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Ask the Medical Expert Archives 2000-2004

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June 2001

Q. After years of believing myself to have irritable bowel syndrome, I was recently (post-colonoscopy) diagnosed with colitis -- that being the base of information, I have not had a normal formed bowel movement since March, mostly it is frequent, watery stool, relatively urgent I might add -- can a diagnosis of colitis be all the explanation one needs for this set of symptoms? The gastroenterologist recommends a powerful course of prednisone but it is such a serious medication with such serious side effects, I really don't want to go that route -- are there other methods out there?

A. Since there are several different types of colitis, and I don't know which you have, I am not able to talk about your treatment options. Instead, I will talk in general about irritable bowel syndrome and colitis.

Irritable bowel syndrome is a chronic condition that causes constipation, gas, or diarrhea. Colitis will also cause bloating and diarrhea, oftentimes with blood or mucous, and it can cause the urgency that you describe. The way to diagnose colitis is through a sigmoidoscopy or a colonoscopy (a patient with irritable bowel syndrome will have a normal colonoscopy). Since your doctor found abnormalities on the colonoscopy, it seems likely that you have a colitis and not irritable bowel syndrome. A very common and a very powerful treatment for colitis is prednisone. At times the prednisone is given orally, at others it is given as a suppository or an enema, depending on where the colitis is located. You are right in saying that prednisone is a ³serious medication with serious side effects.² However, this is only with long term use. It may be that a short course of prednisone is all that you will need to obtain significant relief, and this short course will have little or no side effects.

One good Web site belongs to the Crohn's and Colitis Foundation of America:


PLEASE NOTE: I am not saying that you have either Crohn's disease or ulcerative colitis (remember, all I know is that you have "a colitis"). Still, this Web page provides a lot of useful information that may help you no matter what type of colitis you ultimately end up having.

Another site < http://www.crohnspharmacist.com/ > is a proprietary site aimed at selling products. However, it does have a host of useful information about a couple of different types of colitis. Again, this site may help once you learn which type of colitis you have.

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