Enterocolitis is a condition characterized by an inflamed digestive tract. There are different types, with different possible causes.
Enteritis is inflammation of the small intestine. Colitis is inflammation of the colon. Combined, the two conditions are called enterocolitis or coloenteritis.
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Types of enterocolitis
There are a few different types of enterocolitis, each with their distinct symptoms and causes.
Necrotizing enterocolitis occurs when the inflammation is accompanied by the death of tissues in the lining of the intestine. The problem is most common in babies born prematurely or infants who become ill.
The cause of necrotizing enterocolitis is unknown at this point. Some suggest that premature babies have an undeveloped immune system and are more prone to bacterial attack. Excess bacteria in the intestines seem to make the problem worse.
Other theories suggest that a loss of blood flow or oxygen to the bowels causes the original inflammation, which bacterial infection then makes worse. Some believe that overfeeding an infant puts too much bacteria in their intestines before they are ready for it, causing the symptoms.
Signs and symptoms of necrotizing enterocolitis to look out for include:
- bloated, swollen, or discolored abdomen
- bloody stool
Necrotizing enterocolitis can be fatal if it is left untreated. A baby with necrotizing enterocolitis should get immediate medical care.
It is also possible for symptoms of enterocolitis to show up after antibiotic treatment.
In a healthy person's intestines, bacteria fight for a place on the intestinal wall, where they help break down and digest foods. When a person takes antibiotics, most of these bacteria are killed off. This leaves a perfect environment for bacteria such as Clostridia difficile to infect.
Antibiotics treatment is a potential cause of enterocolitis. This form of the inflammation has specific symptoms, such as watery diarrhea and cramping.
As Clostridia difficile spread, they release toxins in the body. These toxins damage and inflame the inner wall of the intestines and cause different symptoms. The first symptoms usually show up within 10 days of antibiotic treatment.
Symptoms can include:
- cramps and bloating
- increased bathroom breaks
- watery diarrhea
- a general ill feeling or malaise
- severe stomach pain
Enterocolitis associated with antibiotics can also progress into another form of enterocolitis called pseudomembranous enterocolitis.
Pseudomembranous enterocolitis involves inflammation of the lining of the bowel in addition to the intestines.
It is typically caused by a bacterial infection due to antibiotics, meaning that people with pseudomembranous enterocolitis have likely also had antibiotic-associated enterocolitis. This is not always the case, however.
Specific symptoms of pseudomembranous enterocolitis include persistent watery diarrhea with a very foul smell, fever, and painful cramping.
This disease also causes collections of white blood cells, mucus, and the release of proteins from the intestinal wall. These come out during a bowel movement and can be seen easily upon inspection of the stool.
Hemorrhagic enterocolitis is another type of inflammation caused by a bacterial infection. Certain strains of the Escheria coli bacterium infect the intestines, producing a toxin that causes problems in the body.
Hemorrhagic enterocolitis typically causes severe cramps and watery, bloody diarrhea. Some people also experience a fever.
Hemorrhagic enterocolitis can pose a serious risk if it is left untreated. If bacteria enter the bloodstream, the infection may spread and affect other organs.
In severe cases, people may develop a disease called hemolytic-uremic syndrome. This disease puts them at risk for other conditions, such as kidney failure, nerve damage, and stroke.
Common symptoms of enterocolitis
Symptoms of enterocolitis may vary depending on the person and the type of enterocolitis they have. Enterocolitis affects the lower end of the digestive system and all types of the disease share some common symptoms.
Some of the most common symptoms are:
- swelling near the stomach
- a general feeling of being unwell
Some people who have particular types of enterocolitis may experience additional symptoms, such as rectal bleeding.
Diagnosing enterocolitis can require a few different tests, and treatment takes time.
To diagnose enterocolitis, a doctor will take down the person's medical history and give them a physical exam. The doctor will likely order various tests, such as a complete blood count (CBC) test, blood culture test, and a stool sample. Inspecting the stool helps doctors rule out pseudomembranous colitis or other cases of enterocolitis caused by severe infection.
In some cases, doctors will order imaging tests such as CT scans or MRIs. These images can highlight signs of inflammation in the intestines and other markers of the disorder.
Ultrasounds are also useful in many cases. An abdominal ultrasound allows doctors to see if the walls of the colon have thickened or if the intestines are dilating or filled with fluid.
Treatment for enterocolitis may include having fluids applied intravenously, or blood transfusions. In serious cases, surgery may be required.
Each type of enterocolitis requires different treatment methods and considerations.
Once enterocolitis has been diagnosed, a doctor will discuss different treatment options with the person.
Treatment options can vary from person to person and largely depend on the type of enterocolitis a person has, and how far it has progressed.
Many people will need to go to the hospital for treatment so that doctors can monitor their progress and keep track of the disorder. The person may receive fluids through a vein if they are losing too much liquid through their diarrhea. Others may require blood or platelet transfusions.
In cases of recurrent enterocolitis, doctors may do a fecal microbial transplantation, where they replace the disrupted gut microorganisms with live bacteria taken from a healthy donor.
Treatments do not include anti-diarrheal drugs, as these can make the disease worse and do little for symptoms.
Antibiotics are rarely prescribed as they can promote infection and lead to further complications. This is especially true in cases where hemorrhagic enterocolitis and enterocolitis have been caused by antibiotics. Doctors may prescribe antibiotics, however, to prevent life-threatening sepsis.
Some severe cases of enterocolitis require surgery. Those who have torn tissues in the intestines are likely to need urgent surgery. These people, however, may be less likely to respond to conservative treatment and may be more prone to hemorrhaging or sepsis.
Surgery typically involves draining infected areas and removing infected parts of the intestines.
Diet for enterocolitis
It is possible for a person to support their treatment by changing their diet. Possibly the most important dietary consideration for a person with enterocolitis is water.
Enterocolitis typically causes persistent diarrhea that is very watery. This deprives the body of water and electrolytes, which must be replenished.
Drinking extra water throughout the day can reduce the chances of dehydration. High-liquid foods can be an excellent addition to the diet as well, as they often provide various nutrients and electrolytes to the body in addition to water.
Enterocolitis is a disorder of the gut, so eating to improve gut health is vital. Probiotics and prebiotics can be added to the diet to help establish healthful micro-organisms in the intestines.
Discussing the ideal diet for supporting enterocolitis treatment with a qualified healthcare practitioner is the best course of action. They may be able to provide recommendations based on a person's situation.