Ischemic colitis

What is ischemic colitis?

This condition is the most common type of intestinal ischemia that occurs when blood flow to part of the colon is reduced or diminished.

Any part of the colon can be affected by this condition but it typically causes pain on the left side of the abdomen. Ischemic colitis can be mild or severe. Often times the condition will heal on its own.

What causes ischemic colitis?

Many times, the cause of the diminished blood flow isn’t clear, but health professionals have determined additional conditions and medications that may increase your risk.

Some conditions and medications associated with ischemic colitis include:

  • Hormonal medication, such as birth control
  • Medications that constrict blood vessels, such as those that treat migraines
  • A blood clot in an artery supplying blood to the colon
  • Very low blood pressure—associated with trauma, heart failure, or major surgery
  • A bowel obstruction—this can be caused by scar tissue, a hernia, or tumor
  • Bowel enlargement due to an obstruction
  • Medical conditions that affect your blood vessels, such as sickle cell anemia or lupus

Additional medications that may cause ischemic colitis include antibiotics and cold medicine, although this is very rare.

The biggest risk factor of ischemic colitis is age. It is most common in those over the age of 60. Other risk factors are high cholesterol, previous abdominal surgery, and heavy exercise, such as marathon running.

Symptoms

Signs of ischemic colitis may present suddenly or gradually. Sudden symptoms can differ from those that occur more gradually.  

Sudden, acute symptoms

  • Abdominal pain (mild or severe)
  • Frequent forceful bowel movements
  • An urgent feeling to move your bowels
  • Blood in your stool—this may be bright red or maroon colored

Sudden, severe abdominal pain and blood in the stool requires immediate medical attention.

Gradual, chronic symptoms

  • Abdominal pain that gets progressively worse over weeks/months
  • Cramps and fullness in the abdomen after eating
  • Diarrhea
  • Bloating
  • Nausea
  • Unintended weight loss

Symptoms of ischemic colitis are similar to symptoms of many other gastrointestinal issues. If you are experiencing symptoms, visit a doctor.

Diagnosis

If you are experiencing symptoms of ischemic colitis there are a number of exams your doctor may perform.

Imaging exams
An abdominal ultrasound or CT scan can rule our disorders such as inflammatory bowel disease and allow doctors to see abnormalities.
Colonoscopy
A small flexible tube with a camera can be inserted into your colon. A biopsy can also be done during this exam—where a tissue sample is taken for testing.
Stool test
From a stool sample, doctors can determine if your symptoms may be due to infection.

If you are diagnosed with ischemic colitis due to an underlying condition your doctor may want to perform additional tests.

Treatment

Generally, treatment is supportive and includes IV fluids and antibiotics. Mild cases of ischemic colitis may heal on their own and typically symptoms will go away within a few days. Your doctor may recommend avoiding any medications that constrict blood vessels. If your ischemic colitis was due to an underlying condition your doctor may provide additional treatment options.

If your symptoms are severe and have caused colon damage or additional complications, surgery may be necessary. Surgery can repair and remove dead colon tissue, blockages, or parts of the colon that are extremely narrowed and not working properly.

Last reviewed: 
October 2018

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