Symptoms
Depending on the cause, the signs of inflammation of the colon differ from one another. Most of them have diarrhea and abdominal pain in common. The infectious inflammation caused by the various pathogenic germs usually begins hours after ingestion, e.g. of food containing the germ, with nausea, followed by diarrhoea and vomiting.
Fever can accompany this. These symptoms usually disappear by themselves within a few days. Appendicitis usually begins with stabbing or pressing abdominal pain around the navel, which then typically moves to the right lower abdomen.
An inflammation of a diverticulum (lat. : diverticulitis) usually manifests itself with abdominal pain in the affected area, usually in the lower left part of the abdomen where most diverticula are located. These inflammations are accompanied by fever and often blood is found in the stool of the affected person.
A chronic inflammatory bowel disease is usually only recognized in its course. A striking indication is often persistent diarrhea, which in ulcerative colitis can also contain blood. In Crohn’s disease, blood is often not visible.
In the flare-up of a chronic inflammatory bowel disease, diarrhea is often accompanied by colicky, i.e. swelling and decongestion, abdominal pain and fever. The extent of the symptoms depends on the extent of the intestinal inflammation, which can change constantly during the course of the disease. Due to the permanent inflammation of the intestinal cells, their function is restricted and as a result of a nutrient deficiency in the body, weight loss and deficiency symptoms can occur.
An inflammation in the context of a gastro-enteritis usually ends by itself within a few days to a maximum of two weeks. A drug therapy is not necessary in most cases. Since most cases are caused by viruses, antibiotics are rarely necessary and should only be used if the bacterial cause is proven.
It is important in all cases to compensate for the loss of fluid due to diarrhoea and the loss of important salts in the body. This loss can lead to total dehydration of the body and in extreme cases can be life-threatening. Especially babies and elderly people are threatened by dehydration quite quickly.
A hospital stay is then necessary to compensate for the loss of fluid and salt by directly administering fluid into the body’s vascular system, the so-called “drip”. Outside of the hospital it is important to keep the loss of fluid as low as possible by drinking enough. Tea, in this case herbal teas such as black tea or chamomile tea, are particularly suitable for this purpose, as they are said to have an additional calming effect on the gastrointestinal tract.
Cola is also very well suited for this purpose, as its high sugar content additionally promotes the absorption of fluids into the body. An appendicitis can only be treated definitively by removal. If the signs of inflammation are less pronounced, it is also possible to wait under pain therapy to see whether it heals by itself.
The inflammation can then reappear at any time and then make surgery necessary. Chronic inflammatory bowel diseases are more difficult to treat and can only be cured in the rarest of cases. It is not uncommon for a chronic inflammatory bowel disease to require lifelong therapy with medication.
To reduce the inflammation, cortisone therapy or a therapy with drugs that suppress the immune system, e.g. mesasalazine, is often used. This is considered to be very well tolerated and is available as suppositories. For severe attacks a preparation called azathioprine can also be used.
This has a strong inhibitory effect on the human immune system. It only takes effect after several months of use and has many side effects. To prevent a relapse, a small dose of one of the drugs must often be taken permanently.As a non-drug measure, it is important to ensure a balanced diet and foods that cause intolerance should be avoided.
During a relapse, light, low-fiber food is recommended. In severe cases of ulcerative colitis it may be necessary to remove parts of the colon surgically to prevent the wall of the colon from rupturing due to a severe inflammation. In Crohn’s disease one is much more reluctant to potentially remove parts of the bowel, since the inflammation can affect all parts of the bowel and only a removal of certain amounts of bowel is compatible with adequate digestion.
The treatment of a diverticulum varies depending on the extent of the inflammation. If the inflammation is mild, it can be treated with antibiotics and anti-inflammatory drugs. Affected persons can positively influence the healing of the inflammation by regular bowel movements, low-fiber food and sufficient fluid intake.
In the case of a more severe inflammation, a hospital stay is absolutely necessary. In order not to burden the intestine a complete food leave is set there as well as further antibiotics, painkillers and inflammation-relieving medicines is administered. However, if there is a danger of the intestinal wall tearing open, the diverticulum must be treated surgically.
However, emergency surgery should be avoided and suspicious diverticula should be removed in an interval free of inflammation. The diagnosis of gastroenteritis can often be clearly established by questioning the patient. In most cases, no further examination is necessary, as the infection heals on its own, regardless of the germ causing it.
Only in special cases it is necessary to detect the germ and so this can be done by microscopic examination of a stool sample in the laboratory in order to initiate a special therapy adapted to the germ. Unfortunately, appendicitis can only be clearly identified during the operation. However, an ultrasound examination as well as a blood test can provide information to estimate the probability.
In patients with diverticulitis, in addition to the interview, a physical examination is performed, during which a hardening in the affected part of the intestine can be palpated. In addition, procedures such as x-rays, ultrasound or computed tomography (=CT) can reveal diverticulitis and the diagnosis can then be made. In these procedures, inflammations, thickenings, sacculations or even intestinal ruptures can often be clearly seen on the images.
Not least in the case of chronic inflammatory bowel diseases or diverticula, colonoscopy provides the decisive indication in the search for the cause. In the case of diverticula, however, it is only permitted in intervals without inflammation. With the small camera in the tube, it is possible to detect redness and whitish-yellow coatings in the inflamed areas of chronic inflammatory bowel diseases. The last uncertainties can also be clarified in the course of a colonoscopy by a small sampling (= biopsy) and microscopic examination. However, the diagnosis of a chronic inflammatory bowel disease may only be made definitively when all other causes of inflammation such as bacterial infection have been excluded.
