Is Erythematous Mucosa Hurting Your Gut Health?

Erythematous mucosa signals inflammation within your gastrointestinal (GI) tract, commonly due to conditions like gastritis and colitis. Understanding the causes and symptoms can help in seeking effective treatment and relief.

Why Does the Gut Become Inflamed?

Erythematous mucosa, which is a reddening and inflammation of the mucosa of the gastrointestinal tract, can be seen in conditions like gastritis, Crohn’s disease, and ulcerative colitis. Each of these conditions presents with unique symptoms that may suggest inflammation or damage to the GI tract.

Stomach

Gastritis, an inflammation of the stomach lining, can be caused by several factors, such as:

Colon

The exact cause of colon inflammation, or colitis, is often unknown. However, possible causes include:

• Infections related to a parasite or virus
• Bacteria that cause food poisoning 
• Impaired blood flow, called ischemic colitis 
• Radiation in the colon (causing radiation colitis) 
• A condition in newborns called necrotizing enterocolitis, which leads to tissue death in the colon (can impact premature or sick babies, and the exact cause is unknown) 
• Clostridioides difficile,(C. diff) a bacterium that causes colitis 

Rectum

Proctitis, or inflammation of the rectum, can be caused by:

• Inflammatory bowel diseases, such as Crohn’s disease and ulcerative colitis 
• Autoimmune diseases 
• Sexually transmitted infections (STIs), including gonorrhea, herpes, and chlamydia
• Bacterial infections
• Certain medications, like those used for radiotherapy in the prostate or pelvis

How Does Each Condition Affect the GI Tract?

The symptoms associated with erythematous mucosa vary depending on the underlying condition.

Stomach

Many people with gastritis show no symptoms. If symptoms appear, they might include:

• Loss of appetite
• Nausea and vomiting 
• Pain in the upper part of the abdomen 
• Bleeding that can cause black stools 
• Bleeding that can cause vomiting blood or coffee ground-like substance

Colon

Crohn’s disease and ulcerative colitis share several symptoms. 

Key symptoms of Crohn’s disease include:

• Abdominal cramps and pain 
• Fever
• Fatigue 
• Loss of appetite and weight
• Feelings of needing to pass stool
• Watery diarrhea that may have blood 

Other symptoms of Crohn’s disease include:

• Joint pain and swelling
• Ulcers in the mouth
• Red bumps or nodules under the skin that may develop into ulcers 
• Constipation 
• Sores or swelling in the eyes
• Draining of pus, mucus, or stool from the rectum or anus due to a fistula (an abnormal connection between organs and/or skin)
• Rectal bleeding and blood in the stool
• Swelling of the gums 

Similarly, ulcerative colitis may also present as:

• Abdominal cramps and pain 
• Fever 
• Weight loss
• Feelings of needing to pass stool 
• Diarrhea 
• Blood and sometimes pus in the stool

Additional common symptoms of ulcerative colitis include:

• Sounds of gurgling or splashing in the intestines 
• Slow growth in children

Other less common symptoms include:

• Joint pain and swelling
• Sores or ulcers in the mouth 
• Red bumps or nodules under the skin that may develop into ulcers 
• Nausea and vomiting

Rectum

Since inflammation in the colon due to Crohn’s disease or ulcerative colitis can be the cause of proctitis, there is an overlap in symptoms. These include:

What Are the Best Treatment Strategies?

Treatment will vary based on whether the erythematous mucosa is in the stomach, colon, or rectum. The underlying cause of the inflammation will also influence treatment. 

Stomach

Treatment for gastritis includes:

• Stopping medications that may worsen the condition, like the NSAIDs aspirin, ibuprofen, and naproxen 
• Taking over-the-counter (OTC) drugs that decrease stomach acid, such as antacids (Tums), H2 antagonists (Pepcid), and proton pump inhibitors (Prilosec)
• Antibiotics if the cause of gastritis is the bacteria H. pylori 
• Managing diet to avoid triggering foods

Colon

Treatment for inflammatory bowel diseases aims to control symptoms, prevent flare-ups, and support colon healing. 

Managing Crohn’s disease can involve diet, stress management, supplements, medication, or surgery:

To manage Crohn’s disease, dietary recommendations include:

• Eating small, frequent meals 
• Drinking enough water
• Avoiding high-fiber foods
• Avoiding fatty, greasy, fried food and sauces with butter, margarine, or heavy cream 
• Limiting dairy
• Avoiding foods that can cause gas, like those in the cabbage family 
• Avoiding spicy foods

Managing stress is important, as stress can worsen digestive issues.

Supplements may be needed if there are deficiencies. Common shortages from poor absorption in the intestines include iron, calcium, and vitamin B12.

Medication may help treat the symptoms, including:

Surgery may remove a damaged portion or the entire colon. An ileostomy may remove waste when the colon or rectum is removed or isn’t working properly. 

Dietary recommendations are the same for Crohn’s disease and ulcerative colitis. Individuals with ulcerative colitis should also make an effort to manage their stress. 

The entire colon and rectum may be removed in cases where:

• Medication doesn’t improve symptoms
• Changes to the lining of the colon increase the risk of cancer
• The colon ruptures
• Severe bleeding
• Toxic megacolon (a severely inflamed colon causes insufficient blood flow)

Rectum

Rectum inflammation typically resolves once the cause is addressed. If it’s due to an infection, antibiotics are used. Corticosteroids, mesalamine suppositories, or enemas can relieve symptoms.

Understanding Long-term Symptoms and Risks

Stomach

The prognosis for inflammation of the stomach is often good, but it depends on the underlying cause of gastritis. Blood loss is a possible complication of gastritis.

Colon

Crohn’s disease is incurable and alternates between periods of improvement and flare-ups. A higher risk of cancer in the small bowel or colon is a complication of this condition.

About half of the people with ulcerative colitis have mild symptoms. Severe symptoms associated with ulcerative colitis tend to be less responsive to medication. The risk of developing cancers increases with each decade after diagnosis.

Complications include the thickening of the intestinal walls, causing severe flare-ups. This thickening can cause:

• Colon narrowing or blockage 
• Severe bleeding
• Severe infection
• Toxic megacolon
• Perforation of the colon (tears or holes)
• Anemia

Ulcerative colitis can also present problems with nutrient absorption, which can contribute to the following:

• Osteoporosis 
• Issues with maintaining a healthy weight 
• Slow growth and development in children 
• Anemia

Rectum

Proctitis tends to have a good outcome with treatment. Possible complications include:

• Anal fistula
• Anemia
• Recto-vaginal fistula in women
• Severe bleeding

Cancer Risk

Cancer risk increases with the state of inflammation in the various areas of the digestive tract. Below are potential risks to be aware of.

• Inflammation in the stomach increases the risk of gastric cancer.
• Individuals with Crohn’s disease may be at higher risk of small bowel or colon cancer. Screening for colon cancer, including a colonoscopy, may be recommended for those with Crohn’s disease for more than eight years.
• The risk for cancer increases each decade after being diagnosed with ulcerative colitis.

A healthcare provider can help monitor your inflammation and recommend screening for cancer if needed.