Colitis

Colitis is an inflammatory condition affecting the large intestine and colon of rabbits, causing significant digestive disturbance and discomfort. The term colitis simply means inflammation of the colon, but in rabbits this condition has important implications because of their unique digestive physiology. Unlike dogs and cats where colitis may cause relatively limited symptoms, inflammation in a rabbit's large intestine can disrupt the critical cecal fermentation process and lead to cascading health problems. Colitis can occur as a primary condition or secondary to other diseases, infections, or dietary problems, making it a relatively common concern in rabbit medicine.

The rabbit's digestive system relies on a delicate balance of beneficial bacteria in the cecum and large intestine to ferment fiber and produce essential nutrients. When inflammation disrupts this environment, the normal bacterial balance is disturbed, and the rabbit's ability to properly digest food and absorb nutrients becomes compromised. The inflammatory process causes the intestinal lining to become swollen, irritated, and sometimes ulcerated, leading to pain, altered motility, and abnormal fecal production. Because cecal fermentation is essential for rabbit nutrition and health, colitis has implications beyond simple digestive upset.

Colitis in rabbits can range from mild, self-limiting episodes to severe, life-threatening illness depending on the underlying cause, the extent of inflammation, and how quickly appropriate treatment is provided. Acute colitis may develop suddenly following dietary indiscretion, stress, or infection, while chronic colitis may cause ongoing or recurrent symptoms over weeks to months. Any form of colitis can trigger secondary GI stasis, a potentially fatal slowing of the digestive system that must be monitored for and addressed promptly. The interconnected nature of rabbit digestive health means that colitis rarely exists in isolation.

With appropriate veterinary care and management, many rabbits recover well from colitis, though some cases require extended treatment and dietary modification. Early recognition and treatment significantly improve outcomes, but since rabbits instinctively hide signs of illness, symptoms may be subtle or advanced by the time they are noticed. Working with a rabbit-savvy veterinarian who understands rabbit digestive physiology is essential, as treatment approaches differ significantly from those used in cats and dogs. Prevention through proper diet, stress management, and good husbandry is far preferable to treating established colitis.

Colitis in rabbits can result from numerous primary causes, with infectious agents being among the most common. Bacterial infections including pathogenic E. coli, Clostridium species, and Salmonella can cause acute inflammatory responses in the colon. Parasitic infections, particularly coccidiosis affecting the intestinal tract, trigger inflammation as part of the immune response to these organisms. Certain viral infections may also cause colitis as part of their disease process. In many cases, the infectious agent disrupts the normal bacterial flora, leading to secondary overgrowth of harmful bacteria that perpetuates and worsens the inflammation.

While colitis itself is not hereditary, genetic factors may influence a rabbit's susceptibility to developing the condition. Some rabbits may have inherently more sensitive digestive systems or less robust immune function that makes them prone to intestinal inflammation. The composition of gut flora, which is established early in life and influenced by the doe's flora and early diet, varies between individuals and may affect disease susceptibility. Rabbits with other hereditary conditions such as dental malocclusion may experience chronic stress and dietary challenges that predispose to digestive problems including colitis. No specific breed inheritance patterns have been established for colitis susceptibility.

Environmental and dietary factors play major roles in the development of colitis. Inappropriate diet is perhaps the most significant modifiable risk factor, with insufficient fiber intake being the primary concern. Rabbits require unlimited grass hay comprising at least eighty percent of their diet to maintain healthy gut function. Diets too high in simple carbohydrates from excessive pellets, grains, or sugary treats alter the cecal pH and bacterial balance, creating conditions favorable for inflammation and pathogenic bacterial overgrowth. Sudden dietary changes, even seemingly positive ones like introducing new vegetables, can trigger colitis if the gut flora cannot adapt quickly enough. Contaminated food or water and ingestion of toxic plants can also cause acute colitis.

Stress is a powerful predisposing factor for colitis due to its effects on immune function and gut motility. Common stressors include environmental changes, transportation, introduction of new animals, loud noises, temperature extremes, overcrowding, pain from other conditions, and improper handling. Rabbits are highly sensitive to stress as prey animals, and chronic or acute stress can trigger or exacerbate colitis. Antibiotic treatment is a significant cause of colitis in rabbits, as many antibiotics that are safe for other species disrupt rabbit gut flora and cause severe, sometimes fatal, intestinal inflammation. Oral penicillins, amoxicillin, ampicillin, lincomycin, clindamycin, and erythromycin are particularly dangerous.

