Differential Diagnosis for Colitis or Jejunitis

Given the question of whether a condition would cause colitis or jejunitis, we must consider various potential diagnoses. The following differential diagnosis is organized into categories to help prioritize and consider the potential causes.

• Single Most Likely Diagnosis

  • Inflammatory Bowel Disease (IBD): This includes conditions like Crohn's disease and ulcerative colitis, which are known for causing inflammation in the gastrointestinal tract. Crohn's disease, in particular, can affect any part of the GI tract, from the mouth to the anus, but it most commonly affects the terminal ileum and the beginning of the colon. Ulcerative colitis, on the other hand, typically affects the colon. The presentation of chronic diarrhea, abdominal pain, weight loss, and sometimes blood in the stool makes IBD a likely consideration for colitis.

• Other Likely Diagnoses

  • Infectious Colitis: Caused by bacteria (e.g., Salmonella, Shigella, Campylobacter), viruses (e.g., Norovirus), or parasites (e.g., Giardia), infectious colitis can present with acute onset of diarrhea, which may be bloody, abdominal cramps, and fever.
  • Irritable Bowel Syndrome (IBS): While IBS does not cause inflammation, it can present with chronic abdominal pain, bloating, and alteration of bowel habits, which might be confused with inflammatory conditions like colitis or jejunitis in the absence of diagnostic testing.
  • Food Allergies or Intolerances: Conditions like celiac disease (an autoimmune reaction to gluten) can cause jejunitis, leading to malabsorption and symptoms similar to those of colitis, including diarrhea and abdominal pain.

• Do Not Miss Diagnoses

  • Ischemic Colitis: Reduced blood flow to the colon can cause ischemic colitis, which presents with sudden onset of abdominal pain and bloody diarrhea. This condition requires prompt diagnosis and treatment to prevent complications.
  • Clostridioides difficile (C. diff) Infection: A bacterial infection that can cause colitis, especially in individuals who have recently used antibiotics. It's crucial to diagnose and treat C. diff infection promptly due to its potential for severe complications.
  • Neutropenic Colitis (Typhlitis): Typically occurring in immunocompromised patients, this condition involves inflammation of the cecum and can be life-threatening if not recognized and treated early.

• Rare Diagnoses

  • Eosinophilic Gastroenteritis: A rare condition characterized by the presence of eosinophils in the gastrointestinal tract, leading to inflammation and symptoms that can mimic colitis or jejunitis.
  • Behçet's Disease: A form of vasculitis that can affect various parts of the body, including the gastrointestinal tract, causing symptoms similar to those of colitis or jejunitis.
  • Chronic Granulomatous Disease: A genetic disorder that affects the immune system, making it harder for the body to fight off certain infections, which can lead to gastrointestinal complications, including colitis.