Definition of Ischemic colitis:

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.

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.