The mechanism of colitis development involves inflammatory cells infiltrating the intestinal wall in response to infection, irritation, or immune dysfunction. This inflammatory infiltrate causes swelling that disrupts the normal architecture and function of the intestinal lining. The mucous membrane may produce excess mucus as a protective response, which alters fecal consistency. Blood vessel permeability increases, potentially leading to fluid accumulation and bleeding. The inflammation disrupts normal intestinal motility, which can cause both diarrhea from rapid transit and stasis from hypomotility. Damage to the intestinal barrier may allow bacteria to translocate into the bloodstream, potentially causing sepsis. The disruption of cecal flora from inflammation can create a self-perpetuating cycle where altered fermentation produces compounds that further irritate and inflame the bowel.

Early warning signs of colitis in rabbits are often subtle and require attentive observation to detect. Owners may first notice slight changes in fecal pellet appearance, with pellets becoming smaller, irregularly shaped, or connected by strands of hair or mucus. Appetite may decrease slightly, with the rabbit being less enthusiastic about pellets while perhaps still eating hay. Behavior changes include reduced activity, spending more time in a corner of the enclosure, or being less interactive during usual play times. The rabbit may assume a slightly hunched posture or show reluctance to move around normally. Since rabbits hide illness instinctively, these early signs deserve serious attention and should prompt closer monitoring.

The most common symptoms of colitis relate to altered fecal production and consistency. Soft, pasty, or malformed fecal pellets are typical, sometimes progressing to frank diarrhea in severe cases. Mucoid feces, characterized by jelly-like mucus coating or connecting fecal pellets, is a hallmark sign of colitis. The rabbit may produce excessive cecotropes or cecotropes that are abnormal in appearance, or conversely may have difficulty producing normal cecotropes. Straining to defecate is common, and some rabbits may produce only small amounts of mucus with no formed stool. Fecal staining around the perineum and tail base is common as abnormal stool consistency leads to soiling.

Behavioral changes become more pronounced as colitis progresses. Affected rabbits typically show decreased appetite, which may start with refusing pellets and progress to reduced hay intake. Complete anorexia is a serious sign requiring immediate attention, as rabbits cannot safely go without eating for extended periods. Lethargy and depression are common, with the rabbit spending excessive time lying down and showing little interest in surroundings. Pain indicators include teeth grinding (bruxism), which has a different sound from the contented tooth purring of a happy rabbit, and a hunched posture with the abdomen pressed to the ground. Some rabbits become irritable or aggressive when handled due to abdominal discomfort, while others may seek comfort and be unusually clingy.

Physical examination may reveal several concerning signs. Abdominal palpation often reveals gas distension, particularly in the cecum, or may find doughy, abnormal-feeling intestinal contents. Dehydration develops as fluid is lost in loose stools or as reduced water intake accompanies decreased appetite. Signs of dehydration include decreased skin elasticity, dry mucous membranes, and sunken eyes. Weight loss may occur rapidly, especially if the condition persists for several days. Body temperature may be normal, elevated if infection is present, or decreased in severely compromised rabbits. The coat may become dull and unkempt as the rabbit stops grooming normally.

Symptom progression in colitis varies depending on the underlying cause and treatment response. Acute colitis may develop rapidly over hours to days, with quick progression from normal stools to obvious diarrhea. Chronic colitis may wax and wane over weeks to months, with periods of relative normalcy interrupted by flares. Without treatment, acute colitis often worsens and may trigger secondary GI stasis as pain and malaise cause the rabbit to stop eating. The transition from soft stools to no fecal production whatsoever indicates GI stasis has developed and represents a serious deterioration. Progressive dehydration, weakness, and loss of body condition occur as the condition persists untreated.

Emergency symptoms that require immediate veterinary attention include complete loss of appetite lasting more than twelve hours, no fecal production for more than twelve hours, bloody diarrhea or blood in the stool, severe lethargy or collapse, a bloated or tympanic abdomen, and signs of severe pain such as loud teeth grinding or reluctance to move at all. Open-mouth breathing is a dire emergency indicating respiratory distress that may accompany severe systemic illness. A cold rabbit or one unable to maintain normal body temperature needs emergency warming and veterinary care. Any rabbit with diarrhea should be seen by a veterinarian, but the symptoms listed above indicate the situation has become critical and time is essential.

