What is ischemic colitis?
Ischemic colitis is a type of inflammation of the lining of the colon caused by decreased blood flow to the colon.
What are the symptoms of ischemic colitis?
- Abdominal pain, which can be anywhere, but most often on the left side
- Bloody stools, which usually occur after the pain begins
- Abdominal bloating or distension
- Rarely patients may not have any symptoms
What causes ischemic colitis?
- Spontaneous, with no apparent underlying cause (this is common)
- Blood clot in an artery supplying the colon (mesenteric vessels)
- Buildup of fatty deposits on the walls of an artery (artherosclerosis)
- Low blood pressure from any cause (heart attack, congestive heart failure, etc.)
- Drugs (diuretics, estrogens, non-steroidal anti-inflammatories, simvastatin, cocaine, etc.)
- Long distance running
- Infection (CMV, E. coli O157:H7)
What are the complications of ischemic colitis?
- Usually the colitis will heal on its own (85% of cases) and most patients improve within one to two weeks
- Persistent or recurrent colitis (failure of the inflammation to heal)
- Stricture (scar tissue which blocks the channel of the colon)
- Severe involvement may require hospitalization for more intensive treatment
- Occasionally surgery is required, but this is unusual
What is the treatment for ischemic colitis?
It depends on the severity, but generally, the inflammation will heal on its own. You may be asked to stay on a bland, low-fiber diet for 1-2 weeks. Avoiding non-steroidal inflammatory drugs (Ibuprofen, etc) may speed the healing of the colitis. If a drug is identified that may have caused the ischemic colitis, you may be asked to stop it. Smoking cessation improves the health of the blood vessels supplying your colon. If you have had blood clots in other areas of the body, or a family history of blood clots, then you may be asked to undergo testing for blood clotting disorders (hypercoagulable state). If you have had more than one episode of ischemic colitis, additional imaging may be recommended to look at the vessels that supply blood to the colon. Occasionally, a repeat colonoscopy is recommended to assure that the colon has healed, but depends on the severity of the involvement, and will be determined by your physician.