Overview
Ischemic colitis is a condition where blood flow to a part of the large intestine, known as the colon, is temporarily reduced, leading to reduced oxygen for the cells in the digestive system. This reduced blood flow can cause tissue damage in the affected area of the intestine. Symptoms may include abdominal pain, diarrhea, rectal bleeding, and weight loss, but it usually heals on its own within 2 to 3 days. The cause of ischemic colitis may be due to clotting problems, high cholesterol, reduced blood flow, previous abdominal surgery, or heavy exercise, among other factors.
Understanding the disease
Symptoms
The symptoms of ischemic colitis may include pain, tenderness, or cramping in the belly, bright red or maroon blood in the stool or blood passing alone without stool, a feeling of urgency to move the bowels, diarrhea, nausea, and a higher risk of complications when symptoms occur on the right side of the belly. If you experience sudden, severe pain in your belly, it is considered a medical emergency and you should seek immediate medical care.
Risk Factors
Risk factors for ischemic colitis include age, with the condition occurring mostly frequently in adults older than age 60, and clotting problems, such as factor V Leiden. Other risk factors are high cholesterol, which can lead to atherosclerosis, and reduced blood flow due to heart failure, low blood pressure, or shock. Ischemic colitis is also more common in women.
Development
Ischemic colitis can develop due to a temporary reduction in blood flow to the colon. This reduced blood flow may be caused by narrowing of the blood vessels supplying the colon or reduced blood flow due to low blood pressure. The diminished blood flow can result in tissue damage to the affected area of the intestine. Factors that may increase the risk of ischemic colitis include clotting problems, such as factor V Leiden, high cholesterol, reduced blood flow due to heart failure, low blood pressure, or shock, previous abdominal surgery, and heavy exercise. It is essential to seek medical attention if you experience symptoms of ischemic colitis, as timely treatment can help prevent complications such as tissue death, hole formation, bowel obstruction, or persistent bleeding.
Assessment and Diagnosis
Triage
You should see a doctor immediately if you suspect ischemic colitis and experience sudden, severe abdominal pain. Pain that makes you uncomfortable to the point where you can't sit still or find a comfortable position is considered a medical emergency. If you have other concerning symptoms, such as diarrhea, nausea, or rectal bleeding, it's also advisable to make an appointment with your healthcare provider.
Diagnosis
To diagnose ischemic colitis, your doctor may recommend the following imaging tests based on your symptoms: abdominal CT scans and colonoscopy. Colonoscopy provides detailed images of your colon and can help diagnose ischemic colitis. It can also be used to check for cancer and see how well a treatment has worked. Stool analysis may be done to rule out infection as a cause of your symptoms.
Management and Treatment
Complications
Potential complications of ischemic colitis include tissue death (gangrene), hole formation (perforation) in the intestine, persistent bleeding, and bowel obstruction (ischemic stricture). Severe complications are more likely when symptoms occur on the right side of the belly.
Treatment
Treatments for ischemic colitis typically involve addressing the underlying cause and managing symptoms. Since the cause of ischemic colitis isn't always clear, treatment may focus on relieving symptoms and preventing complications. Some potential treatments include:
- Rest: If the ischemic colitis is caused by vigorous exercise or heavy physical activity, rest is often recommended to allow the intestine to recover.
- Hydration: It's important to stay adequately hydrated, especially when doing vigorous outdoor activities, as dehydration can exacerbate the symptoms of ischemic colitis.
- Medications: Over-the-counter pain relievers, such as acetaminophen or ibuprofen, may be recommended to help manage abdominal pain and cramping. Antidiarrheal medications may also be prescribed to help control diarrhea.
- Antibiotics: If an infection is present, antibiotics may be prescribed to prevent its spread and treat the infection.
- Surgery: In severe cases or if complications arise, surgery may be necessary to remove damaged or necrotic tissue or to repair a bowel obstruction. It's important to consult a healthcare professional for a proper diagnosis and appropriate treatment plan.