Initial veterinary examination for suspected colitis begins with a comprehensive history and physical assessment. The veterinarian will ask detailed questions about diet, recent changes, stressors, antibiotic exposure, housing conditions, and the timeline of symptom development. Finding a rabbit-savvy veterinarian is crucial, as the diagnostic approach and interpretation differs significantly from that used for cats and dogs. Physical examination includes assessment of body condition, hydration status, and thorough abdominal palpation to evaluate intestinal contents, gas accumulation, and areas of pain or discomfort. The perineum is examined for fecal soiling and any skin irritation secondary to diarrhea.

Diagnostic testing helps identify the underlying cause and assess the severity of illness. Fecal examination is fundamental, including flotation for parasites, direct smear for protozoa, and evaluation for abnormal bacteria. Fecal culture may identify pathogenic bacteria, with sensitivity testing guiding antibiotic selection if bacterial treatment is indicated. Blood work including complete blood count and biochemistry panel assesses overall health, identifies infection or inflammation, and evaluates hydration and organ function. Rabbit blood values differ from dog and cat reference ranges, so the laboratory and veterinarian must be familiar with rabbit-specific normal values. Radiographs of the abdomen help evaluate gas patterns, identify potential obstructions, and assess overall intestinal appearance.

Differential diagnosis for colitis includes other conditions that cause similar symptoms. GI stasis can present with similar signs and often co-occurs with colitis, requiring treatment of both conditions. Coccidiosis and other parasitic infections must be ruled out or treated if present. Mucoid enteropathy, particularly in young rabbits, presents with mucus production similar to colitis. Intestinal bacterial infections such as colibacillosis or clostridiosis cause acute diarrhea and require specific treatment. Dietary-induced diarrhea from inappropriate food intake may resolve with diet correction alone. Systemic diseases affecting other organs can sometimes present with gastrointestinal symptoms. The veterinarian may recommend additional testing to differentiate these conditions and identify concurrent problems.

Diagnosis confirmation relies on correlating clinical signs, history, and diagnostic test results. There is no single definitive test for colitis, so diagnosis is typically made based on the constellation of findings. The presence of soft stools or diarrhea with mucus in a rabbit with appropriate history strongly suggests colitis. Identification of an underlying cause such as coccidia, pathogenic bacteria, or clear dietary indiscretion supports the diagnosis and guides specific treatment. Response to appropriate therapy provides additional confirmation. In cases where initial treatment fails or chronic colitis is suspected, more advanced diagnostics such as endoscopy with intestinal biopsy may be considered, though these are rarely necessary and carry significant risk in debilitated rabbits.

Emergency treatment for severe colitis focuses on stabilization and preventing life-threatening complications. Fluid therapy is essential to correct dehydration and maintain hydration, administered subcutaneously for mild to moderate cases or intravenously for severely compromised rabbits. Pain management is a priority, as pain from intestinal inflammation contributes to anorexia and stress that worsen the condition. Meloxicam is the most commonly used rabbit-safe pain medication, while opioids may be added for severe pain. If the rabbit is not eating, syringe feeding with critical care formula must begin immediately to maintain gut motility and prevent hepatic lipidosis. Gut motility medications such as metoclopramide or cisapride may be used if there is no evidence of obstruction to help maintain intestinal movement.

Medical management depends on the underlying cause of colitis. If bacterial infection is identified or suspected, appropriate rabbit-safe antibiotics are prescribed. Safe options include enrofloxacin, trimethoprim-sulfamethoxazole, metronidazole for anaerobic bacteria, and chloramphenicol. Critically, oral amoxicillin, ampicillin, clindamycin, lincomycin, erythromycin, and most penicillin-based antibiotics must never be used in rabbits as they cause fatal disruption of gut flora. If coccidiosis is diagnosed, treatment with medications such as ponazuril or sulfadimethoxine is initiated. Anti-inflammatory medications may help reduce intestinal inflammation, though corticosteroids are generally avoided in rabbits due to their profound immunosuppressive effects. Probiotics may help restore beneficial bacterial populations.

