Did you know that women, particularly during menopause, experience twice as many digestive problems as men? (Menopause Now, 2019). Here we delve into one of them: colitis. We explain its symptoms and causes, how the diagnosis and treatment are done and how it relates to menopause. In addition, we give you some tips to prevent it or relieve your symptoms.

What is colitis?

Colitis is a gastrointestinal disease that involves inflammation of the inner lining of the colon and, by extension, of the entire large intestine. It should be clarified that it is not the same as diarrhea and that there are many types. The two most common are ulcerative colitis and crohn's disease. These are different types of inflammatory bowel disease (Martínez, 2020; Ramos, 2021; Top Doctors, 2021). Ulcers and erosions appear in the mucosa in both of them. In addition, in these damaged areas inflammatory foci occur and extend to other parts of the sigmoid colon (the final part of the large intestine), becoming the cause of sigmoiditis or diverticulitis (Medical Format, 2017).

Causes of colitis

Some of the most common are (MedlinePlus, 2021):

• Infections caused by a virus or parasite.
• Food poisoning due to bacteria.
• Lack of blood flow (colitis ischemic).
• Previous radiation to the large intestine (enteritis and colitis by radiation).
• Colitis pseudomembranose caused by an infection with Clostridium difficile (a bacterium that lives normally in the large intestine but can grow too much on antibiotics).

Menopause is other cause of colitis. Digestive problems at this stage are often caused by alterations in the interaction of cortisol with the estrogen. Cortisol (called a "stress hormone") is produced in situations that cause anxiety and inhibit your digestion, but is usually countered by estrogen. When the levels of this decrease, during your perimenopause or menopause, cortisol has a greater effect on your digestive system. That is, it decreases the ability of your intestines to function properly (Menopause Now, 2019).

Symptoms of colitis during menopause

Symptoms of colitis may be (Mayo Clinic, 2021):

• Diarrhea, often with blood or pus.
• Abdominal pain and cramping.
• Pain in the rectum.
• Rectal bleeding (presence of a small amount of blood in the stool).
• Imperative need to defecate.
• Inability to defecate despite the urgency.
• Weight loss.
• Fatigue.
• Fever.

Diagnosis

It should always be diagnosed by a doctor. To identify the type of colitis physical exams, personal history tests, blood tests, stool tests may be done, barium enema x-rays, computed tomography, colonoscopy, biopsy, among others (Top Doctors, 2021).

Treatment

It is aimed at the cause of the disease. So, for each type of colitis there will be a different treatment. In addition, this will always depend on its severity and the type of person who has it. It usually involves improving your diet and sometimes taking nutritional supplements or medications. If yours is due to menopause, the hormone replacement therapy it can help relieve symptoms. A study from the University of Chicago concluded that women who receive hormone replacement therapy are 80% less likely to have inflammatory bowel disease (La Enfermedad de Crohn, 2021). You may also be prescribed several medications to help control your symptoms. These may include anti-inflammatory medications (to treat swelling and pain), antibiotics (to treat infections), analgesics (for pain), antispasmodics, and supplements for nutritional deficiencies (Lee, 2021). The mild form of this disease responds well to these medications. More severe symptoms may require some stronger, suppressing the immune system to prevent inflammation. Only in severe cases surgery is required (Top Doctors, 2021).

Healthy habits that help treat or prevent colitis

Some simple strategies can help you a lot in perimenopause and during menopause (Menopause Now, 2019). For example, don't smoke, and control your stress level. Also do yoga, meditate, chew well and not eat fast. Once symptoms appear, you should also keep a food diary to identify the triggers of your discomfort. You can even apply clay poultices in the belly area, to help reduce inflammation of the intestines (Martínez, 2020; Millar, 2021). Now let's take a closer look at some of these healthy habits:

Get enough sleep

A good quality of sleep is essential to activate your parasympathetic nervous system, which regulates rest and digestion. Sleeping seven to eight hours a day helps eliminate heartburn. And some research shows that sleeping on the left side helps improve your digestion during menopause. This is because the stomach and intestines are slightly inclined to the left and lying on that side allows food to pass through these organs more easily (BBC News, 2018; Menopause Now, 2019).

Exercise

Play sports, start an exercise routine, or walk regularly at a good pace. The WHO (2020) recommends that adults engage in moderate physical activity for at least 150 to 300 minutes a week. Physical activity can help your body move gas through the digestive system more quickly, which relieves bloating (Menopause Now, 2019).

