Ischemic Colitis

Ischemic colitis is the inflammation of the large intestine due to damage caused by disruption in blood supply.

  • Pain in the abdomen and blood-stained stools are the usual symptoms.
  • A CT scan or colonoscopy may be done to diagnose the condition.
  • Fluids are administered intravenously to rest the digestive system for a few days.
  • If damage is severe, surgical removal of a portion of the intestine may be necessary.

A temporary disruption in blood supply to parts of the large intestine due to a blockage in the arteries is the cause of ischemic colitis. The blockage may have resulted from blood clots lodged in the arteries supplying the large intestine, or from the narrowing of arteries due to atherosclerosis and other vascular diseases. The exact cause of the disruption is not always identifiable. Ischemic colitis commonly occurs in older people, especially in those who have cardiovascular diseases or a tendency for developing blood clots. A surgery on the heart or the aorta may increase the risk of ischemic colitis.

The reduced blood flow to the large intestine causes damages to its inner walls and lining, resulting in the development of ulcers. The blood clots found in the stool result from the bleeding of these ulcers. The inflammation makes the intestine prone to infections too.

Symptoms and Diagnosis

Abdominal pain is the most common symptom of ischemic colitis. It is often accompanied by mild fever. Pain may be either localized to the left side of the abdomen or may involve the entire area. High frequency of bowel movements with blood clots in the stool is a typical feature of ischemic colitis.

When older people above the age of sixty have symptoms such as abdominal pain and blood in the stool, doctors are alerted to the possibility of this condition. However, further tests are conducted to confirm that the symptoms are not due to some other disorders of the digestive system such as inflammatory bowel disease. Particularly, it is essential to rule out an extremely dangerous condition called acute mesenteric ischemia resulting from total irreversible blockage of blood supply to the intestine. Imaging tests such as a CT scan, and viewing the large intestine with a colonoscope, help in accurate diagnosis.

Prognosis and Treatment

Treatment for ischemic colitis is initiated with hospitalization of the patient. Complete rest to the intestines is given by stopping all liquids and food intake. Fluids and nutrients are administered intravenously for a few days. Antibiotic treatment is initiated to combat as well as prevent possible infections in the inflamed large intestine. The patient is kept under observation and as the condition gradually improves, antibiotic treatment is stopped and oral feeding is restarted. Within a week or two, most patients recover from ischemic colitis without any further treatment.

If severe damage has been caused by the disruption in blood supply, a portion of the intestine may have become irreparably damaged. Surgical removal of the damaged portion is the only option in such cases.  In rare cases, the patient may initially recover from ischemic colitis but scar tissue formed in the injured area may cause obstruction to the bowel movements. Surgical correction may be necessary in such situations.

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Yasser Elnahas

MD, PHD, Professor Of CardioVascular Surgery
Dr. Yasser Elnahas, Is an associate Professor of Cardiovascular Surgery. Dr. Elnahas was trained as a fellow At Texas Heart Institute And Mayo Clinic Foundation.Dr. Elnahas is dedicated to educating the general public about different disease conditions and simplifying the medical knowledge in an easy to understand terminology.

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