Surgical intervention is rarely required for uncomplicated colitis but may become necessary if complications develop. Intestinal obstruction, severe bloat unresponsive to medical management, or perforation would require surgical exploration. Surgery carries significant risk in debilitated rabbits and requires an experienced exotic veterinarian. Rabbits should not be fasted before anesthesia, unlike dogs and cats, because their digestive system must remain active. Post-surgical care is intensive and prognosis is guarded for rabbits requiring surgery for colitis complications. Most rabbits with colitis are managed medically without surgical intervention.

Supportive care is fundamental to colitis treatment and recovery. Nutritional support through syringe feeding ensures the rabbit continues to receive adequate calories and fiber even when appetite is reduced. Critical care formula or pureed pellets mixed with water can be fed via syringe, with the amount and frequency based on the rabbit's size and needs. Unlimited grass hay should always be available, as fiber is essential for gut health. Subcutaneous fluids may be given at home to maintain hydration if the veterinarian provides instruction. Keeping the rabbit warm, comfortable, and in a quiet environment supports healing. Gentle abdominal massage may help relieve gas and stimulate gut motility.

Alternative and complementary approaches may support conventional treatment. Gentle exercise, even if just encouraging the rabbit to move around a safe enclosed space, promotes gut motility. Some owners offer diluted chamomile tea or water infusions of digestive herbs, though these should not replace medical treatment. Massage and warmth can help relieve gas discomfort. Fresh herbs such as cilantro, parsley, or dill may encourage eating in rabbits with reduced appetite. Acupuncture is offered by some veterinary practices for gastrointestinal support, though evidence for its efficacy in rabbits is limited. Any complementary treatments should be discussed with the veterinarian to ensure they do not interfere with medical care.

Treatment decisions consider multiple factors including the severity of illness, identified underlying cause, response to initial treatment, and practical considerations. Some cases of mild colitis respond quickly to dietary management and supportive care without intensive medical intervention. Severe cases or those with identified bacterial infections require comprehensive medical treatment and close monitoring. Financial considerations are relevant as exotic veterinary care can be expensive, and owners should discuss costs openly with their veterinarian to develop an appropriate treatment plan. Quality of life assessment is ongoing, with humane euthanasia considered if the rabbit is suffering and not responding to treatment.

Recovery timeline from colitis varies considerably based on the underlying cause and severity. Mild dietary-induced colitis may resolve within a few days once the offending food is removed and supportive care provided. Infectious colitis typically requires one to two weeks of treatment before full resolution, with improvement often seen within the first few days. Chronic colitis may require ongoing management with periodic flares rather than complete cure. Young rabbits may recover more quickly than seniors, and rabbits that were otherwise healthy before developing colitis generally have better outcomes than those with concurrent conditions.

Post-treatment care focuses on dietary management and gradual return to normal function. Once the acute episode resolves, the diet should be kept simple, emphasizing unlimited grass hay as the foundation. Pellets should be limited to appropriate amounts and greens reintroduced gradually, one type at a time. Consistent dietary management prevents recurrence in many cases. Any prescribed medications should be completed as directed even if the rabbit appears fully recovered. Follow-up veterinary appointments allow assessment of recovery and early detection of complications or recurrence. Fecal output should be monitored daily, with any return of abnormal stools prompting immediate attention.

Prognosis depends on multiple factors. The underlying cause significantly influences outcomes, with dietary-induced colitis having good prognosis and infectious or chronic colitis being more variable. Rabbits treated early in the disease course generally recover better than those presented after prolonged illness. Development of secondary GI stasis worsens prognosis but is often manageable with aggressive treatment. Rabbits that maintain some appetite throughout the illness fare better than those requiring extensive syringe feeding. Age and overall health status influence recovery capacity, with young, otherwise healthy rabbits typically recovering most readily.

Long-term outlook for rabbits recovering from colitis is generally favorable with appropriate ongoing management. Some rabbits experience no further problems after a single episode, particularly if the trigger was identifiable and correctable. Others may have increased digestive sensitivity and require careful long-term dietary management to prevent recurrence. Chronic or recurrent colitis may require periodic treatment and close monitoring but is often manageable. Quality of life can be maintained even for rabbits with ongoing digestive sensitivity through appropriate diet, stress management, and prompt attention to any concerning signs. Most rabbits that survive the acute episode and initial recovery period go on to live comfortably with attentive care.

