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Ischemic Cholitis

Ischemic colitis is the inflammatory disorder of the large intestine (i.e. colon) which develops due to an inadequate blood supply to the colon. Ischemic colitis can occur in any part of the colon but usually causes pain on the left side of the abdomen.

Causes

Ischemic colitis develops due to the poor blood supply to the colon which reduces the oxygen supply to the cells of the colon. This happens as a result of the hardening of the mesenteric arteries which supply the colon. The hardening begins due to fatty deposits in the arteries called plaque formation.

An acute form of ischemic colitis can occur due to the formation of clots and is a medical emergency. Plaque formation in the arteries leads to chronic ischemic colitis. The condition can also lead to the death of the patient if the death of the tissue occurs in the colon.

Symptoms

The most common symptom of ischemic colitis is the abdominal pain. The pain occurs suddenly and is similar to the feeling of stomach cramps. It usually occurs after eating.

Blood may be seen in the stools which is not much severe in the case of ischemic colitis unlike other forms of colitis.

Other symptoms include:

  • Urgency for bowel movement
  • Vomiting
  • Diarrhea
  • Nausea
  • Abdominal tenderness

Risk factors

  • Ischemic colitis can occur in people of any age group. However, it occurs more often in people aged 60 years and above.
  • If you have the history of medical conditions such as peripheral vascular disease or coronary artery disease, then you are more likely to develop plaques than others.
  • People with arrhythmias are more prone to develop blood clots.
  • Other medical conditions which increase the risk of developing ischemic colitis are diabetes, low blood pressure, and congestive heart failure.
  • Your risk is also high for ischemic colitis if you have undergone a surgery of the aorta.
  • Certain medications that cause constipation also increase the risk of ischemic colitis.

Complications

Generally, ischemic colitis is self-limiting, i.e. it improves by itself, within two to three days. However, complications can arise if more severe forms are not treated on time. They include:

  • Tissue death due to reduced blood supply
  • Perforations in the intestine and persistent bleeding
  • Bowel obstruction
  • Inflammation of the bowel

The risk of you getting severe complications is high if you have pain in the right side of the abdomen.

The symptoms of ischemic colitis are similar to many other conditions such as ulcerative colitis and Crohn’s disease (which are not linked to blood flow but are due to a poor immune system). Therefore, to confirm if you have ischemic colitis, your doctor performs the following tests:

Test typePurpose of the test
Imaging tests Produce detailed images from different angles of the colon and the associated blood vessels
Stool samples To check for the presence of any infections producing the symptoms
Colonoscopy To look the inside of your colon
Biopsy Tissue sample from the colon is also collected to confirm the diagnosis

The intake of liquid diet for over a short period along with antibiotics can help in improving mild conditions. You will be giving fluids through IV line to keep you hydrated. You should not eat or drink anything for a few days till your colon heals.

In the case of a severe ischemic colitis, your surgeon will remove the dead tissue and repair the damage. Other surgical procedures include

  • Repairing the hole in the colon
  • Removal of part of the colon which is constricted due to scarring
  • By-passing a blockage in the intestinal artery

A colonoscopy is performed to check if there are no lasting problems.

If you have an underlying condition, then medications are given to treat them.

You should avoid medications such as migraine drugs, certain heart drugs, and hormone medications which cause constriction of the blood vessels.

Most of the people get complete relief from the condition with the treatment but in few cases, there can be a relapse.

Follow the below tips to prevent the odds of ischemic colitis:

  • Stay well hydrated
  • Regularly discuss with your doctor about your medications
  • Stop smoking