What is a Colitis Flare up?

Mary McMahon

A colitis flare up is an episode of abdominal cramping, bloody diarrhea, and fever caused by an inflammation in the large intestine, also known as the colon. People with ulcerative colitis, a form of inflammatory bowel disease (IBD), can develop colitis flare ups at random or in response to lifestyle or medication changes. Treatment is available to manage the symptoms of a flare up and keep the patient comfortable and follow up care can be provided to limit the potential for flare ups in the future.

Bloody diarrhea, abdominal pain, fever and abdominal cramping all occur during a colitis flare up.
Bloody diarrhea, abdominal pain, fever and abdominal cramping all occur during a colitis flare up.

In ulcerative colitis, the large intestine becomes inflamed and lesions appear along the lining of the intestine. The inflammation rarely extends through the full thickness of the intestine, and the causes are not well understood. People usually start to develop inflammation between the ages of 15 and 30, although onset can appear later in life as well. The first sign of ulcerative colitis is often a colitis flare up, where the inflammation becomes so severe that the patient begins experiencing symptoms.

A colitis flare up can cause abdominal cramps and pain.
A colitis flare up can cause abdominal cramps and pain.

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In a colitis flare up, patients pass loose, mucusy stool with fresh red blood in it. They can experience abdominal cramps and pain, may develop a fever, and can feel generally unwell. Patients can also feel an urge to defecate even when the colon is relatively clear. Treatments for flare ups include anti-inflammatory drugs to reduce the inflammation, drugs to coat and protect the colon, antibiotics in case the patient has an infection, and immune medications to address the overactive immune responses believed to be contributing factors in a colitis flare up.

In addition, the patient may need to make some dietary changes. Fiber is reduced to limit the strain on the colon, and the patient may be encouraged to eat bland foods to avoid irritating the ulcers. High protein meals are a common component of ulcerative colitis treatment. Once the flare up resolves, the patient can be put on medications to keep inflammation minimal in the future. These medications may need to be periodically adjusted.

There are some complications associated with ulcerative colitis. Beyond the occasional colitis flare up, this condition can also potentially lead to serious injuries to the large intestine, some of which can cause life-threatening complications like intestinal paralysis. In addition, patients with this condition have an increased risk of colon cancer. Colon cancer monitoring should be increased to catch any signs of cellular changes inside the colon early, before the cancer has an opportunity to spread.

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