Ischemic colitis

Digestive system

The esophagus, stomach, large and small intestine, aided by the liver, gallbladder and pancreas convert the nutritive components of food into energy and break down the non-nutritive components into waste to be excreted.

Also known as: Colonic ischemia

Definition

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:

Symptoms

Signs and tests

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.

References

Hauser SC. Vascular diseases of the gastrointestinal tract. In: Goldman L, Ausiello D. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 146.

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Review date:
January 20, 2010
Reviewed by:
David C. Dugdale, III, MD, Professor of Mediicne, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and George F. Longstreth, MD, Department of Gastroenterology, Kaiser Permanente Medical Care Program, San Diego, California. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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