Definition

Ischemic colitis happens if the blood flow to the colon is diminished because of shrunken or blocked arteries. The reduced blood flow doesn’t provide enough oxygen for the cells in the digestive system. This can damage the colon and cause pain. It can affect any part of the colon. Most of the people suffering from this condition experience pain on the left side of the abdomen.

Ischemic colitis usually affects people older than 60 years. It may heal on itself, but medications are needed in order to treat and prevent infections or surgery in case the colon has been damaged.

 

Symptoms

Symptoms of ischemic colitis may be:

  • Pain
  • Cramps that can happen suddenly or gradually
  • Feeling for urgent bowel movement
  • Diarrhea

If the patient has symptoms on the right side of the abdomen, the risk of severe complication is higher.

Timely diagnosis and proper treatment can prevent serious complication, so the patient should seek emergent medical care if he/she feels uncomfortable, experiences difficulties to sit still, and/or feels sudden and severe pain in the abdomen.

 

Causes

It is not always clear what causes the reduced blood flow to the colon. Several factors that can increase the risk of colon ischemia include:

  • Bowel obstruction caused by scar tissue, hernia or a tumor
  • Buildup of fatty deposits on the walls of an artery
  • Dangerously low blood pressure associated with heart failure, major surgery or trauma
  • Surgery involving the heart or blood vessels
  • Surgeries of the digestive or gynecological systems
  • Venous thrombosis (a blood clot in an artery supplying the colon)
  • Medical disorders (blood inflammation, lupus or sickle cell anemia)
  • Methamphetamine or cocaine use
  • Colon cancer (rare)

Although rare, some medications can also cause ischemic colitis. They are:

  • Antibiotics
  • Heart and migraine pills that narrow blood vessels
  • Hormone medicines (for instance: estrogen)
  • Nonsteroidal anti-inflammatory drugs
  • Some medications for irritable bowel syndrome
  • Chemotherapy medications

 

Risk factors

The risk factors for ischemic colitis can be:

  • Age-affects people older than 60
  • High cholesterol
  • Previous medical conditions, such as: abdominal surgery, heart failure, low blood pressure and shock
  • Surgery (involving the aorta)
  • Irritable bowel syndrome
  • Heavy exercise (marathon running)

 

Complications

Ischemic colitis normally mends on its own in two or three days. However, in some cases it can lead to complications, such as:

  • Gangrene
  • Perforation
  • Infection of the bowel
  • Obstruction of the bowel

 

Treatment

Even though the symptoms may reduce in two or three days, the doctor may suggest some of the following treatments:

  • Antibiotics that prevent inflammation
  • Intravenous fluids
  • Treatment for any underlying condition
  • Avoiding medicine that narrow the blood vessels (heart pills, migraine pills and some hormone pills)

If the condition is more severe and is not getting better, if the colon has been damaged, the patient may need surgery to:

  • Remove dead tissue
  • Repair perforation
  • Bypass a blockage in an intestinal artery
  • Remove part of the colon that has narrowed because of scarring, and is causing a blockage

 

Prevention

Many of the people with ischemic colitis recover very quickly and never again have another occurrence of it. Although the condition gets better on its own, and it’s not very clear what causes it, in order to diminish the risk of ischemic colitis, it is recommendable to:

  • Avoid medications that reduce blood flow
  • Medicine for lowering cholesterol
  • Treatment for certain underlying condition (heart disease, high blood preasure or diabetes)
  • Exercise regularly