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Cytomegalovirus Gastroenteritis/Colitis

Last updated May 4, 2018

Approved by: Krish Tangella MD, MBA, FCAP

Cytomegalovirus Gastroenteritis is an inflammation of the stomach (gastric region) or large intestine (colon), caused by the cytomegalovirus (CMV), when blood vessels lying on the surface are infected.

What are the other Names for this Condition? (Also known as/Synonyms)

  • CMV Gastroenteritis/Colitis
  • Cytomegalovirus Gastroenteritis
  • Gastrointestinal CMV Disease

What is Cytomegalovirus Gastroenteritis/Colitis? (Definition/Background Information)

  • Cytomegalovirus Gastroenteritis is an inflammation of the stomach (gastric region) or large intestine (colon), caused by the cytomegalovirus (CMV), when blood vessels lying on the surface are infected
  • CMV Colitis is an inflammation of the colon caused by the pathogen cytomegalovirus
  • The CMV Gastroenteritis/Colitis can spread by sexual contact; through blood transfusions; urine, nose, and mouth secretions; but, it can only mildly infect healthy persons having normal resistance
  • This infection mostly affects those, in whom the immune system is compromised; like AIDS, HIV-infected persons, or those who have undergone an organ transplantation
  • The disease results in stomach, intestine ulcers causing abdominal pain, difficulty in eating and swallowing food. Severe ulcers can also lead to gastrointestinal bleeding
  • Early diagnosis of the condition, treatment with medications and surgery (occasionally), and the overall health status of the individual, are factors that influence a favorable outcome

Who gets Cytomegalovirus Gastroenteritis/Colitis? (Age and Sex Distribution)

  • All individuals (regardless of age or gender), whose immune systems are weakened by immunodeficiency infections, or other debilitating conditions, or had had recent organ transplants, are easily prone to contract Cytomegalovirus Gastroenteritis/Colitis
  • Healthy individuals are rarely affected by CMV Gastroenteritis/Colitis, but those at an advanced age (over 70 years), or with an impoverished health status, are more prone to be infected

What are the Risk Factors of Cytomegalovirus Gastroenteritis/Colitis? (Predisposing Factors)

Following are the risk factors for Cytomegalovirus Gastroenteritis/Colitis:

  • Individuals who have undergone any organ, or bone marrow transplantations (since they are on immuno-suppressant drugs)
  • Individuals undergoing treatment for (or suffering from) acute viral infections, such as HIV and AIDS; due to reduced blood lymphocyte count
  • Those undergoing blood transfusions, kidney dialysis, for a prolonged period
  • Those suffering from cancer, undergoing chemotherapy for cancer
  • Individuals on steroid therapy (either low or high dosage), for a variety of health issues
  • Those with inflammatory bowel disease
  • Alcohol dependence, malnourishment, are other potential risk factors

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Cytomegalovirus Gastroenteritis/Colitis? (Etiology)

  • Cytomegalovirus Gastroenteritis/Colitis disease is an indication of a frail immune system (which is caused by other medical conditions or viral infections). This imposes additional barriers to recovery, worsening the already feeble physical condition
  •  The CMV virus occurs latently in most of the humans (in about 60-80% of them), but remain inactive, since a healthy host immunity is strong and resilient
  • In those who have a highly susceptible or immuno-compromised system, the virus is activated and affects many regions like, the large intestine, small intestine, and the stomach. CMV Gastroenteritis/Colitis is a contagious disease, spreading by physical contact and air, affecting those who have weak immune systems

What are the Signs and Symptoms of Cytomegalovirus Gastroenteritis/Colitis?

Cytomegalovirus Gastroenteritis/Colitis infection is usually present along with many other conditions that affect other parts of the body system. Hence, these have to be considered while isolating signs and symptoms specific to the infection. The signs and symptoms include:

  • Ulcerous sores on the surface of the stomach and other gastrointestinal regions, making it painful and difficult to swallow
  • Nausea, vomiting
  • Loss of appetite, weight loss, general malaise
  • Constipation, or watery/bloody diarrhea
  • Abdominal pain, tenderness
  • Blood in stools
  • Fever
  • Under severe infection – ischemia, perforation of the bowel might occur

How is Cytomegalovirus Gastroenteritis/Colitis Diagnosed?

The immuno-compromised susceptibility of an individual, with stomach/intestine ulcers, accompanied by biopsy of tissue samples can clearly help establish Cytomegalovirus Gastroenteritis/Colitis infection. Nevertheless, since other medical complications and diseases are present, a differential diagnosis is considered. Diagnostic tests that are performed include:

  • Physical exam and medical history evaluation
  • Colonoscopy or sigmoidoscopy; to visualize the region and obtain specimens for biopsy
  • CMV antigenemia test; to diagnose any CMV infection
  • Culture of blood, stool samples
  • EGD (Esophagogastroduodenoscopy) test; to examine the esophageal tract by using an endoscope
  • Barium enema (called lower GI exam); special x-ray of the rectum, colon area
  • Upper GI and small bowel series: These are x-rays of the colon, stomach, and esophagus, taken as a set

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Cytomegalovirus Gastroenteritis/Colitis?

Complications due to Cytomegalovirus Gastroenteritis/Colitis include:

  • Narrowing of the intestines; stricture formation
  • CMV infection at other locations; like CMV Esophagitis
  • Perforated colon, stomach (occasionally)
  • Recurrence of the infection
  • Side effects from the medications used to treat CMV Gastroenteritis/Colitis

How is Cytomegalovirus Gastroenteritis/Colitis Treated?

Quick, early diagnosis and appropriate treatment is the key to speedy recovery from Cytomegalovirus Gastroenteritis/Colitis. Surgical procedures maybe required in severe cases (rare), otherwise proper medications with nutritional supplementation are adequate

  • Intravenously or orally administered antiviral medications are effective in treating patients with weak immune systems caused by conditions other than HIV and AIDS
  • Those affected by immunodeficiency viruses have shown improvement with antiretroviral therapy drugs that are normally prescribed for HIV and AIDS infections
  • Surgical intervention in the form of colectomy (removal of a part of the colon) may be necessary, under severe CMV Colitis causing life-threatening situation
  • Sometimes pain relievers and drugs are used to prevent diarrhea

How can Cytomegalovirus Gastroenteritis/Colitis be Prevented?

CMV Gastroenteritis/Colitis is an opportunistic infection. Hence, averting immunodeficiency infections, providing suitable treatment and medical care after an organ transplant, or when a body immune system is weakened by other illnesses, can be helpful in preventing a CMV infection.

Educating the immunity-compromised patients and creating an awareness of such possible conditions, would enable them to be better prepared and seek timely medical treatment.

What is the Prognosis of Cytomegalovirus Gastroenteritis/Colitis? (Outcomes/Resolutions)

  • CMV Gastroenteritis/Colitis can be effectively treated; other outlying medical conditions of the patient, being favorable
  • If the health condition of the patient is poor or if there are other complications; the prognosis is adversely effected
  • Mortality is not normally attributed to the CMV infection, because conditions causing the damaged immune system may have a greater role
  • A healthy immune system recovers faster, with little or no treatment

Additional and Relevant Useful Information for Cytomegalovirus Gastroenteritis/Colitis:

The microorganism cytomegalovirus (CMV) causes a host of other diseases in those who are rendered vulnerable, due to weak immune systems.

What are some Useful Resources for Additional Information?

References and Information Sources used for the Article:

Helpful Peer-Reviewed Medical Articles:

Reviewed and Approved by a member of the DoveMed Editorial Board
First uploaded: Aug. 15, 2013
Last updated: May 4, 2018