Primary prevention of colitis centers on maintaining the dietary and husbandry practices that support healthy gut function. Diet is the single most important preventive factor, with unlimited grass hay forming the foundation of a healthy rabbit diet. Hay should comprise at least eighty percent of dietary intake, providing the fiber essential for normal gut motility and cecal fermentation. Timothy, orchard grass, meadow hay, and other grass hays are appropriate for adult rabbits, while alfalfa hay is suitable for rabbits under six months and nursing does. Pellets should be high quality, timothy-based, and limited to appropriate amounts based on the rabbit's size. Fresh greens should be introduced gradually and limited to appropriate portions.

Environmental prevention involves maintaining clean, appropriate housing and minimizing stress. Enclosures should be cleaned regularly with fecal material removed daily and complete sanitization performed weekly. Food and water containers should be positioned or designed to prevent fecal contamination and cleaned daily. Proper ventilation prevents ammonia buildup while avoiding drafts. Temperature should be maintained in a comfortable range, as both heat and cold stress can trigger digestive problems. The environment should be calm and secure, providing hiding spaces where the rabbit can retreat when stressed. Routine and predictability help reduce chronic stress.

Dietary prevention requires consistent feeding practices and avoidance of harmful foods. Sudden dietary changes are a common trigger for colitis and should be avoided by making any transitions gradually over one to two weeks. New foods should be introduced one at a time to identify any that cause problems. Foods to avoid entirely include high-sugar treats, grains, bread, crackers, cookies, chocolate, and processed human foods. Iceberg lettuce and other low-fiber watery vegetables can cause diarrhea. Some vegetables including beans, potatoes, onions, and rhubarb are toxic to rabbits. Fresh, clean water must always be available, with water containers cleaned daily.

Health maintenance supports the immune function and gut health that protect against colitis. Regular veterinary care with a rabbit-savvy veterinarian allows early detection and treatment of problems before they become serious. Dental health is indirectly important because dental pain reduces eating and disrupts normal digestion. Regular weight monitoring helps detect illness early. Appropriate exercise supports gut motility and overall health. Grooming, particularly for long-haired breeds, prevents excessive hair ingestion that can contribute to digestive problems. Vaccination where appropriate reduces overall disease burden.

Early intervention when problems are noticed can prevent mild issues from progressing to serious illness. Owners should learn their rabbit's normal behavior, appetite, and fecal output so they can recognize when something is wrong. Any change in fecal appearance or production warrants attention, with soft stools, mucus, or decreased output being concerning signs. Decreased appetite should prompt immediate evaluation of possible causes. Having critical care formula, syringes, and basic supplies on hand allows supportive care to begin promptly if needed. Establishing a relationship with a rabbit-savvy veterinarian before emergencies occur ensures access to appropriate care when needed.

Daily management for rabbits prone to or recovering from colitis requires consistent attention to diet and monitoring. Hay intake should be monitored to ensure the rabbit is eating adequate fiber, which is essential for maintaining healthy gut function. Pellet portions should be measured rather than free-fed to prevent overconsumption. Fresh greens should be provided in appropriate amounts, with any that cause digestive upset being eliminated. Water intake should be monitored, with decreased drinking prompting investigation. The litter box should be checked at least twice daily, noting the quantity, size, shape, and consistency of fecal pellets. Any abnormalities should be addressed promptly rather than waiting to see if they resolve.

The home environment should support digestive health and minimize stress. Housing should provide adequate space for exercise, which promotes gut motility. Flooring should be comfortable and easy to keep clean, with solid areas provided to rest feet. Temperature should be maintained between sixty and seventy degrees Fahrenheit, avoiding extremes that stress the digestive system. The location should be quiet and away from predator animals, loud noises, and high household traffic. Routines should be consistent, as rabbits find predictability reassuring. Any necessary changes should be made gradually when possible.

Maintaining quality of life for rabbits with digestive sensitivity involves balancing careful management with allowing normal behaviors. Daily exercise outside the enclosure promotes gut motility and provides mental stimulation. Enrichment through hay-based toys, tunnels, and foraging opportunities encourages hay consumption while keeping the rabbit mentally engaged. Social needs should be met through companionship, whether from bonded rabbit partners or regular human interaction. Signs of good quality of life include bright, alert behavior, normal appetite and fecal output, willingness to exercise and play, normal grooming behavior, and showing interest in surroundings and enrichment.

