enterokolitis

Enterokolitis, or enterocolitis, is an inflammatory condition that involves both the small intestine (enteritis) and the colon (colitis). It presents with diarrhea, abdominal pain, and sometimes fever, nausea, vomiting, and dehydration. The clinical course depends on the underlying cause and the extent of intestinal involvement.

Common causes include infectious etiologies such as bacterial, viral, or parasitic infections; inflammatory bowel diseases; antibiotic-associated enterocolitis, notably Clostridioides difficile infection; ischemic injury due to reduced blood flow; radiation exposure; and chemical or toxin-induced injury from certain medications or toxins.

Diagnosis relies on history and physical examination, stool studies to identify pathogens, laboratory tests including complete blood count and inflammatory markers, imaging such as ultrasound or CT if complications are suspected, and endoscopy with biopsy in selected cases.

Treatment focuses on addressing the underlying cause and maintaining hydration and electrolyte balance. Mild infectious enterocolitis may be managed with oral rehydration and supportive care, while bacterial infections may require targeted antibiotics. In Clostridioides difficile infection, oral vancomycin or fidaxomicin is preferred, with metronidazole used only in specific circumstances. Severe disease or complications such as perforation, toxic megacolon, or bowel ischemia often require hospitalization and potentially surgical intervention.

Prognosis varies with cause and patient factors; many cases resolve with appropriate treatment, but severe disease can lead to dehydration, organ dysfunction, or surgical emergencies.

Prevention includes good hand hygiene, infection control, and prudent antibiotic use to reduce the risk of antibiotic-associated enterocolitis.