What is Fulminant Colitis?

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  • Written By: D. Jeffress
  • Edited By: Jenn Walker
  • Last Modified Date: 07 November 2019
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Fulminant colitis is a potentially life-threatening variety of large intestine inflammation. It can develop from any type of acute or chronic inflammatory bowel problem, though 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 drugs and blood transfusions. Surgery to remove the colon is needed if other treatments fail to relieve inflammation within a few hours.

There are several different forms of colitis. Acute colon inflammation 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 possibility that irritation can suddenly engulf the entire large intestine and rectum.

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


It is essential to visit the emergency room if symptoms arise. A doctor can provide intravenous fluids to combat dehydration and corticosteroid injections to temporarily reduce inflammation. A series of x-rays and other diagnostic imaging scans are taken to determine the extent of colon damage and 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, preparations are usually made for emergency surgery.

A total colectomy involves removing the entire colon from a person with non-responsive fulminant colitis. In most cases, a colectomy is performed through a long incision along the lower abdomen. The large intestine is removed and a small hole called a stoma is made in the abdomen. The bottom part of the stomach is connected to a tube to drain waste out of the stoma and 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 are able to recover.


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Post 3

@turkay1-- You're absolutely right about early diagnosis. My uncle died of shock due to fulminant colitis symptoms. He waited too long to go to the hospital.

Post 2

@ysmina-- It's not like doctors are dying to remove someone's colon when there is fulminant colitis. They do so because they have no choice, without a colectomy the patient might die.

Of course, the first line of treatment is medications, not surgery. But if the medications aren't working, then what can doctors do? The longer fulminant colitis continues, the higher the chance of complications leading to death. So surgery is mostly unavoidable.

The best treatment for fulminant colitis is prevention and early colitis diagnosis. People with inflammatory bowel disease have to keep their conditions under control and go to the hospital at the first signs of fulminant colitis.

Post 1

Isn't there a treatment for fulminant colitis that doesn't involve removing the entire colon permanently? Can't a colostomy bag be placed temporarily without removing the colon so that the colon has time to heal?

My friend's mom had colon cancer and she was given a colostomy bag while she underwent treatment but her colon wasn't removed. Eventually the colostomy bag was taken out too. She's absolutely fine now. Can't something similar be done for fulminant colitis?

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