Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
Viewer Question: I was tested and told I have microscopic colitis, it seems that i have constant dull pain at bottom rib cage, also my joints all over my body are always stiff sore, could the stiff sore joints,
shoulders, hips etc, have anything to do with the microscopic colitis?
Doctor's Response: The primary symptom of microscopic colitis is chronic, watery diarrhea . Patients with microscopic colitis can have diarrhea for months or years before the diagnosis is made. The chronic diarrhea of microscopic colitis is different from the acute diarrhea of infectious colitis which typically lasts only days to one week. Some patients with microscopic colitis also report mild abdominal cramps or pain. Blood in the stool is unusual.
Colitis is inflammation of the inner lining of the colon and is associated with
diarrhea,
pain, and
blood in the stool. There are
numerous reasons for the colon to become inflamed including:
The colon is
a hollow, muscular tube that receives products of digestion from the small intestine and
ultimately eliminates them from the body through the anus. The colon is
located in the abdomen and has numerous sections that are named based on their location.
Colitis can affect different sections of the colon.
The colon begins in the
right lower abdomen with the cecum
(located just above the appendix) into which the
products of digestion empty from the small intestine.
The ascending portion of the colon then ascends from
the lower to the upper right side of the abdomen.
It traverses the abdomen as
the transverse portion of the colon from the right upper to left upper abdomen
before descending from the upper to the lower left side of the abdomen.
The last
portions of the colon are the sigmoid colon low in
the abdomen and finally the anus.
The colon also has several layers. The mucosa
(inner layer
or lining) comes into contact with the products of digestion and fluid and
actively removes water and electrolytes to help solidify the feces. A layer of
smooth muscle (a special type of muscle) surrounds the inner layer and is
responsible for squeezing and mixing the undigested food and transporting it
through the length of the colon to the anus.
What are the causes (types) of colitis
All types of colitis are associated with inflammation of the colon, though
some types may be more severe and potentially dangerous than others. When a
patient complains of pain and diarrhea with or without bloody stool, it is
important to diagnose the type of colitis since treatments are different for the
different types of colitis.
Abdominal pain is pain in the belly and can be acute or chronic. Causes include inflammation, distention of an organ, and loss of the blood supply to an organ. Abdominal pain can reflect a major problem with one of the organs in the abdomen such as the appendix, gallbladder, large and small intestine, pancreas, liver, colon, duodenum, and spleen.
Rectal bleeding (hematochezia) refers to the passage of bright red blood from the anus. Rectal bleeding may be moderate to severe and most bleeding comes from the colon, rectum, or anus. Common causes include anal fissures, hemorrhoids, diverticulitis, and more.
Diarrhea is a change is the frequency and looseness of bowel movements. Cramping, abdominal pain, and the sensation of rectal urgency are all symptoms of diarrhea. Absorbents and anti-motility medications are used to treat diarrhea.
Dehydration is the excessive loss of body water. There are a number of causes of dehydration including heat exposure, prolonged vigorous exercise, and some diseases of the gastrointestinal tract. The best way to treat dehydration is to prevent it from occurring.
Crohn's disease is a chronic inflammatory disease,
primarily involving the small and large intestine, but which can
affect other parts of the digestive system as well. Abdominal pain, diarrhea, vomiting, fever, and weight loss are
common symptoms.
Colon cancer is a malignancy that arises from the inner lining of the colon. Most, if not all, of these cancers develop from colonic polyps. Removal of these precancerous polyps can prevent colon cancer.
Clostridium difficile (C. difficile) is a bacterium, and is one of the most common causes of infection of the colon. C. difficile spores are found frequently in hospitals, nursing homes, extended care facilities, and nurseries for newborn infants. They can be found on bedpans, furniture, toilet seats, linens, telephones, stethoscopes, fingernails, rings, floors, infants' rooms, and diaper pails. They even can be carried by pets. Antibiotic-associated (C. difficile) colitis is an infection of the colon caused by C. difficile that occurs primarily among individuals who have been using antibiotics. Treatment for C. difficile colitis hydration, replenishment of electrolyte deficiencies, discontinuing the antibiotic that caused the colitis, and using antibiotics to eradicate the C. difficile bacterium.
Ulcerative colitis is a chronic inflammation of the colon. Symptoms include abdominal pain, diarrhea, and rectal bleeding. Ulcerative colitis is closely related to Crohn's disease, and together they are referred to as inflammatory bowel disease. Treatment depends upon the type of ulcerative colitis diagnosed.
Stool color is generally brown. When stool color changes, often, an individual becomes concerned. The presence of the bilirubin in bile is generally responsible for stool color. Bilirubin concentration can vary bile color from light yellow to almost black in color. Changes in bilirubin can cause stool to turn green, gray, or clay-like in color. Intestinal bleeding may turn stool black, tarry, red, maroon, or smelly stool. Medication and food may also affect stool color.
Food poisoning is common, but can also be life threatening. The most common form of food poisoning is caused by bacteria and include symptoms such as fever, abdominal pain, diarrhea, nausea and vomiting.