Ongoing monitoring allows early detection of recurrence or complications. Weight should be recorded weekly, with any unexplained loss prompting veterinary consultation. A health journal tracking food intake, fecal output, activity level, and any concerning signs provides valuable information over time. Regular veterinary checkups should occur every six to twelve months for healthy rabbits, with more frequent visits for those with chronic digestive issues. Any return of soft stools, mucus, decreased appetite, or lethargy should prompt immediate attention. Being attuned to subtle changes allows intervention before problems become serious.

Caregiver support is important for sustainable long-term management. Caring for a rabbit with health challenges requires time, attention, and financial resources. Connecting with other rabbit owners through organizations like the House Rabbit Society provides support, practical advice, and community. Online forums and social media groups dedicated to rabbit care can answer questions and provide encouragement. Understanding the costs of ongoing care helps with planning and reduces financial stress. Taking care of the caregiver's own wellbeing enables sustained excellent care for the rabbit. Accepting that some conditions require ongoing management rather than cure helps maintain realistic expectations and reduce frustration.

Colitis does not show strong breed predisposition, as susceptibility is primarily related to diet, stress, and environmental factors rather than genetics. All rabbit breeds can develop colitis given appropriate triggering circumstances. However, certain characteristics associated with some breeds may indirectly influence risk. Dwarf breeds and other small rabbits may show effects of dehydration more quickly due to their small body size and higher metabolic rate, making prompt treatment more critical. Long-haired breeds such as Angoras require meticulous grooming to prevent excessive hair ingestion, which can contribute to digestive problems. Lop breeds prone to dental issues may have increased baseline stress and dietary difficulties that predispose to digestive upset.

Age is a more significant risk factor than breed for colitis. Young rabbits, particularly those recently weaned, have less established gut flora and may be more susceptible to dietary disruptions and bacterial imbalances. Senior rabbits may have reduced digestive efficiency and immune function that increases susceptibility. Rabbits of any age that have experienced previous digestive problems may be more prone to recurrence. Show rabbits experience stress from transportation, handling, and exposure to unfamiliar animals that may increase risk. Rabbits in breeding programs may face additional stressors that affect digestive health.

Screening recommendations for colitis focus on husbandry evaluation rather than genetic testing. When acquiring a new rabbit, inquiring about diet and any history of digestive problems provides useful information. During the settling-in period, new rabbits should be monitored closely for signs of stress-related digestive upset. Rescue rabbits with unknown histories deserve particular attention as their dietary and health background may be unclear. Regular veterinary wellness examinations allow early detection of developing problems. For breeders experiencing recurrent digestive issues in their herds, consultation with a rabbit-savvy veterinarian can identify husbandry factors that may be contributing.

GI stasis is the most important co-occurring condition with colitis, representing both a potential cause and consequence. When a rabbit with colitis experiences pain and stops eating normally, gut motility slows and GI stasis can develop. Conversely, GI stasis from any cause can disrupt normal bacterial balance and lead to secondary colitis. Any rabbit with colitis should be monitored closely for signs of GI stasis, including decreased fecal output, abdominal distension, and complete anorexia. Treatment must address both conditions simultaneously. The interconnection between colitis and GI stasis illustrates the integrated nature of rabbit digestive health.

Several conditions cause symptoms similar to colitis and must be differentiated or may co-occur. Coccidiosis, a parasitic infection of the intestinal tract, causes diarrhea and weight loss that can resemble colitis and may occur simultaneously. Bacterial enteritis from pathogenic E. coli, Clostridium, or other organisms causes acute intestinal inflammation. Mucoid enteropathy, particularly in young rabbits, produces characteristic mucoid feces. Dietary-induced diarrhea from inappropriate food intake may resolve with diet correction. Systemic diseases affecting liver, kidneys, or other organs may present with gastrointestinal symptoms. Accurate diagnosis allows appropriate treatment.

Potential complications of colitis include dehydration from fluid loss in loose stools, which can progress to organ dysfunction if uncorrected. Hepatic lipidosis develops when rabbits stop eating and mobilize fat stores, overwhelming the liver. Secondary bacterial infections may complicate initially simple inflammation. Chronic colitis may lead to intestinal damage, strictures, or permanent alterations in gut function. Malnutrition and weight loss occur when digestion and absorption are impaired. Prevention of complications requires prompt treatment, nutritional support to maintain eating, and careful monitoring for deterioration. Most complications are preventable with appropriate early intervention.