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Vitamin K

Vitamin K helps the blood to clot to enable cuts and scrapes to stop bleeding. Persons suffering from liver disease, inflammatory bowel disease or cystic fibrosis are at risk of Vitamin K deficiency. Symptoms of Vitamin K insufficiency include heavy bleeding, anemia, bleeding gums and even osteoporosis. Low levels of Vitamin K do not allow sufficient use of calcium in bones. This vitamin is naturally found in green leafy vegetables, broccoli, and soya beans.

Colitis

An inflammation of the inner lining of the colon is colitis. Colitis is an inflammation in the colon and can be associated with diarrhea which could be due to infection, loss of blood supply to the colon, inflammatory bowel disease and invasion of the colon wall with lymphocytic white blood cells or collagen. While the many causes of colitis may be self-limiting and can be treated with diet and observation, nevertheless it is important to find why the inflammation had occurred as there can be more serious causes.


In case of ulcerative colitis, the exact cause remains unknown and previous diet and stress are suspected. However, doctors opine that these causes may aggravate but not cause ulcerative colitis. One possible reason could be immune system malfunction. An abnormal immune response can cause the immune system to attack the cells in the digestive tract and thereby cause malfunction. Heredity can also play a role in ulcerative colitis and it is more common in those who have a family history of the disease.


Infectious Colitis

The most common bacteria that can cause colitis are Campylobacter, Shigella, E. coli, Yersinia, and Salmonella. Most of the time infections occur as the patient has eaten contaminated food. Hence the symptoms of diarrhea with or without blood, abdominal cramps, dehydration from loss of water.

Yet another bacteria that can cause colitis is Clostridium difficile. While C.diff which is found in the colon of a healthy individual co-exists with other normal bacteria, when antibiotics are prescribed, the susceptible bacteria in the colon can be destroyed and this allows clostridia to grow unchecked, and thereby cause colitis. Unfortunately, these bacteria are also found in many surfaces in the hospitals, and hence can be contagious from person to person.


In fact, worldwide the most common parasite infection that can cause colitis is Entamoeba histolytica. This is acquired by drinking infected water and can also be passed on from one to another because of poor hygienic and sanitation conditions.

Microscopic colitis can infiltrate the wall of the colon, as a result of inflammation and this is an uncommon illness and could be an auto-immune disease. In this case, the diarrhea is watery and no blood is present in the feces. In infants younger than a year, colitis is often due to allergies to cow and soy milk. Allergic colitis can also be seen in breast fed babies, where the mother drinks cow's milk and passes that protein into their breast milk.


Ulcerative Colitis can be severe depending upon its location, reading from the signs and symptoms. Depending upon which part of the colon is inflamed it could cause diarrhea, abdominal cramps, rectal pain, rectal bleeding, urgency to defecate, inability to defecate despite urgency, weight loss and fatigue, fever and failure to grow in children.


Diagnosis of Colitis

To confirm the diagnosis, the doctor may prescribe the following tests and procedures:


  • Blood tests for anemia and to check signs of infection.
  • A stool sample to help rule out other disorders such as infections caused by bacteria, viruses and parasites.
  • Colonoscopy to view the entire colon. The doctor can take a small biopsy during the procedure for laboratory analysis. A tissue sample can help confirm the diagnosis.
  • Flexible Sigmoidoscopy to examine the last portion of the colon and if it is severely inflamed, the doctor can perform this test instead of colonoscopy.
  • X rays of abdominal area to rule out serious complications, such as a perforated colon.

Treatment

There are several categories of drugs depending upon the severity of the condition. The drugs may work well for some but not for all. Also, drugs can cause serious side effects which can far overweigh the benefits of the treatment.

Anti-inflammatory drugs are the first step in the treatment of inflammatory bowel disease. Aminosalicylates, and Corticosteroids and immune system suppressors are prescribed. These are given orally, intravenously or by enema depending upon the location that is affected. Corticosteroids can have several side effects including puffy face, excessive facial hair, insomnia and hyperactivity and more serious ones such as hypertension, diabetes, osteoporosis, bone fractures and cataracts. These are not usually prescribed for long term.

While immune system suppressors can reduce inflammation, they do so by suppressing the immune system and therefore start the process of inflammation. A combination of drugs works better is most cases. Other medications include antibiotics, anti-diarrheal medications, pain relievers and iron supplements.


Surgery

Surgery can eliminate ulcerative colitis by removing the entire colon and rectum. This procedure called ileoanal anastomosis eliminates the need to wear a bag to collect the stool. The surgeon constructs a pouch from the end of the small intestine. This pouch is then attached directly to the anus allowing expulsion of waste relatively normally. When a pouch is not possible, the surgeon creates a permanent opening in the abdomen, through which the stool is passed for collection into an attached bag.


Complications of colitis

It is recommended to have more frequent screening for colon cancer because of increased risk although it will depend on the location and duration of the disease. Some complications that can occur:


  • Severe bleeding
  • Perforated colon
  • Severe dehydration
  • Liver disease
  • Osteoporosis
  • Inflammation of joints, skin, joints of eyes, and sores in the lining of mouth
  • Increased risk of colon cancer
  • Swelling colon
  • Increased blood clots in veins and arteries.


Chronic Inflammation

Inflammation is a generalized response of the body when affected by a trauma or an infection. Inflammatory response is a significant indication of the body's immune system reaction. A cascade of events usually follow inflammation based on which the form of inflammation is determined as acute or chronic. Acute inflammatory response is short lived but chronic inflammation is a progressive form.

Inflammatory response cascade consists of tissue necrosis, fibrous granulation, lymphocyte aggregation and collagen damage. Although the body's natural response with respect to tissue damage is activated; a dormant stage can also occur in some cases of chronic inflammation such as the stalemate stage in which the balance between damaged tissue and fresh tissue is not neutralized. In some cases chronic inflammatory diseases can also be caused as result of autoimmune diseases.


Clinical manifestations

Chronic inflammatory disease can occur in various parts of the body. It activates the production of macrophages and T- Cell immune response to prevent apoptosis of the healthy tissue. In most cases the diseases associated with chronic inflammatory responses are asymptomatic in the acute phase. The chronic form infectious diseases primarily occurs because of immune comprised status of the host.

Inflammatory response is also caused by irritants such as uric acid crystals, which are endogenous materials and other irritants such as silica, asbestos and prosthetic materials. Other clinical manifestations of chronic inflammatory disease are associated with underlying medical conditions such as organ specific like Hashimoto's Thyroiditis and non organ specific such as rheumatoid arthritis, Crohn's disease and inflammatory bowel disease.

Anti-inflammatory drugs are recommended in most cases for chronic inflammation. One of the most successful ways to treat persistent inflammation is to include foods that have high anti-inflammatory properties. Fruits and vegetables such as broccoli, pineapple, avocados and diary products such as yoghurt have potent anti-inflammatory properties.

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Bibliography / Reference

Collection of Pages - Last revised Date: October 22, 2019