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What is Ischemic Colitis?

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  • Written By: J.M. Willhite
  • Edited By: Heather Bailey
  • Last Modified Date: 22 August 2016
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Acute, colonic inflammation resulting from impaired blood flow through the lower digestive system is known as ischemic colitis. Though the condition may be triggered by a variety of factors, it commonly affects individuals of advanced age who have been diagnosed with peripheral artery disease (PAD). The restricted blood flow associated with ischemic colitis can result in potentially life-threatening conditions that require immediate medical attention, including gangrene and sepsis. Treatment for this condition is dependent on symptom severity, generally involves the administration of antibiotics, and may require hospitalization in severe cases.

Frequently, arterial constriction is initiated by the presence of blood clots that form due to plaque-lined arterial walls. The insufficient blood flow resulting from arterial constriction ultimately deprives colonic tissue of oxygen and impairs its ability to function properly. The reduction or absence of oxygenated blood causes the onset of acute inflammation of the colonic tissue and intestinal disruption.

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There are several factors that may contribute to the development of ischemic colitis. Individuals who have been diagnosed with a hernia or have a history of colon cancer may be at an increased risk for developing this form of colonic inflammation. Certain systemic conditions, such as vasculitis and rheumatoid arthritis, may also increase an individual’s chances for becoming symptomatic. In some cases, a parasitic presence or bacterial-based infection may induce sudden colonic inflammation. Additionally, the regular use of certain medications, such as synthetic hormones and non-steroidal anti-inflammatory drugs (NSAIDs), may place an individual at risk for developing acute colonic inflammation.

Frequently, those who are diagnosed with ischemic colitis are of advanced age and have been diagnosed with a chronic medical condition that contributes to arterial dysfunction and impairs proper blood flow, such as peripheral artery disease. Individuals with a history of cardiovascular issues, including arrhythmias or coronary arterial damage, may possess an increased risk for this form of colitis. Other chronic conditions, including chronic obstructive pulmonary disease (COPD) and high blood pressure, may also contribute to symptom development. Signs indicative of the onset of acute, colonic inflammation are generally patterned in their presentation.

Individuals will frequently experience abdominal discomfort that may be accompanied by sudden urges to defecate. Generally, symptomatic individuals may also experience nausea, diarrhea, and vomiting. It is not unusual for individuals with this form of colitis to develop bloody stool that is deep or bright red in color. Abdominal discomfort that presents primarily on the right side may be indicative of a blockage impairing the functionality of the small intestine which can result in necrosis, or tissue death. Considered to be a life-threatening situation, intestinal blockages must be surgically removed to prevent gangrene or other serious complications.

In order to confirm a diagnosis, an individual may be referred for additional testing following an initial physical examination. A colonoscopy may be performed to evaluate the condition of the colon. The procedure involves the rectal insertion of a small, flexible tube outfitted with a tiny camera that relays pictures back to a video monitor. Imaging tests of the abdominal region, including a computerized tomography (CT) scan, X-rays, and magnetic resonance imaging (MRI), may be conducted to further evaluate arterial function and the condition of the colon. Additionally, a blood test may be administered to assess the individual’s white blood cell count, which elevates in the presence of inflammation, and a stool sample may be obtained for further laboratory testing.

Treatment for ischemic colitis is wholly dependent on symptom severity and the overall health of the individual. Mild cases usually do not require hospitalization and subside within a few days with appropriate treatment. An antibiotic is generally administered as a precautionary measure to prevent infection and additional medication is utilized to regulate blood pressure and restore proper blood circulation. Moderate to severe cases often require more extensive treatment.

Dehydrated individuals who are experiencing severe symptoms may be hospitalized to stabilize their condition. Supplemental nutrients are usually administered intravenously and the individual’s diet may be restricted until proper colonic function is restored. Some individuals may also require an analgesic medication to alleviate discomfort. Those who have been diagnosed with a bowel obstruction may undergo immediate surgery to remove the blockage and restore proper intestinal function.

Prognosis associated with ischemic colitis is dependent on the presentation of the condition, as well as, timely and appropriate treatment. If symptoms are left untreated, the risk for infection development increases dramatically and may place the individual’s life at risk. Complications associated with ischemic colitis include gangrene, sepsis, and intestinal perforation. To lower one’s risk for recurrent ischemic colitis, individuals are generally instructed to adopt a healthy, balanced diet and get plenty of exercise. It may also be recommended that individuals refrain from risky behaviors, such as smoking, and take proactive measures to reduce their cholesterol.

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