Enterocolitis is inflammation of inner lining of the small and large intestine. The word enteritis is termed for inflammation of the small intestine and colitis is termed for inflammation of the large intestine. Enterocolitis often results from disturbances in the digestive system and is presented with frequent disturbances in bowel movements.
Enterocolitis commonly occurs in preterm babies or babies who have been unwell. If enterocolitis also results in death of the tissues of intestine, it is termed as necrotizing enterocolitis. Another type of enterocolitis is called pseudomembranous colitis, in which there is inflammation of the large intestine. It is caused by a bacterial infection, the bacterial agent being Clostridium Difficile. Other disorders of the bowel like irritable bowel disease, inflammatory bowel disorders like Crohn's disease and ulcerative colitis, too may be considered as other variants.
Causes of Enterocolitis
Some of the common causes of enterocolitis include, diarrheal infections caused by various pathogens. These are mainly, bacterial agents like Salmonella, E.coli, Shigella, etc. viral agents like rotaviruses, enteroviruses, adenoviruses, etc. parasitic agents causing giardiasis, amebic dysentery, etc. and fungal agents causing candidiasis and other fungal infections.
People with a suppressed immune system, those having regular intake of certain drugs or those having taken a prolonged course of antibiotics maybe at an increased risk of such gastric disturbances. Other risk factors include autoimmune disorders, long distant travels, travelling to areas having spread of enterocolitis, poor sanitation, unhygienic handling of food, exposure to contaminated water and environment or people having enterocolitis.
Certain medications like chloramphenicol, toxins or chemicals can contribute to the bowel disturbances and increase chances of enterocolitis. Sometimes allergic reactions to certain food items or other substances too can cause gastric upset and inflammation of the colon. Other treatment modalities like radiation therapy, certain herbal supplements, etc. can also cause enteritis.
Symptoms of Enterocolitis
The common symptoms of enterocolitis include, bowel changes, abdominal bloating, diarrhea, bloody stools may be present at times, painful passing of stools or mucus like discharge with stools, cramping abdominal pain, nausea and vomiting. Loss of appetite, poor feeding in kids, fever, chills, fatigue and dehydration are also commonly seen.
Necrotizing Enterocolitis (NEC)
It is commonly seen in sick or preterm babies. Babies often show poor tolerance to feedings, bloated or swollen abdomen, loose motions, may be present with passage of blood, repeated vomiting, irritability, lethargy or weak feeling.
Babies who are at higher risk of suffering from necrotizing enterocolitis are those born prematurely, those receiving blood transfusion, babies on concentrated infant formula and those exposed in child care centers where chances of spread of infections are higher.
Diagnosis of Enterocolitis
Enterocolitis can be suspected from the nature of bowel movements and observable symptoms. A careful history of exposure to infected areas or people may be present, clinical examination reveals bloated abdomen and other signs of dehydration need to be assessed.
Investigations include blood tests to determine infection, inflammatory marker tests, urine and stool examination to assess the presence of causative organisms may be done. If required further studies to determine the condition of the gastrointestinal tract may be done like abdominal X-rays or scanning, colonoscopy and barium enema.
Treatment of Enterocolitis
Enterocolitis is treated based on the presenting symptoms. Regular oral food intake needs to be stopped and intravenous fluids are given to maintain electrolyte balance. Antibiotics and antidiarrheal medicines are given depending on the causative organism of enterocolitis.
Medicines that help release of gases are given to reduce abdominal bloating. A tube may be placed in the stomach to remove fluid or air in the bowel. Breathing support is considered, as appropriate. These are required more in case of necrotizing enterocolitis in babies. Treatment and improvement is monitored with necessary scanning and blood tests.
In severe cases of enterocolitis, which has resulted in perforation or inflammation in intestine, surgical procedures may be required. Surgery is aimed at removing the dead tissue in the intestine and correcting the damage caused to the intestine. Immediate medical care in severe cases of enterocolitis can help preserve the digestive function. Timely aggressive and appropriate treatment can help protect lives and improve the outcome.
Complications of Enterocolitis
Premature infants, sick babies and young kids are at an increased risk of enterocolitis and its complications. In case of severe infection in enterocolitis, frequent diarrhea and vomiting can cause excess water loss and can increase the risk of dehydration. If the symptoms remain for long and a chronic infection persists, it can cause more damage to the digestive system and pose a serious health problem. Severe infection increases the risk of intestinal perforation, sepsis, inflammation of the intestine and intestinal strictures, which can create medical emergency.
Diet for Enterocolitis
In case of elders, a healthy balanced meal can help to protect the gut. Regular intake of probiotics like yogurt, buttermilk is required to improve digestion. Some researchers also suggest that regular consumption of healthy fats, fish oils, walnuts, olive oil, etc. can help to keep the gut healthy. It may be useful to avoid spicy, oily or fried foods and stimulants, alcohol caffeine and meat, depending on individual condition.