What is Left Side Colitis & How is it Treated? | Causes, Symptoms, and Management of Left Side Colitis

Ulcerative colitis is a condition in which the colon gets inflamed. Also known as distal ulcerative colitis, left sided colitis is a type of ulcerative colitis in which only the left side of the colon is inflamed. It is a chronic condition and a person experiences symptoms throughout life after being diagnosed with it.

The distal colon extends from the rectum up to the colon and stops at the splenic flexure, a point where the colon bends. Its inflammation leads to small ulcers in the lining of the colon which lead to mucous and pus and other symptoms.

There are numerous risk factors that are known to play a role in causing left side colitis. These include:

• Genetics
• Microbiome
• Atypical immune response
• Environmental factors

The symptoms of left side colitis are similar to those of other types of ulcerative colitis.

People with left side colitis may have constipation. They may complain of frequent desire for stool. This sensation is known as tenesmus and occurs as a result of irritation and inflammation of the rectum. When the stool is passed it is very small in quantity.

Other symptoms of left side colitis include:

• Rectal spasm
• Fever
• Weight loss
• Dehydration due to diarrhea
• Constipation
• Abdominal and rectal pain
• Blood in stool

Blood in the stool may signal significant damage to the colon. This condition demands medical attention.

Diagnosing left side colitis correctly is the most important step to moving ahead in the treatment.

Endoscopy is performed by the doctors, in which a camera is used to create pictures of the inside of the colon. This helps the doctor to look for signs of inflammation inside the colon. These signs include redness, water retention, and irregularities.

Once the camera goes beyond the splenic flexure the signs of left side colitis disappear.

The treatment of left side colitis depends on the severity of symptoms and how the person is responding to medication.

Medications are the first line of treatment for ulcerative colitis. Medications are recommended depending on which part of colon is affected.⁽¹⁾

The severity is evaluated by the doctor before deciding on the medication. The medication given for left side ulcerative colitis includes the following:

• 5-Aminosalicylic Acid: It helps in reducing inflammation and is an effective therapy for people with left side ulcerative colitis.⁽²⁾ It is researched to be more effective than oral therapy in the treatment of left side colitis.⁽³⁾
• Corticosteroids: Some people do not respond to 5-Aminosalicylic acid. Corticosteroids are prescribed to manage inflammation.
• Immunosuppressants: These medications target proteins in the immune system that cause inflammation.
• Biologics: These medications target the immune system protein called tumor necrosis factor (TNF) and help in reducing inflammation.
• JAK inhibitors: These are fast-acting medications that block the inflammation pathways in the body. These are approved by the Food and Drug Association to treat moderate to severe ulcerative colitis.

Severe cases may require hospitalization. Intravenous medications and steroids are given to give relief from the symptoms and reduce them.

In rare cases where severe damage is involved, inflammation, or bleeding in the affected area, removing the part of the colon may be recommended by the doctor.

There are a few complications of left side colitis including toxic megacolon and anemia.

Toxic megacolon is a common complication of the inflammatory colon. In it, the colon dilates due to the build-up of inflammation. The symptoms of toxic megacolon include:

• Abdominal pain
• Fever
• Malnutrition
• Dehydration

Toxic megacolon increases the risk of rupture of the colon.

Anemia is another complication of left side colitis. It is due to the loss of blood from the inflamed intestine. In such cases, iron supplements are given.

Left side colitis can be managed with dietary and lifestyle changes. Eating a varied diet is recommended by the doctors. It consists of a diet high in fiber and low in refined carbohydrates.

Placebo is also recommended for those with ulcerative colitis.

Acupuncture is recommended to manage symptoms. However, there is not much research to prove its effectiveness.

There are also a few natural supplements and dietary choices that people with ulcerative colitis can use. It includes:

• Turmeric
• Folate and iron-rich foods
• Omega-3 fatty acids

Any kind of diet or home remedy if being adopted should be discussed with the doctor beforehand.