Ischemic Colitis – Causes, Symptoms and Treatment Methods

Ischemic colitis involves an area of inflammation caused by interference with the blood flow to the colon. Most of the classifications of intestinal ischemia in the literature are based on the major causative factors. This is a potentially serious condition and requires care from your doctor. Patients may present with colicky abdominal pain, which becomes continuous. The extent of IBD can range from mild to severe based on the amount of damage from lack of oxygenated blood. The sooner IBD is treated, the more favorable the outcome. Ischemic colitis may result from sudden (acute) or, more commonly, long-term (chronic) blockage of blood flow through arteries that supply the large intestine. The extent of IBD can range from mild to severe based on the amount of damage from lack of oxygenated blood. This is a potentially serious condition and requires care from your doctor. The sooner IBD is treated, the more favorable the outcome. Venous infarction occurs in young patients, usually after abdominal surgery. A sudden drop in the colonic blood supply is key to its development, but in most patients, no specific cause of the decrease can be identified. It may be associated with vomiting, diarrhea, or rectal bleeding. Ischemic colitis can span a wide spectrum of severity; most patients are treated supportively and recover fully, while a minority with very severe ischemia may develop sepsis and become critically ill.

Ischemic colitis is the most common form of intestinal ischemia. The damage produces ulcers in the lining of the large intestine. Ischemic colitis affects primarily people who are 50 or older. The disease was first described by Boley and associates (1) as a “reversible vascular occlusion” of the colon, and Marston and colleagues (2) went on to detail the gangrenous, stricturing, and transient forms. Two mechanisms may cause bowel ischemia: The first and most common is diminished bowel perfusion due to low cardiac output often seen with in patients with cardiac disease or in prolonged shock of any etiology. The second mechanism is occlusive disease of the vascular supply of bowel due to atheroma, thrombosis, or embolism in which the collateral circulation is not adequate to maintain bowel integrity. Patients with mild to moderate ischemic colitis are usually treated with IV fluids, analgesia, and bowel rest until the symptoms resolve. Also known as colonic ischemia, ischemic colitis occurs most often in people age 50 and older. Most patients make a full recovery; occasionally, after severe ischemia, patients may develop long-term complications such as a stricture or chronic colitis. In older adults, ischemic colitis is one of the most common medical conditions affecting the large bowel.

Causes of Ischemic colitis

The common causes and risk factor’s of Ischemic colitis include the following:

Interference with blood flow to the colon is the cause of ischemic colitis.

Abdominal radiation exposure.

Congestive heart failure.

Diabetes.

Previous aortic surgery with unintentional damage to the artery supplying the colon.

History of stroke.

Hypercoagulable states.

Sickle cell disease.

Easy blood clotting (hypercoagulable state).

Symptoms of Ischemic colitis

Some sign and symptoms related to Ischemic colitis are as follows:

Abdominal pain.

Diarrhea.

Nausea.

A feeling of urgency to move your bowels.

Vomiting.

Bright red blood via the rectum ( blood in the stool ).

Low-grade fever.

Back pain, low.

Treatment of Ischemic colitis

Here is list of the methods for treating Ischemic colitis:

Mild, transient ischemic colitis is treated by maintaining good blood pressure.

Chronic ischemic colitis leading to stricture formation is treated by surgical removal of the stricture.

With such conservative measures, symptoms often diminish in 24 to 48 hours in mild cases, without the need for hospitalization.

Severe ischemic colitis leading to gangrene is treated with replacement of blood volume, antibiotics, and surgical removal of the affected bowel area.

Antibiotics are sometimes used.

Surgery may be necessary in some people with ischemic colitis. You may need surgery if you have abdominal tenderness and fever that are severe and persistent, despite initial conservative medical care.