What Is Ischemic Colitis?
Ischemic colitis is a condition that occurs when blood flow to part of the large intestine (colon) is reduced, leading to inflammation and injury to the colon lining. It can range from mild and temporary to severe and life-threatening, depending on the degree and duration of the reduced blood supply.
It is more common in older adults and can affect any part of the colon, though the left side is most frequently involved.
What Causes It?
Ischemic colitis is caused by insufficient blood flow to the colon. This can result from:
- Narrowing or blockage of blood vessels supplying the colon
- Low blood pressure from shock or dehydration
- Heart failure or arrhythmias
- Atherosclerosis (hardening of the arteries)
- Blood clots or emboli
- Surgery or trauma involving the abdomen
- Certain medications (like vasoconstrictors, diuretics, or digitalis)
Who’s at Risk?
Risk factors for ischemic colitis include:
- Age over 60
- Heart disease
- Peripheral artery disease
- High cholesterol
- Smoking
- Diabetes
- History of blood clots
- Use of estrogen-containing medications
- Dehydration or severe infections
What Are the Symptoms?
Symptoms of ischemic colitis often develop suddenly and may include:
- Crampy abdominal pain, usually on the left side
- Urgent need to defecate
- Bloody or maroon-colored stools
- Diarrhea
- Abdominal tenderness
- Nausea and vomiting
- Mild fever
In more severe cases, symptoms may progress to shock or perforation of the bowel.
How Is It Diagnosed?
Diagnosis involves a combination of medical history, physical examination, and tests such as:
- Stool tests – To rule out infection
- Blood tests – To assess white blood cell count and kidney function
- CT scan – Can detect bowel inflammation, thickening, or complications
- Colonoscopy – Allows direct visualization of the colon and helps confirm diagnosis
- Angiography – Rarely used, but can show blood flow problems in the intestines
What Are the Treatment Options?
Mild to Moderate Cases
- Bowel rest – Avoid eating or drinking for a short period
- IV fluids – To prevent dehydration
- Antibiotics – To prevent or treat infection
- Monitoring and supportive care – Until symptoms resolve
Severe Cases
- Surgery may be needed if:
- There is colon perforation
- Severe bleeding
- Tissue death (gangrene) of the colon
In such cases, the damaged portion of the colon may be removed.
Can It Be Prevented?
Prevention focuses on managing risk factors, such as:
- Controlling blood pressure, diabetes, and heart disease
- Staying hydrated
- Avoiding medications that may reduce blood flow (under doctor supervision)
- Quitting smoking
- Staying physically active and eating a heart-healthy diet
When to Seek Medical Help
Seek medical attention immediately if you experience:
- Severe or persistent abdominal pain
- Bloody diarrhea
- Signs of dehydration (dry mouth, dizziness, low urine output)
- Fever with abdominal discomfort
Prompt treatment can prevent complications and improve outcomes.