The condition can develop through several different mechanisms depending on the underlying cause, including:

• Infections– bacterial, viral or parasitic infections can inflame the lining of the colon and trigger diarrhoea, pain and fever 
• Immune system dysregulation– in inflammatory bowel diseases (IBDs), such as ulcerative colitis, the immune system mistakenly attacks the colon lining, leading to chronic inflammation
• Microscopic immune reactions – in microscopic colitis, inflammation cannot usually be seen during colonoscopy and is only detected through biopsy analysis under a microscope, often in association with immune-related activity or certain medications.
• Reduced blood supply to the colon– decreased circulation to parts of the intestine may cause ischaemic colitis, particularly in older adults or individuals with vascular disease
• Medication-related irritation– certain medications, including some antibiotics or anti-inflammatory drugs, may irritate the bowel lining in susceptible individuals
• Radiation therapy– prior pelvic or abdominal radiation can injure the colon lining and lead to delayed inflammation

What are the symptoms of colitis?

Symptoms vary depending on the severity and cause of inflammation, but generally include:

Colitis can affect people of different ages, although certain medical, lifestyle and environmental factors may increase the likelihood of developing bowel inflammation.

When should colitis symptoms be assessed?

Not all bowel symptoms indicate serious disease. 

Many digestive conditions can produce similar symptoms, including:

• Irritable bowel syndrome (IBS)
• Food intolerance
• Haemorrhoids
• Colon infections
• Colorectal polyps
• Colorectal cancer

Because of this overlap, ongoing diarrhoea or rectal bleeding should not be assumed to be solely due to “sensitive stomach” or dietary irritation.

The assessment may involve:

• Clinical evaluation and symptom review– helps identify symptom patterns, severity and possible triggers associated with bowel inflammation
• Blood investigations– used to assess for infection, anaemia, inflammation or dehydration
• Stool testing– helps detect bacterial, viral or parasitic infections affecting the intestines
• Colonoscopy– allows direct examination of the colon lining to identify inflammation, ulcers, bleeding or abnormal tissue changes
• Biopsy sampling– small tissue samples may be analysed to confirm the specific type of colitis and exclude other conditions
• Computed Tomography (CT) imaging– sometimes used to evaluate bowel swelling, complications or severe inflammation extending beyond the colon lining

How is colitis treated?

Treatment is tailored according to the underlying cause, severity of inflammation and whether symptoms are acute or long-term.

Depending on the diagnosis, treatment may involve:

Medication-based treatment

• Anti-inflammatory medication– helps reduce inflammation within the colon lining and control flare-ups in inflammatory bowel disease
• Antibiotics– used when a bacterial infection is responsible for the bowel inflammation
• Immune-modulating medication– helps regulate abnormal immune activity contributing to chronic inflammatory bowel disease
• Symptom-control medication– may help reduce diarrhoea, abdominal cramping or bowel urgency

Dietary and supportive management

• Temporary dietary modification– helps reduce bowel irritation during active flare-ups
• Hydration management– important for patients experiencing prolonged diarrhoea or fluid loss
• Nutritional monitoring– helps address weight loss, reduced appetite or nutritional deficiencies associated with chronic bowel inflammation

Surgical treatment

In selected patients with severe or complicated disease, surgery may occasionally become necessary to remove severely inflamed bowel segments, control bleeding or treat complications such as perforation or obstruction.

Colitis vs IBS: why many patients confuse both

In the Philippines, chronic bowel symptoms are sometimes broadly labelled as irritable bowel syndrome (IBS), sensitive stomach or stress-related digestive problems.

However, colitis differs from IBS because actual inflammation is present within the bowel.

Living with chronic colitis

For patients with recurrent or long-term colitis, symptoms may affect much more than digestion alone.

Some individuals experience:

• Anxiety about bowel urgency
• Fear of travelling or eating outside
• Sleep disruption due to nighttime symptoms
• Fatigue from chronic inflammation
• Work and social disruption
• Nutritional concerns from prolonged bowel symptoms

Coming to Singapore for colitis evaluation

For many patients from the Philippines, colitis symptoms often begin as repeated episodes of diarrhoea, abdominal pain, or “stomach flu” that seem to improve with medication but keep returning. Over time, some patients go through multiple treatments or emergency visits without a clear diagnosis, which can be both physically and mentally exhausting.

The main challenge is often uncertainty, whether the symptoms are due to infection, food-related irritation or a chronic inflammatory condition that needs longer-term management.

In this context, some patients seek evaluation in Singapore for a more coordinated and complete assessment rather than treating each episode separately. This allows symptoms to be reviewed as a whole, with clearer differentiation between infection, inflammatory bowel disease and functional bowel conditions.

For overseas patients, this typically means:

• Consolidated specialist assessment and investigations within a shorter timeframe
• Access to colonoscopy, biopsy and imaging when needed
• Clearer diagnosis rather than repeated short-term treatments
• A more structured long-term management plan

Planning your visit from the Philippines

For patients travelling from the Philippines, the process of arranging care at Alpine Surgical can begin before you leave home.

Online consultation

An initial teleconsultation with Dr Aaron Poh can be arranged prior to your trip. This allows your symptoms, medical history and any existing investigation results to be reviewed in advance, so that the most appropriate assessments can be planned ahead of your arrival. Coming in with a clearer picture of what is needed helps make your time in Singapore more focused and efficient.

To prepare for your teleconsultation, it may be helpful to have the following ready:

• A summary of your symptoms and how long they have been present
• Any previous investigation results, including stool tests, blood tests or imaging
• A list of medications you are currently taking
• Any questions you would like to discuss with Dr Aaron

Coordination and travel support

The team at Alpine Surgical Practice is available to assist with the practical aspects of planning your visit. This includes guidance on scheduling investigations and follow-up appointments within your intended stay, as well as answering questions about what to expect during your visit.

Patients are encouraged to reach out to the clinic in advance so that arrangements can be made to accommodate your travel dates as smoothly as possible.

Your care experience at Alpine Surgical Practice

Colitis can sometimes resemble many other digestive conditions during the early stages, which is why careful evaluation becomes important before long-term treatment decisions are made.

At Alpine Surgical Practice, attention is placed not only on controlling symptoms, but also on understanding what is driving the inflammation in the first place.

For overseas patients, this more structured approach may help provide greater clarity regarding whether symptoms are temporary, infection-related or part of a longer-term inflammatory bowel condition requiring ongoing care.

If you have persistent diarrhoea, rectal bleeding or recurring bowel symptoms, arranging an early specialist consultation may help clarify whether inflammation, infection or another digestive condition is contributing to your symptoms.