blood culture: organism

Diagnosis

Diagnostic criteria: colitis on imaging (CT)

Differentials: Gastroenteritis, Diverticulitis 

Classification

• Aetiology

  1. Infective colitis: 

     • Pseudomembranous Colitis

       • Shigella, Campylobacter, Salmonella

       • Clostridium Difficile

       • E.coli 

       • Tuberculosis 

     • Parasites: entamoeba 

     • Viruses: CMV (Cytomegalovirus) 

  2. Inflammatory colitis

     • Ulcerative Colitis 

     • Crohn's Disease 

  3. Ischaemic colitis

  4. Microscopic Colitis 

  5. Drug induced Colitis- NSAIDs, aspirin, PPIs, betablockers, statins

  6. Radiation colitis

  7. Necrotising enterocolitis (paediatrics)

• Severity markers: lactate

Management

• Supportive: IVF

• Treat underlying cause

Resources and References

1. Azer SA, Sun Y. Colitis. [Updated 2023 Aug 7]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK541037/

Written in 2025