Ischemic Colitis

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Ischemic Colitis is a medical condition in which inflammation and injury of the large intestine result from inadequate blood supply. Although uncommon in the general population, ischemic colitis occurs with greater frequency in the elderly, and is the most common form of bowel ischemia.

Causes of the reduced blood flow can include changes in the systemic circulation (e.g. low blood pressure) or local factors such as constriction of blood vessels or a blood clot. In most cases, no specific cause can be identified.Ischemic colitis is usually suspected on the basis of the clinical setting, physical examination, and laboratory test results; the diagnosis can be confirmed via endoscopy.

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.Patients with mild to moderate ischemic colitis are usually treated with IV fluids, analgesia, and bowel rest (that is, no food or water by mouth) until the symptoms resolve.

Those with severe ischemia who develop complications such as sepsis, intestinal gangrene, or bowel perforation may require more aggressive interventions such as surgery and intensive care. Most patients make a full recovery; occasionally, after severe ischemia, patients may develop long-term complications such as a stricture or chronic colitis.

Ischemic colitis is injury of the large intestine that results from an interruption of its blood supply.
•    Abdominal pain and bloody stools are common.
•    Colonoscopy is usually done.
•    Most people get better with fluids given intravenously and nothing to eat, but a few require surgery.

Ischemic colitis results from a temporary blockage of blood flow through arteries that supply the large intestine. Often doctors cannot find a cause for the reduced blood flow, but it is more common among people with heart and blood vessel disease, people who have had surgery on their aorta, or people who have problems with increased blood clotting.

Ischemic colitis affects primarily people who are 60 or older.Blockage of blood flow damages the inside lining and inner layers of the wall of the large intestine, causing ulcers (sores) in the lining of the large intestine, which can bleed. Usually, the person experiences abdominal pain. The pain is felt more often on the left side, but it can occur anywhere in the abdomen.

The person frequently passes loose stools that are often accompanied by dark red clots. Sometimes bright red blood is passed without stool. Low-grade fevers (usually below 100° F [37.7° C]) are common.A doctor may suspect ischemic colitis on the basis of the symptoms of pain and bleeding, especially in a person older than 60. People with ischemic colitis are hospitalized.

Initially, the person is given neither fluids nor food by mouth so that the intestine can rest. Instead, fluids, electrolytes, and nutrients are given intravenously. Antibiotics are often given to prevent infection that might follow the inflammation.