Infectious colitis
Infectious colitis is the inflammation of the colon resulting from a bacterial or viral infection. This condition can arise from foodborne illnesses, often referred to as food poisoning, caused by pathogens such as Escherichia coli, Salmonella, Shigella, and Campylobacter. It can also occur when antibiotics disrupt the normal bacterial flora in the colon, allowing for an overgrowth of Clostridium difficile, leading to pseudomembranous colitis. Symptoms of infectious colitis vary based on the causative agent, but common manifestations include diarrhea (which may be bloody), abdominal pain, fever, and general malaise.
Diagnosis typically involves evaluating symptoms, physical examination, and possibly laboratory tests, as no specific screening test exists. Treatment mainly focuses on bowel rest, hydration, and in cases of C. difficile infection, targeted antibiotic therapy. Preventive measures include consuming safe food and water, proper hand hygiene, and cautious use of antibiotics. Understanding these aspects of infectious colitis can help individuals recognize the condition and seek appropriate care.
Infectious colitis
- ANATOMY OR SYSTEM AFFECTED: Colon, digestive system, gastrointestinal system, intestines
- ALSO KNOWN AS: Clostridium difficile infection
Definition
Infectious colitis is inflammation of the colon caused by a bacterial or viral infection.
Causes
Infectious colitis is caused by viruses and bacteria that are introduced into the body or develop from antibiotic use that allows an overgrowth of normal bacteria in the colon. Food-borne illnesses, commonly called food poisoning, deliver bacteria that may include Escherichia coli, Salmonella, Shigella, and Campylobacter. Pseudomembranous colitis, now referred to as Clostridium difficile infection, occurs when antibiotics alter the normal bacteria in the colon, allowing for an overgrowth of C. difficile.
Risk Factors
Eating spoiled or unclean food and drinking unclean water may lead to food poisoning and could increase the risk for infectious colitis in any age group. The use of antibiotics may cause the normal bacteria of the colon to be affected, leading to an overgrowth of bacteria. International travel may expose persons to unclean conditions and bacteria. Women and older adults are at greater risk of C. difficile infection. Drugs that are used for indigestion, such as proton pump inhibitors, or drugs that limit the ability of the colon to move waste, such as some pain medicines, may also increase the risk of infection.
Symptoms
Symptoms depend on the cause of the infectious origin of the colitis. Colitis related to food poisoning usually includes bloody diarrhea and may lead to dehydration. Infection with C. difficile includes a fever and the production of a toxin that causes non-bloody diarrhea. In both cases, persons may have abdominal pain, may always feel the need to have a bowel movement, may experience weight loss, may experience appetite loss, and may have other signs of infection, such as sore joints and a general, overall poor feeling. Blood work usually shows an elevated white blood cell count, which often indicates infection in the body.
Screening and Diagnosis
No screening test exists for colitis of infectious origin. Diagnosis is made based on presenting symptoms. Because both bloody and non-bloody diarrhea are symptoms of a variety of diseases, the doctor will ask specific questions designed to narrow possible causes. The doctor will feel the affected person’s abdomen, do a rectal examination, order a blood stool test, and order blood work, which will include a complete blood count that measures white blood cells and electrolyte levels. More severe cases may need a colonoscopy or radiology tests, such as a computed tomography (CT) scan.
Treatment and Therapy
The goal of therapy is to rest the bowel. A clear liquid diet and rest are often all that is needed for most cases of infectious colitis. The body will rid itself of the causative bacteria or virus. If the causative agent is found to be C. difficile, however, the causative antibiotic is usually stopped and an antibiotic specific to C. difficile is prescribed. Hospitalization and intravenous fluids may be given to combat severe dehydration, and antidiarrheal medicines and pain medicines may be prescribed. Most people with mild forms of colitis do not need treatment.
Prevention and Outcomes
Preventive measures include ingesting safe food, drinking clean water, and using antibiotics appropriately. One should ensure that food is carefully prepared and stored at appropriate temperatures, ensure that one’s drinking water is from safe sources (or has been boiled), and ensure that one’s hands are washed frequently. Also, one should report any diarrhea while on antibiotics or other medicines.
C. difficile infection, which is caused by an overgrowth of bacteria from antibiotic overuse or misuse, is more difficult to prevent because people may need to take antibiotics to treat other infections in the body.
Bibliography
Feldman, Mark, Lawrence S. Friedman, and Lawrence J. Brandt, eds. Sleisenger and Fordtran’s Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management. New ed. 2 vols. Philadelphia: Saunders/Elsevier, 2010.
Fletcher, Jenna. "What to Know About Infectious Colitis." Medical News Today, 25 Apr. 2023, www.medicalnewstoday.com/articles/infectious-colitis. Accessed 3 Feb. 2025.
Johnson, Leonard R., ed. Gastrointestinal Physiology. 7th ed. Philadelphia: Mosby/Elsevier, 2007.
Walsh, Christopher. Antibiotics: Actions, Origins, Resistance. Washington, D.C.: ASM Press, 2003.
Weese, J. S. “ Clostridium difficile in Food: Innocent Bystander or Serious Threat?” European Society of Clinical Microbiology and Infectious Diseases 16 (2009): 3-10.