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What is Distal Colitis?

By Jacob Queen
Updated: Mar 03, 2024

Distal colitis is also known as left-sided colitis. The term is used to describe a particular variety of ulcerative colitis, which is an inflammatory disease of the colon. In the distal version of the disease, only the left half of the colon is inflamed. Often, the inflammation may extend all the way down to the rectum and all the way up to the descending colon. Distal colitis can significantly increase a person’s risk of colon cancer, especially if the symptoms are especially severe.

Each variety of ulcerative colitis has its own particular symptoms. Distal colitis tends to cause painful cramps, pain on the left side of the body, diarrhea with blood in it, and weight loss. Some other symptoms that all ulcerative colitis sufferers may experience include rectal bleeding, fever, arthritis, and anemia. Some patients also lose their appetite and may occasionally feel nauseous.

The cause of colitis is still uncertain, but some researchers think it’s caused by a person’s own immune system. These researchers think there might be some kind of bacterial infection in the colon that causes the immune system to overreact and attack the colon itself, leading to inflammation. Some people also think it may be symptomatic of a dysfunctional immune system that is reacting to a threat that doesn’t actually exist. Heredity does seem to also play a role, but the extent of that role is unclear.

Other than heredity, there are a few other risk factors for distal colitis and other forms of ulcerative colitis. In terms of age, people in their 30s seem to be at a slightly greater risk. White people and especially Jewish people are at a higher risk, and people who use a lot of non-steroidal anti-inflammatory drugs (NSAIDs) have a greater chance of developing the disorder.

The symptoms of distal colitis can be somewhat similar to several other disorders, including Crohn’s disease, colon cancer, and irritable bowel syndrome. Doctors will normally have to do a few tests to rule out these other possibilities before treating a person. Some of these tests might include a blood test, colonoscopy, and a barium enema.

When treating distal colitis, doctors usually start by trying to reduce the inflammation directly. Several prescription anti-inflammatory drugs may be tried. Some of these have very severe side effects, so it often takes a while to find a good medication for each patient. If these medications aren’t effective, doctors may try other things like immune system-suppressors. In some severe cases, doctors may have to resort to surgery.

The Health Board is dedicated to providing accurate and trustworthy information. We carefully select reputable sources and employ a rigorous fact-checking process to maintain the highest standards. To learn more about our commitment to accuracy, read our editorial process.
Discussion Comments
By anon990740 — On May 07, 2015

I've gone from moderate-to-severe ulcerative colitis to mild distal colitis. I got U-C in 2009 and it was M-to-S until April when I had the colonoscopy.

Now, as we know, colitis affects everyone differently, and everyone's diet is different. The ultimate surprise for me is that when I have a flare-up, the thing that sits best in me is a McDonald's double-cheese burger. Why? - I have no idea!

Two other things I eat/drink. When I have a sandwich for lunch, I have a side of Kimchi. Kimchi is a Korean sauerkraut. It is pretty, shall we say, aromatic. Since eating it, the large intestine seems to be pretty happy. I just learned that the Koreans have been using it for thousands of years for digestive system problems. Since eating it, shall we say, when I'm done using the bathroom, the air is much nicer than it used to be.

The other thing I do is drink a little hot sake in the evening. That helps make me sleepy and "adjusts" my Type-A personality from "Stress-man" to "Mellow-man".

I'm not pushing my diet on others (boy - I hate when people do that!) but just letting you know what works for me.

At this time I can eat pretty much anything, if I do it in moderation. Too much fiber will cause some problems.

By anon353235 — On Oct 29, 2013

@turquoise: I too have left sided severe colitis. A biopsy confirms if you have UC or Crohn's disease. Basically, Crohn's disease affects the whole wall of the colon, whereas colitis only affects the inner lining of the colon.

By anon334624 — On May 14, 2013

I've never had any pain. I feel light-headed throughout the day at different points. I sometimes go dizzy and I'm always tired. Quality of life for me is low.

By turquoise — On Jun 26, 2012

I was recently diagnosed with distal colitis too and I'm confused by my diagnosis.

I initially went in due to recurrent diarrhea and loss of appetite. First my doctor thought I had IBS, followed by Crohn's disease. But after my biopsy results came back, he said I have distal colitis.

What I don't understand is how doctors are able to differentiate between these when they are so similar. After all, aren't they all basically inflammation of the bowels? How can he be sure that I really have colitis and not IBS or Crohn's? I'm so confused.

By burcinc — On Jun 25, 2012

@anamur-- I experienced distal ulcerative colitis temporarily once, so I can't really answer your question.

I know it sounds weird that I had it temporarily, but apparently it happens to quite a few people. Mine was due to NSAIDs (non-steroidal anti-inflammatory drugs). My colitis resolved itself after I stopped taking NSAIDs. But I agree with you that it's a bad condition and the symptoms can be debilitating. I still remember how much pain I experienced on the left side of my abdomen.

It's great that you respond well to steroids and don't have to look for other treatments though. My aunt, who has chronic ulcerative colitis, is on immunosuppressants and those are not fun. She rarely leaves her house nowadays because she's so afraid of getting sick.

By serenesurface — On Jun 25, 2012

I have distal colitis and aside from a flare up every six months or so that involves stomach cramps, diarrhea and nausea, I don't have any other issues. I was diagnosed with it several years ago and have not been using anything other than steroid medications (mainly corticosteroid) during flare-ups.

Just curious, do other people who have distal colitis been experiencing the same?

When I have an ulcerative colitis flare-up, I feel really sick and I just want to go to the ER and stay there. Other times, when I'm not having a flare-up, I feel fine and normal.

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