Cryptitis is a term used in histopathology to describe inflammation of the intestinal crypts. The crypts are glands found in the lining of the intestines. They are sometimes called the crypts of Lieberkühn.
Histopathology is the microscopic study of diseased tissues. Histopathology is one of many important tools doctors use to help diagnose certain diseases.
When tissue from the intestines is examined under a microscope, the presence of cryptitis can be helpful in diagnosing diseases such as:
When viewed under a microscope, someone with cryptitis will have white blood cells, known as neutrophils, between their intestinal cells. The tissue may also appear red, swollen, and thick.
The degree of cryptitis can also be useful for doctors to understand how far certain conditions, like ulcerative colitis, have progressed. This information may be used when determining the best treatment option.
Cryptitis vs. colitis
Cryptitis and colitis are both terms used to describe inflammation in the intestines, but the terms are used in different contexts.
Cryptitis refers specifically to the presence of inflammation in the crypts of the small or large intestine when viewed under a microscope. Cryptitis isn’t a disease or a diagnosis. Rather, it’s a manifestation or sign that you may have another disease.
Colitis is a more general term. Colitis refers to conditions that are characterized by swelling (inflammation) anywhere in the large intestine (colon). The presence of cryptitis in the large intestine can be considered a sign of colitis.
What symptoms are associated with cryptitis?
If you have cryptitis, you will likely be experiencing other signs or symptoms caused by an underlying bowel disease, such as ulcerative colitis or infectious colitis.
Symptoms associated with cryptitis can include:
- abdominal pain
- bloody stools
- loss of appetite
- an urgent need to have a bowel movement
What causes cryptitis?
Cryptitis is a result of an inflammatory process in the intestines. Infections with parasites or food-poisoning bacteria can result in inflammation in the intestines. You can also develop cryptitis if your large intestine has been treated with radiation.
In diverticular disease, pouches known as diverticula form when weak spots in the intestinal wall balloon outward. The pouches then become inflamed. Bacteria gather in them and cause an infection, which can lead to cryptitis.
Ulcerative colitis and Crohn’s disease are thought to be caused when the immune system undergoes an abnormal response to bacteria and cells in the intestine. The immune system may incorrectly attack the cells in the intestines, leading to inflammation.
Treatment options for cryptitis
Treatment for cryptitis depends on the underlying cause.
For diverticulitis, treatment includes a low-fiber diet, a liquid diet, and in some cases, antibiotics.
Crohn’s disease and ulcerative colitis
People with ulcerative colitis or Crohn’s disease may need to make changes to their diets or take medications to reduce inflammation and swelling. Examples of medications used to treat these conditions include sulfasalazine (Azulfidine) and mesalamine (Asacol and Lialda).
In more severe cases, you may need to take drugs known as corticosteroids to reduce the inflammation. Newer agents known as biologics can also help to block the inflammation in a different way.
Some people may need surgery to remove part of their small intestine, colon, or rectum.
Treatment typically involves replacing lost fluids or rehydrating with electrolyte solutions. Symptoms typically go away on their own in a few days.
Some treatments for colitis caused by radiation include:
- antidiarrheal medicine
- prescription pain medications
- dietary changes, including avoiding lactose and high fat foods
If you have radiation colitis, your doctor may need to make changes to your radiation therapy.
Mild cases of ischemic colitis (IC) are often treated with antibiotics, pain medications, fluids, and a liquid diet. If the ischemic colitis comes on suddenly (acute IC), treatment may include:
- thrombolytics, which are medications that help dissolve blot clots
- vasodilators, which are drugs that can widen your mesenteric arteries
- surgery to remove the blockage in your arteries
Conditions associated with cryptitis
Cryptitis can help your doctor diagnose a disease or infection of the bowel. If a histopathological analysis shows that you have cryptitis, it’s likely that you have one of the following conditions:
- Ulcerative colitis. This inflammatory bowel disease causes inflammation and ulcers within the inner lining of the large intestine (colon) or rectum.
- Crohn’s disease. This chronic inflammatory bowel disease causes severe inflammation and ulcerations of all parts of the digestive tract.
- Diverticulitis. This inflammation of the diverticula (pouches that occur along the digestive tract) is thought to be caused by fecal matter blocking the opening of the diverticula.
- Infectious colitis. This inflammation in the colon is caused by food-poisoning bacteria or parasites.
- Ischemic colitis. This inflammation of the colon develops when there isn’t enough blood flow to the colon. It’s usually caused by a buildup of plaque inside the arteries (atherosclerosis).
- Radiation colitis. This inflammation of the colon occurs as a side effect of cancer radiation treatments to the abdomen or pelvis.
A doctor will use the presence of cryptitis, along with the results of other diagnostic tests and your specific symptoms, to help figure out which particular condition you have.
What is the outlook?
The outlook for cryptitis depends on the underlying condition. Some causes of cryptitis, like infectious colitis, will clear up on their own in a few days.
If not treated, cryptitis caused by chronic conditions, like ulcerative colitis, can extend into the surrounding tissues and lead to the formation of an abscess or fistula.
People with Crohn’s disease or ulcerative colitis will need to follow an individualized treatment plan for the rest of their lives. In some cases, the only cure for the condition that caused cryptitis is removal of the entire colon and rectum.