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Female Number of posts : 29
Location : Tennessee
Registration date : 2007-03-08

PostSubject: Colitis   Sun Jan 13, 2008 8:55 pm


In brief “colitis” is inflammation of the colon.


The colon is another term for the large or lower intestine. For those who do not know the lower intestine from the upper intestine, a short tour is in order:

Food is chewed up in the mouth and swallowed. At this point the goal is to convert the food from what is in the bowl to a liquid slurry that will flow evenly through the intestinal tract bathing the vast absorption surfaces lower down. The first step is to liquefy the food and chewing begins this process. Adding saliva adds some enzymes to further begin the breakdown of food structure. The breakdown of food into the liquid slurry is called DIGESTION.

From the mouth and throat food travels through the chest via a tube called the esophagus. This is a well coordinated muscular movement rather than just natural flow or gravity. The esophagus connects to the stomach where the food completes its breakdown process. The stomach is capable of not only serious grinding but also squirts strong acid into the mix. Gradually the food mixture is squirted out of the stomach into the small intestine. At the end of this process, only the most undigestible material is left in the stomach. It is either vomited up or a single large stomach contraction (called a “house keeper contraction”) moves this material into the small intestine as well.

The small intestine is divided into 3 parts: the duodenum, jejunum and ileum. The food at this point is in the duodenum where digestion completes. The duodenum is where the bile duct and pancreatic duct are located. As food enters the duodenum, bile is squirted into the mixture to neutralize the stomach acid and help dissolve the dietary fats in the mixture. Pancreatic enzymes squirt in to digest the starches. From here on in, the name of the game switches from DIGESTION to ABSORPTION.

The food mixture flows along the small intestine where it is absorbed into the body. Bacteria live in the small intestine symbiotically, producing vitamins and assisting in food breakdown as the food passes by.

After the long journey through the small intestine, most of what is left in the tract is undigestible fibers and any material that was not absorbed earlier.

NOW THE FOOD ENTERS THE COLON. The colon has three functions: absorption of water, storage of stool, and further digestion of unabsorbed nutrients. The bacterial population in the colon is about 10 time more dense than that of the small intestine. We are talking about New York City for bacteria.

These bacteria take undigestible fibers and digest them into the three biochemicals: acetate, propionate, and butyrate (in addition, they produce assorted gases and pigments to create stool as we know it). These biochemicals nourish the colon cells (which only live about a week anyway) and control colon pH so that excreted toxins will not be reabsorbed.


In classifying diarrhea, it is important to determine whether the problem relates to the small intestine (diarrheas originating here are more serious) or large intestine. Diarrheas of the large intestine have the following common characteristics:

They are not associated with weight loss

They are associated with straining and sense of sudden urgency

They often involve fresh blood in the stool

They often involve slime or mucus in the stool

They often involve a stool that starts normal and finishes loose

They involve stool quality that is more gooey or slimy than watery
A diagnosis of colitis is generally straight forward given the above classic findings though how one should proceed depends on the course of the signs. Is the problem acute (ie suddenly there) or chronic (been happening for several weeks regularly) or episodic (happens then goes away then happens again)?


A pet that has symptoms of colitis suddenly probably has a stress related colitis (common after boarding, moving, severe weather or other change) or a dietary indescretion related colitis (related to treats or raiding the garbage). These cases are generally minor and can be cleared with a short course of medication (metronidazole is commonly prescribed) and/or dietary therapy. Parasites can also cause colitis and may have to be ruled out as well.


If your pet has had symptoms of colitis for one month or more, a search for the actual cause of the colitis should be sought. Your first move is to run a basic database. This should include blood chemistry, a white and red cell profile (a CBC), and at least one fecal test for parasites. Cats should have their viral status ( feline leukemia virus and feline immunodeficiency virus) confirmed. A test for pancreatic ability to produce digestive enzymes may also be in order. A fecal “smear” or “cytology” test where the bacteria of the stool sample (as opposed to worm content) is examined microscopically can help rule out pathogenic bacteria that can cause colitis (Clostridial organisms especially)

In the dog, whipworms are difficult to confirm by fecal test (the test detects worm eggs and whipworms only periodically release their eggs). It may be prudent to deworm the dog for whipworms and see if the problem resolves.

