The term "colitis" comprises several types of inflammatory intestinal disorders, as distinguished from Irritable Bowel Syndrome (IBS), a "functional" disorder of motility in which inflammation is not apparent. The main types of colitis are ulcerative colitis (UC) and Crohn's Disease (CD), which have different characteristic appearances and radiological and blood testing presentations. They are collectively referred to as Infammatory Bowel Disease (IBD).
While CD and UC have not generally been thought of as infectious diseases, one form of colitis, pseudomembranous colitis, is know to be caused by a bacterium, clostridium difficile.
More researchers are coming to believe that imbalances in intestinal flora may be at the root of IBD. Immune cells in the walls of the intestinal tract are engaged in continual "cross talk" with the trillions of bacteria that inhabit our gut. When beneficial bacteria are suppressed and harmful bacteria proliferate, the intestinal defense system may go into over-drive, resulting in an over exuberant immune response. This triggers autoimmunity and consequent inflammation.
This disordered state of intestinal microbes sis sometimes referred to as "dysbiosis". Evidence that dysbiosis might be a contributing factor in IBD comes from several sources:
- Frequent administration of antibiotics can exacerbate symptoms
- Use of powerful acid-blocking medications increase risk for IBD
- Breastfeeding may be protective against IBD
- Probiotics appear to help with the symptoms of IBD
Whether because of over-dependency on pharmaceutical drugs, refined foods or other factors, IBD incidence is on the rise, affecting as many as 1.4 million Americans. Some also point to the "hygiene hypothesis," or the idea that our quest for sanitary conditions has increased the likelihood that our idle immune systems may inappropriately target our own tissues.
While there is evidence that administration of wide variety of oral supplements and nutrients may be justified in IBD, caution must be exercised. A gradual introduction is the best method, with supplements added only as tolerated.