Ischemic colitis

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Diseases and Conditions

Ischemic colitis

Definition Alternative Names Causes, incidence, and risk factors Symptoms Signs and tests Treatment Expectations (prognosis) Complications Calling your health care provider Prevention References

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

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.

Review Date: 1/20/2010
Reviewed By: David C. Dugdale, III, MD, Professor of Mediicne, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and George F. Longstreth, MD, Department of Gastroenterology, Kaiser Permanente Medical Care Program, San Diego, California. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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