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Ischemic colitis
Definition
Ischemic colitis is a sudden swelling (inflammation) of part of the large intestine (colon) that occurs when there is a temporary loss of, or reduction in, blood flow to the colon.
Alternative Names
Colonic ischemia
Causes, incidence, and risk factors
Ischemic colitis mainly affects people over 50. Many of them have a history of peripheral vascular disease.
Other risk factors include:
- Atrial fibrillation
- Blockage of the large bowel
- Chronic obstructive pulmonary disease
- Congestive heart failure
- Diabetes
- High blood pressure
- Irritable bowel syndrome
- Low blood pressure
- Past aortic surgery in which damage occurred to the artery that supplies the colon
- Rheumatoid arthritis
- Use of medications that cause constipation
Symptoms
- Abdominal pain
- Blood in the stool (may be bright red or maroon)
- Diarrhea
- Fever
- Vomiting
Signs and tests
- Colonoscopy or flexible sigmoidoscopy
- Computerized tomography (CT scan)
Treatment
Treatment for mild ischemic colitis often involves:
- Antibiotics
- Liquid diet at first
- Fluids through a vein (by IV)
- Pain medications
Severe ischemic colitis that leads to gangrene is treated with:
- Antibiotics
- Replacement of blood volume
- Surgery to remove the affected bowel area
Support Groups
Expectations (prognosis)
Most cases of ischemic colitis are mild and will improve on their own. They do not need surgical treatment.
The death rate is high when gangrene occurs because there is not enough blood supply.
Complications
- Gangrene of the bowel
- Hole in the intestine (perforation)
- Inflammation of the lining of the abdomen (peritonitis)
- Sepsis
Calling your health care provider
Call your health care provider if you develop symptoms of ischemic colitis.
Prevention
Being aware of your risk may allow early diagnosis and treatment. Absolute prevention may not be possible.
References
Hauser SC. Vascular diseases of the gastrointestinal tract. In: Goldman L, Ausiello D. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 146.
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