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Ischemic colitis


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.

Alternative Names:

Colonic ischemia

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.


Review Date: 1/20/2010
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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