A colon polyp is a benign tumor of the large intestine. Benign polyps do not invade nearby tissue or spread to other parts of the body. Benign polyps can easily be removed during colonoscopy and are not life threatening. If benign polyps are not removed from the large intestine, they can become malignant over time.
Salmonella bacteria are known to cause salmonellosis, typhoid fever, and paratyphoid fever in humans. Salmonella infection is usually caused by ingesting large amounts of the bacteria in contaminated food or water.
The inflammatory bowel diseases (IBD) are Crohn's disease (CD) and ulcerative colitis (UC). The intestinal complications of Crohn's disease and ulcerative colitis differ because of the characteristically dissimilar behaviors of the intestinal inflammation in these two diseases.
There are many types of E. Coli (Escherichia coli ). Pathogenic E. coli can cause urinary tract and bladder infections, or lead to sepsis. E coli O157:H7 (EHEC) causes bloody diarrhea and colitis. Complications of E. coli infection include hemorrhagic diarrhea, hemolytic-uremic syndrome, and thrombotic thrombocytopenic purpura. Symptoms include severe abdominal pain and bloody diarrhea. E coli O157:H7 commonly is due to eating raw or undercooked hamburger or raw milk or dairy products.
Travelers' diarrhea is generally contracted by eating contaminated food or drinking contaminated water. Food is the primary source of travelers' diarrhea. Enterotoxigenic E. coli is the cause of up to 70% of all cases of travelers' diarrhea. There are five unique classes of E. coli that causes gastroenteritis. Other bacteria responsible for travelers' diarrhea include
Campylobacter, jejuni, shigella, and salmonella. Viruses such as rotavirus and Norwalk virus (norovirus) and giardia lamblia a parasite may cause travelers' diarrhea. Prevention is careful eating and drinking of water.
Microscopic colitis (lymphocytic colitis and collagenous colitis) is a disease of inflammation of the colon. Microscopic colitis is only visible when the colon's lining is examined under a microscope. The cause of microscopic colitis is not known. Symptoms of microscopic colitis are chronic watery diarrhea and abdominal pain or cramps. Microscopic colitis is diagnosed through biopsies of several areas of the colon. There is no standardized treatment for microscopic colitis; however, eliminating NSAIDs, and treatment medications such as Imodium, Lomotil, Petpo-Bismol, Entocort EC, and mesalamine (Asacol) have been helpful in some individuals.
Vascular disease includes any condition that affects your circulatory system. Vascular disease ranges from diseases of your arteries, veins and lymph vessels to blood disorders that affect circulation.
Travelers should prepare for their trip by visiting their physician to get the proper vaccinations and obtain the necessary medication if they have a medical condition or chronic disease. Diseases that travelers may pick up from contaminated water or food, insect or animal bites, or from other people include malaria, meningococcal meningitis, yellow fever, hepatitis A, typhoid fever, polio, and cholera.
Shigellosis is a disease caused by the Shigella bacteria. Bloody diarrhea, stomach cramps and fever are common symptoms. Mild infections usually resolve on their own. Antibiotics are used to treat more severe cases.
Cytomegalovirus (CMV) is a virus that is spread from person to person via spit, semen, vaginal secretions, urine, blood, sexual contact, breastfeeding, blood transfusions, organ transplants, and breast milk. Symptoms of CMV include fatigue, swollen glands, fever, and sore throat. You can take precautions to prevent CMV such as washing hands frequently and thoroughly, using condoms, if you work in day care centers wash hands thoroughly after contact with body secretions, and avoiding oral contact with objects covered in saliva. Individuals with HIV infection are at most risk of contracting CMV.
Enterovirulent Escherichia coli (E. coli) are strains of related bacteria that have a strong propensity to cause gastrointestinal tract infections. Examples of strains include: EHEC (enterohemorrhagic E. coli), ETEC (enterotoxigenic E. coli), EPEC (enteropathogenic E. coli), EIEC (enteroinvasive E. coli), EAEC (enteroadherent E. coli), and EAggEC (enteroaggregative E. coli). Symptoms may vary depending on the strain the individual contracts. Infection is spread generally through contaminated food or drink.
Travelers' diarrhea is a gastrointestinal illness that occurs in travelers.
Travelers' diarrhea usually is caused by eating food contaminated with bacteria or, less commonly, with parasites or viruses.
The treatment of travelers' diarrhea is usually plenty of oral liquids as well as over-the-counter medications that control diarrhea and cramps.
Antibiotic prophylaxis (prevention) for travelers' diarrhea is available but is not recommended generally.
The prognosis of travelers' diarrhea is good. It is rarely fatal, and
most cases resolve within a week.
What is travelers' diarrhea?
Travelers' diarrhea is defined by most experts as three or more unformed
stools in a 24 hour time period, passed by a person who is traveling. Travelers'
diarrhea is commonly accompanied by abdominal cramps, nausea, and bloating.
Travelers' diarrhea is a general term and does...
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