If response to a short course of simple treatment is short-lived and if blood testing, then colonoscopy with biopsies will probably be necessary to reach a diagnosis.

Please read the section on INFLAMMATORY BOWEL DISEASE for more information on specific therapy. It is very important to rule out IRRITABLE BOWEL SYNDROME at this point, which will mimic colitis but be related to psychological stress and tissue sampling is the only way to do this.


Colitis is best managed when its cause is known and specific therapy can be instituted. When this is not possible, symptomatic management is often attempted. The following are therapeutic medications and strategies that can be helpful in the treatment of colitis.

Metronidazole: This medication has anti-inflammatory properties in the large intestine as well as ability to kill harmful organisms such as Clostridia and giardia. For more information on this medication, see the link.

Sulfasalazine: This medication consists of a sulfa antibiotic bound to a salicylate anti-inflammatory. The sulfa bond protects the anti-inflammatory medication until it gets to the large intestine thus saving the anti-inflammatory effect for the disease of the large intestine. This is a very effective medication but is typically given three times a day which is an inconvenience. Cats are sensitive to salicylates thus this medication is primarily used in dogs.

Dietary Fiber: The role of fiber in colitis is confusing as there are an assortment of fiber preparations (soluble fibers, insoluble fibers, and mixtures). In general, colitis is felt to be a “fiber-responsive” disease. Fibers are broken down into nutrients for colon cells and also for food for beneficial colon bacteria.

Fructooligosaccharides (FOS): One of the prescription Iams diets as well as the Innovative Veterinary Hi Factor diet emphasizes the addition of FOS to its formulation. FOS’s are carbohydrates involving fructose (fruit sugar) units attached to glucose (starch sugar) units. Most carbohydrates are digested by the bacteria of the small intestine leaving only the undigested fibers and other dregs for the teeming masses of the large intestine. FOS’s are not fibers but they are digested in the large intestine (not the small intestine) in the same way that fibers are yielding the same biochemicals that fibers do. Why is this good? Tests in healthy cats indicate that this will help remove pathogenic bacteria from the large intestine and promote the growth of helpful bacteria. Think of it as an anti-crime program in the New York City of bacteria. Diets that contain FOS’s may be helpful in the management of colitis.

Elimination Diet: Colitis can result from a food intolerance (an example would be lactose intolerance from which numerous people suffer). Intolerances can result from dyes, preservatives, contaminants or even natural proteins in the food. Similarly, colitis can result from an actual food allergy. The solution for these intolerances is the feeding a “pure” diet, ideally a home cooked food made with carbohydrates and proteins that are novel or new to the patient. An 8-10 week diet course is typically needed and no other chews or treats can be offered during the time of the trial. Food allergy cannot be diagnosed by blood test or skin test. At this time, response to elimination diet is the only test for food allergy or intolerance

Since itchy skin is a common manifestation of food allergy or intolerance, more detail on the subject of elmination diet can be obtained on the food allergy page.

Treating for Clostridium: Clostridial organisms are a group of anaerobic bacteria responsible for such unpleasant conditions as tetanus, botulism, and gangrene. There are Clostridial organisms that normally live in the large intestine but they do not cause any trouble unless some stressful event or diet change allows them to over grow. Once they are present in large numbers the toxins that they produce become significant and can cause colitis. (Think of these organisms as the criminal element in the New York City of bacteria. When there is a large scale blackout in the city, large scale looting occurs with these bad eggs leading the way.)

The diagnosis of Clostridial disease is complicated. A fecal smear may show the presence of Clostridial organisms but that does not mean they are producing toxin. Further tests (the “reverse passive latex antigen test” and the “ELISA” test) may be needed but the accuracy of these tests is in dispute. Often a course of a Clostridium-killing antibiotic is used as a test. Such antibiotics include: amoxicillin, tylosin, metronidazole (which has other colitis-helping properties as well), and clindamycin.

Prednisone: Prednisone is the cornerstone of treatment for Inflammatory Bowel Disease and inflammatory bowel disease must be diagnosed by biopsy. Sometimes a trial course of this medication is suggested for colitis. For more information please see the links.
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