What Is Left-Sided or Distal Colitis?

Most people have heard of colitis, but what exactly is left-sided colitis?

Left-sided colitis

Left-sided colitis is a specific type of ulcerative colitis. Ulcerative colitis creates inflammation in the colon, and left-sided colitis, as you might have imagined, affects the left side. Left-sided colitis is also sometimes referred to as distal ulcerative colitis.

This form of ulcerative colitis begins at the rectum, and follows up to the colon, eventually stopping at the splenic flexure. This is where the colon bends.

Ulcerative colitis in general is cause by abnormal responses of the immune system, resulting in inflammation within the intestinal tract. This can cause tiny ulcers to develop within the lining of the colon. These ulcers generate mucus and pus, which then translate into other symptoms.

Unfortunately, left-sided colitis is a chronic condition, and those who receive a diagnosis tend to cope with the symptoms their entire lives. There is not a cure for ulcerative colitis at the moment.

Symptoms

The symptoms associated with left-side colitis often overlap with other forms of ulcerative colitis. The most common symptom is diarrhea, but there are far more as well.

Many feel as if they constantly need to have a bowel movement, even when this is not the case. This can be debilitating as you will be struck with the urge when trying to go about your day, resulting in an inability to complete tasks. The name of the sensation is "tenesmus," and it originates from irritation and inflammation in the rectum. When those with ulcerative colitis do manage to pass stool, the amount is usually minor, especially compared to the sensation that they have to pass a large amount. Often, the stool will have blood, which signifies sizable colon damage.

Various other symptoms include, but are not limited to, constipation, fever, weight loss, rectal spasms, abdominal or rectal pain, and dehydration caused by diarrhea.

If there is blood in the stool, it is important to call a doctor immediately and request an appointment. If there is more than a small streak, emergency medical attention may be necessary.

Cause

There is no one cause for ulcerative colitis; however, experts have different hypotheses about why it may afflict certain people.
Certain people are at a higher risk for developing ulcerative colitis. This may be the case if you have a history of infections and antibiotic usage, live in a developed nation, have a family history of ulcerative colitis or other digestive disorders, or live far from the equator.

Of course, these are not meant to be considered causes of ulcerative colitis, and even if you have all four, you may never develop the condition. However, it simply means that those with those risk factors possess a higher likelihood of developing ulcerative colitis than those who live close to the equator, live in a developing nation, do not have a family history of ulcerative colitis or other digestive disorders, or lack a history of infections and antibiotic usage.

Diagnosing left-sided colitis

Before treatment can begin for left-sided colitis, it is necessary to get an accurate diagnosis. Normally for diagnosis, doctors will perform an endoscopy (either a sigmoidoscopy or a total colonoscopy), which is when a camera is sent into the colon so doctors can accurately assess what the situation is. From these images, experts can find signs of inflammation, like water retention, redness, or other types of irregularities.

In left-sided colitis specifically, when the camera passes the splenic flexture, signs of the condition no longer are present. Therefore, doctors will be able to analyze where it is left-side colitis or another form of ulcerative colitis.

Treatment

The treatment for left-sided ulcerative colitis depends on a few things, such as how severe the symptoms are, and how the patient generally responds to medications - as these could have the potential to alter the efficacy.

Normally, medication will be offered to those who have ulcerative colitis. Of course, this is dependent on the specific symptoms and severity. Doctors normally prescribe either one, or multiple different types of medications for treatment.

One of the most prescribed medications for the treatment of left-side colitis is 5-ASA, which is short for 5-aminosalicylic acid. This medication can be taken a variety of different ways: orally, applied topically, or with an enema. While these three different forms are usually advised, recent research has stated that topical application may be the most effective route, as findings showed that topical treatments were able to induce remission in 72 percent of cases, within only a month of use. Researchers went even further to state that combining oral and topical treatment is the most effective method, and offers increased efficacy than either form on its own. The medication works to fight against the inflammation that occurs within the colon.

Some people do not respond well to 5-ASA, so there are other forms of medication that they may take - one of the most common being corticosteroids, which assist in the management in inflammation. Or, for those who do respond to 5-ASA, but want a more robust treatment plan, oral corticosteroids can sometimes be combined with 5-ASA.

When patients do not respond well to either 5-ASA or corticosteroids, immunosuppressant medications may be taken. Immunosuppressants target proteins within the immune system that lead to flares of inflammation in ulcerative colitis.

In very severe cases, patients may need to be hospitalized, where they will potentially receive intravenous medications and steroids in an attempt to manage their symptoms. Rarely, removing pieces of the colon may even be necessary, normally when severe damage, bleeding, or inflammation cannot be repaired within that area.

Complications

Unfortunately, there are certain complications that are associated with left-sided colitis, such as toxic megacolon and anemia.

Toxic megacolon is common in many inflammatory bowel diseases, and results in the dilation of the colon due to inflammation. Symptoms can be fever, dehydration, abdominal pain, and malnutrition. Those with toxic megacolon are at a heightened risk of rupturing their colon, and should be treated with medicines, intravenous fluids, or surgery where necessary.

Anemia, or a low blood count, results from a loss of blood caused by the inflamed intestines. For treatment, patients will often be given iron supplements or blood transfusions.

Managing left-sided colitis

So, how do you manage left-sided colitis? One of the biggest ways to fight against the condition is to take a strict look at your diet and lifestyle, then make a few changes. They may seem difficult at first, but a few tweaks can drastically impact your health. None of these methods should be seen as a substitute for treatment, but a tactic in managing the condition alongside medical care.

Certain natural supplements and diet substitutes can assist, such as probiotics, turmeric, omega-3 fatty acids, and folate, or folate-rich foods. Some research has suggested that acupuncture and wheatgrass can also assist in relieving symptoms. Your diet should be well-rounded, and stay high in fiber, while low in refined carbs to lower the amount of inflammation in the colon.

As with any other form of treatment, before making large changes in your diet or lifestyle, you should discuss with your doctor.

Reference

https://www.medicalnewstoday.com/articles/319956.php