Summary about Disease
Ischemic colitis occurs when blood flow to the colon (large intestine) is temporarily reduced, usually due to narrowed or blocked arteries. This reduced blood flow deprives the colon cells of oxygen, leading to inflammation and potential damage. The severity can range from mild, temporary symptoms to severe damage requiring surgery.
Symptoms
Sudden abdominal pain, often on the left side
Urgent need to have a bowel movement
Bright red blood in the stool or maroon-colored stools
Mild diarrhea
Abdominal tenderness or cramping
Nausea and vomiting (less common)
Causes
Ischemic colitis is caused by a reduction in blood flow to the colon. Contributing factors can include:
Atherosclerosis: Hardening and narrowing of the arteries.
Low blood pressure: Shock, dehydration, heart failure, or certain medications.
Blood clots: Clots that block arteries supplying the colon.
Surgery: Procedures that temporarily reduce blood flow.
Certain medications: Including some diuretics, certain heart medications, and pseudoephedrine.
Bowel obstruction: Rarely.
Vasculitis: Inflammation of blood vessels.
Strenuous exercise: (rare) In some cases, strenuous exercise can cause ischemic colitis.
Medicine Used
Treatment focuses on restoring blood flow and preventing complications. Medications may include:
Intravenous fluids: To maintain hydration and blood pressure.
Pain medication: To manage abdominal discomfort.
Antibiotics: To prevent or treat infection.
Medications to treat underlying conditions: Such as heart problems or blood clotting disorders.
Vasodilators: In rare cases, medications to widen blood vessels might be used.
Is Communicable
No, ischemic colitis is not communicable. It is not caused by an infectious agent and cannot be spread from person to person.
Precautions
Manage underlying health conditions (e.g., high blood pressure, high cholesterol).
Stay hydrated.
Avoid medications that may contribute to low blood pressure if possible (under medical supervision).
Quit smoking.
Maintain a healthy weight.
Seek prompt medical attention for sudden abdominal pain and bloody stools.
How long does an outbreak last?
The duration of an ischemic colitis outbreak varies depending on the severity and underlying cause. Mild cases may resolve within 1-2 days with supportive care. More severe cases can last for several weeks or longer and may require hospitalization and/or surgery. Chronic ischemic colitis can persist for months or years.
How is it diagnosed?
Diagnosis typically involves:
Medical history and physical exam:
Colonoscopy: A flexible tube with a camera is inserted into the colon to visualize the lining and take biopsies.
CT scan: To rule out other causes of abdominal pain and assess the extent of the inflammation.
Stool cultures: To rule out infectious causes of colitis.
Blood tests: To check for infection, inflammation, and other underlying conditions.
Angiography: Rarely, to visualize the blood vessels supplying the colon.
Timeline of Symptoms
The onset of symptoms is often sudden.
Initial: Sudden abdominal pain (often left side), urgent bowel movement.
Within hours: Bloody stools, diarrhea.
Days: Symptoms may worsen or improve depending on the severity and treatment. If blood flow is not restored, complications like strictures or gangrene can develop over time.
Important Considerations
Early diagnosis and treatment are crucial to prevent complications.
Ischemic colitis can mimic other conditions, such as inflammatory bowel disease or infection.
People with underlying cardiovascular disease, diabetes, or other risk factors are at higher risk.
Surgical intervention may be necessary in severe cases with gangrene, perforation, or persistent bleeding.
Follow-up colonoscopies may be needed to monitor for strictures (narrowing of the colon).