Definition

What is ischemic colitis?

Ischemic colitis occurs when blood flow to part of the large intestine (colon) is reduced, usually due to narrowed or blocked blood vessels (arteries). The diminished blood flow doesn’t provide enough oxygen for the cells in your digestive system.

Ischemic colitis can cause pain and may damage your colon. Any part of the colon can be affected, but ischemic colitis usually causes pain on the left side of the belly area (abdomen).

The condition can be misdiagnosed because it can easily be confused with other digestive problems. Ischemic colitis may heal on its own. But you may need medication to treat ischemic colitis or prevent infection, or you may need surgery if your colon has been damaged.

How common is ischemic colitis?

Ischemic colitis can occur at any age, but it’s most common among those over the age of 60. Please discuss with your doctor for further information.

Symptoms

What are the symptoms of ischemic colitis?

The common symptoms of ischemic colitis are:

  • Pain, tenderness or cramping in your belly, which can occur suddenly or gradually
  • Bright red or maroon-colored blood in your stool or, at times, passage of blood alone without stool
  • A feeling of urgency to move your bowels
  • Diarrhea
  • Nausea

The risk of severe complications is higher when you have symptoms on the right side of your abdomen. That’s because the arteries that feed the right side of your colon also feed part of your small intestine, and may be blocked too. Pain tends to be more severe with this type of ischemic colitis.

Blocked blood flow to the small intestine can quickly lead to death of intestinal tissue (necrosis). If this life-threatening situation occurs, you’ll need surgery to clear the blockage and to remove the portion of the intestine that has been damaged.

There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.

When should I see my doctor?

If you have any signs or symptoms listed above or have any questions, please consult with your doctor. Everyone’s body acts differently. It is always best to discuss with your doctor what is best for your situation.

Causes

What causes ischemic colitis?

The precise cause of diminished blood flow to the colon isn’t always clear. But several factors can increase your risk of ischemic colitis:

  • Buildup of fatty deposits on the walls of an artery (atherosclerosis)
  • Dangerously low blood pressure (hypotension) associated with heart failure, major surgery, trauma or shock
  • A blood clot in an artery supplying the colon or, less commonly, in a vein (venous thrombosis)
  • Bowel obstruction caused by a hernia, scar tissue or a tumor
  • Surgery involving the heart or blood vessels, or the digestive or gynecological systems
  • Other medical disorders that affect your blood, such as inflammation of the blood vessels (vasculitis), lupus or sickle cell anemia
  • Cocaine or methamphetamine use
  • Colon cancer (rare)

The role of medications

Certain medicines also can lead to ischemic colitis, though this is rare. They include:

  • Some heart and migraine medications
  • Hormone medications, such as estrogen
  • Antibiotics
  • Pseudoephedrine
  • Certain medications for irritable bowel syndrome
  • Chemotherapy medications

Risk factors

What increases my risk for ischemic colitis?

There are many risk factors for ischemic colitis, such as:

  • The condition occurs mostly frequently in adults older than age 60. Ischemic colitis that occurs in a young adult may be a sign of a blood-clotting abnormality or inflammation of the blood vessels (vasculitis).
  • Clotting abnormalities. Conditions that affect the way the blood clots, such as Factor V Leiden, may increase the risk of ischemic colitis.
  • High cholesterol, which can lead to atherosclerosis.
  • Reduced blood flow, due to heart failure, low blood pressure and shock.
  • Previous abdominal surgery. Scar tissue that forms after surgery may cause reduced blood flow.
  • Heavy exercise, such as marathon running, which can lead to reduced blood flow to the colon.
  • Surgery involving the large artery (aorta) that pumps blood from your heart to the rest of your body.

Diagnosis & treatment

The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.

How is ischemic colitis diagnosed?

  • A doctor’s evaluation of symptoms
  • Computed tomography (CT) or sometimes colonoscopy

A doctor may suspect ischemic colitis on the basis of the symptoms of pain and bleeding, especially in a person older than 60. It is important for doctors to distinguish ischemic colitis from acute mesenteric ischemia, a more dangerous condition in which blood flow to part of the intestine is completely and irreversibly blocked.

Doctors usually do CT or sometimes also colonoscopy (examination of the large intestine with a flexible viewing tube) to distinguish ischemic colitis from other forms of inflammation, such as infection or inflammatory bowel disease.

How is ischemic colitis treated?

Mild cases of ischemic colitis are often treated with:

  • Antibiotics (to prevent infection)
  • A liquid diet
  • Intravenous (iv) fluids (for hydration)
  • Pain medication

Acute ischemic colitis is a medical emergency. It may require:

  • Thrombolytics, which are medicines that dissolve blot clots
  • Vasodilators, which are medicines that can widen your mesenteric arteries
  • Surgery to remove the blockage in your arteries

People with chronic ischemic colitis usually only need surgery if other treatments fail.

Lifestyle changes & home remedies

What are some lifestyle changes or home remedies that can help me manage ischemic colitis?

The following lifestyles and home remedies might help you cope with ischemic colitis:

Since the cause of ischemic colitis isn’t always clear, there’s no certain way to prevent the disorder. Most people who have ischemic colitis recover quickly and may never have another episode.

To prevent recurrent episodes of ischemic colitis, your doctor may recommend eliminating any medication that might cause ischemic colitis. He or she may also test for clotting abnormalities, especially if no other cause for ischemic colitis was apparent.

If you have any questions, please consult with your doctor to better understand the best solution for you.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Review Date: September 22, 2017 | Last Modified: September 22, 2017

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