enterocolitis

Enterocolitis is a medical condition characterized by inflammation of the small intestine (enteritis) and the colon (colitis). It commonly presents with diarrhea, abdominal pain, and fever, and can be accompanied by vomiting, dehydration, and weight loss. The inflammation may be focal or diffuse and may be acute or chronic depending on the underlying cause.

Causes include infectious etiologies (bacterial, viral, parasitic), inflammatory bowel disease with colitis, ischemic enterocolitis, antibiotic-associated enterocolitis (notably Clostridioides difficile), radiation-induced enterocolitis, and, in neonates, necrotizing enterocolitis.

In adults, evaluation begins with history and physical exam, basic labs (CBC, electrolytes, CRP), and stool studies to identify pathogens. Imaging such as abdominal radiography, ultrasound, or CT may assess complications. In neonates suspected NEC, abdominal x-ray may show pneumatosis intestinalis and portal venous gas.

Management is cause-specific but generally includes fluid and electrolyte resuscitation, nutritional support, and infection control. Empiric broad-spectrum antibiotics are used when bacterial enterocolitis is suspected; targeted therapy follows culture or PCR results. For antibiotic-associated C. difficile infection, treatment includes oral vancomycin or fidaxomicin. NEC requires bowel rest (NPO), broad-spectrum IV antibiotics, and surgical evaluation for perforation or advanced disease.

Prognosis ranges from self-limited infection to life-threatening illness. NEC carries significant mortality, particularly among very preterm infants. Prevention focuses on proper hand hygiene, infection control, judicious antibiotic use, and, where applicable, maternal and neonatal care practices.