What is fulminant colitis?

Fulminant colitis is a life-threatening type of inflammation of the large intestine. It can develop from any type of acute or chronic inflammatory bowel problem, although it is most commonly a complication of ulcerative colitis. A person may experience bloody diarrhea, severe dehydration and fatigue, and possibly go into shock without emergency care. Treatment may include injections of anti-inflammatory medications and blood transfusions. Surgery to remove the colon is needed if other treatments fail to relieve the swelling within a few hours.

There are several different forms of colitis. Acute inflammation of the colon can be caused by food poisoning, bacterial infections, and some viruses. Long-term chronic inflammation is usually due to an autoimmune disorder such as Crohn's disease or ulcerative colitis. While most types can be managed with medications and specific diets, there is a chance that the irritation could suddenly engulf the entire large intestine and rectum.

When fulminant colitis occurs, a person usually develops extreme, sharp abdominal pain. Episodes of bloody, painful diarrhea can occur in rapid succession, sometimes as frequently as every five to ten minutes for hours on end. The resulting fluid loss can cause severe dehydration, which can lead to weakness, fatigue, nausea, and headaches. If left untreated, the irritation and inflammation can cause the intestines to rupture. A torn colon can introduce air into the abdominal cavity and infectious pathogens into the bloodstream, which can lead to shock.

It is essential to visit the emergency room if symptoms of fulminant colitis arise. A doctor may provide intravenous fluids to combat dehydration and corticosteroid injections to temporarily reduce swelling. A series of x-rays and other diagnostic images are taken to determine the extent of damage to the colon and to check for possible ruptures. A blood transfusion may be scheduled when it is apparent that the bloodstream has been compromised with bacteria from a torn colon. If symptoms do not begin to improve, arrangements are usually made for emergency surgery.

A total colectomy involves removing the entire colon of a person with nonresponsive fulminant colitis. In most cases, a colectomy is performed through a long incision across the lower abdomen. The large intestine is removed and a small hole called a stoma is made in the abdomen. The lower part of the stomach is connected to a tube to drain waste from the stoma and put it into a colostomy bag. A case of fulminant colitis that requires surgery can be life-changing for survivors, but with a positive attitude and a dedicated rehabilitation program, most people can recover.

Go up