What are the signs and symptoms of amebic colitis?

Updated: Jul 19, 2019
  • Author: Vinod K Dhawan, MD, FACP, FRCPC, FIDSA; Chief Editor: Michael Stuart Bronze, MD  more...
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Answer

Amebic colitis is gradual in onset, with symptoms presenting over 1-2 weeks; this pattern distinguishes this condition from bacterial dysentery. Diarrhea is the most common symptom. Patients with amebic colitis typically present with cramping abdominal pain, watery or bloody diarrhea, and weight loss or anorexia. Fever is noted in 10-30% of patients. Intestinal amebiasis may mimic acute appendicitis. [44] Rectal bleeding without diarrhea can occur, especially in children.

Fulminant amebic colitis is a rare complication of amebic dysentery (< 0.5% of cases). It presents with the rapid onset of severe bloody diarrhea, severe abdominal pain, and evidence of peritonitis and fever. Predisposing factors for fulminant colitis include poor nutrition, pregnancy, corticosteroid use, and very young age (< 2 years). Intestinal perforation is common. Patients may develop toxic megacolon, which is typically associated with the use of corticosteroids. Mortality from fulminant amebic colitis may exceed 40%.

Chronic amebic colitis is clinically similar to inflammatory bowel disease (IBD). Recurrent episodes of bloody diarrhea and vague abdominal discomfort develop in 90% of patients with chronic amebic colitis who have antibodies to E histolytica. Amebic colitis should be ruled out before treatment of suspected IBD because corticosteroid therapy worsens amebiasis.


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