Causes

Ischemic colitis mainly affects people over 50. Many of them have a history of peripheral vascular disease.

Other risk factors include:

• Atrial fibrillation
• Blockage of the large bowel
• Chronic obstructive pulmonary disease
• Congestive heart failure
• Diabetes
• High blood pressure
• Irritable bowel syndrome
• Low blood pressure
• Past aortic surgery in which damage occurred to the artery that supplies the colon
• Rheumatoid arthritis
• Use of medications that cause constipation

Symptoms

• Abdominal pain
• Blood in the stool (may be bright red or maroon)
• Diarrhea
• Fever
• Vomiting

Exams and Tests

• Colonoscopy or flexible sigmoidoscopy
• Computerized tomography (CT scan)

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

Outlook (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.

Possible Complications

• Gangrene of the bowel
• Hole in the intestine (perforation)
• Inflammation of the lining of the abdomen (peritonitis)
• Sepsis

When to Contact a Medical Professional

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.

Alternative Names

Colonic ischemia

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.

Update Date: 1/20/2012

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.