Eat well

Eat a balanced diet. We recommend eating foods rich in vitamin D (such as eggs, salmon or sardines). More than half of the people diagnosed with ulcerative colitis are deficient in this vitamin. (Infosalus, 2013; Martínez, 2020). Magnesium is also essential because it treats digestive problems associated with intestinal transit. To acquire this mineral, try consuming cocoa, seeds (pumpkin, flax or sunflower), white beans and peas (Martínez, 2020). Another key aspect is eating plenty of fiber. Whole grains (rice, wheat, and quinoa) and foods such as oats, whole-grain bread, and pasta act as a cleansing kit for the digestive system. And this helps relieve symptoms of colitis during menopause, such as bloating and constipation (Menopause Now, 2019). On the other hand, there are drinks you should avoid, such as sodas (because they are difficult to digest, causing gas, pain and diarrhea) and coffee (because caffeine increases inflammation of the colon and difficulty disposing of food) (Debate, 2017). It is also good to reduce the consumption of raw vegetables, legumes, red or processed meat, seasonings and fried products with a lot of fat. All these foods can aggravate your digestion problems during menopause, especially if you already have heartburn. Fried foods are very difficult to digest and increase inflammation, diarrhea, and pain (García, n.d.; Martínez, 2020; Menopause Now, 2019; Top Doctors, 2021).

Hydration

Drink plenty of fluids. When you increase your fiber intake in your diet, it's important to increase your water intake as well. If not, the first few days you may notice greater constipation due to lack of fluid. In addition, drinking two liters of water a day (between meals and in small sips) helps neutralize acidity in menopause. Also have soups, broths, infusions and juices. Fluids help break down food during digestion, preventing constipation (Martínez, 2020; Menopause Now, 2019).

Warning signs

In any case, it's important to let your doctor know that you think you have this condition and avoid self-medication. You should also search medical care urgent if:

• You experience severe abdominal pain, bloody diarrhea or a great weight loss (Millar, 2021).
• The intensity of the symptoms does not decrease and, over time, other discomfort arises. Constant vomiting, swollen and hard abdomen and black stools are also warning signs (Ramos, 2021).

As you can see, there are many nuances that you need to take into account to understand the origin of the condition and apply the right treatment. But there are simple things you can do to try to prevent it or improve its symptoms, while doing the treatment your doctor recommends. Menopause is a particularly sensitive period to this disease, so we advise you to pay attention to your body and take care of your diet, your rest and your physical condition. In this way, you can live this stage of your life with good intestinal health. Bibliographic references BBC News. (2018). Left or right? Why it's important which way you sleep and which one benefits your health the most. https://www.bbc.com/mundo/noticias-45098540 Debate. (2017). No soft drinks, fried sy coffee Goodbye colitis! https://www.debate.com.mx/salud/Sin-refrescos-frituras-y-cafe-Adios-colitis--20170522-0103.html Garcia, I. (n. f.) Menopause and digestive problems. Menopause Institute. https://www.institutodelamenopausia.com/divulgacion/sintomas/menopausia-y-problemas-digestivos Infosalus. (2013). Calcium and vitamin D, essential in menopause. https://www.infosalus.com/actualidad/noticia-calcio-vitamina-esenciales-menopausia-20130701134340.html Crohn's disease. (2021). Menopause and Crohn's disease. https://laenfermedaddecrohn.com/menopausia-y-enfermedad-de-crohn/ Lee, B. (2021). Everything you need to know about colitis. Healthline. https://www.healthline.com/health/colitis#types-and-causes Martinez Blasco, E. (2020). 10 natural remedies for colitis Better with Health. https://mejorconsalud.as.com/10-remedios-naturales-para-la-colitis/ Mayo Clinic. (2021). Ulcerative colitis. https://www.mayoclinic.org/es-es/diseases-conditions/ulcerative-colitis/symptoms-causes/syc-20353326 Medical Format. (2017). Sigmoiditis: causes, symptoms, diagnosis and treatment http://es.medicalformat.com/644-sigmoiditis-causas-sintomas-diagnostico-y-tratamiento.html MedlinePlus. (2021). Colitis. https://medlineplus.gov/spanish/ency/article/001125.htm Menopause Now. (2019). 6 tips to relieve digestive problems in menopause. https://www.menopausenow.com/es/problemas-digestivos/articulos/6-consejos-para-aliviar-problemas-digestivos-en-la-menopausia#:~:text=Colitis.%20Los%20problemas%20digestivos%20en%20la%20menopausia%20a,digesti%C3%B3n%2C%20pero%20generalmente%20es%20contrarrestada%20por%20el%20estr%C3%B3geno. Millar, H. (2021). What is colitis? Medical News Today. https://www.medicalnewstoday.com/articles/es/que-es-la-colitis World Health Organization . (2020). Physical activity. https://www.who.int/es/news-room/fact-sheets/detail/physical-activity Redwood, N. (2021). Acute colitis: types, causes and treatment Better with Health. https://mejorconsalud.as.com/colitis-tipos-causas-tratamiento/ Top Doctors. (2021). Colitis. https://www.topdoctors.es/diccionario-medico/colitis#