Abdominal pain and bloody stools are common.
Computed tomography is usually done, and colonoscopy is sometimes done.
Most people get better with fluids given by vein and by not eating anything, but a few require surgery.
(See also Overview of Gastrointestinal Emergencies Overview of Gastrointestinal Emergencies Certain gastrointestinal disorders can be life threatening and require emergency treatment. For many people, emergency treatment involves surgery. Abdominal pain, often severe, usually accompanies... read more .)
Ischemic colitis results from an interruption of blood flow through arteries that supply the large intestine. Often doctors cannot find a cause for the reduced blood flow, but it is more common among people with heart and blood vessel disease, people who have had surgery on their aorta, or people who have problems with increased blood clotting. Ischemic colitis primarily affects people who are 60 or older.
Reduction of blood flow damages the inside lining and inner layers of the wall of the large intestine, causing ulcers (sores) in the lining of the large intestine, which can bleed.
Symptoms of Ischemic Colitis
Usually, the person has abdominal pain. The pain is felt more often on the left side, but it can occur anywhere in the abdomen. The person frequently passes loose stools that are often accompanied by dark red clots. Sometimes bright red blood is passed without stool. Low fevers (usually below 100° F [37.7° C]) are common.
Diagnosis of Ischemic Colitis
Computed tomography (CT) or sometimes colonoscopy
A doctor may suspect ischemic colitis on the basis of the symptoms of pain and bleeding, especially in a person older than 60. It is important for doctors to distinguish ischemic colitis from acute mesenteric ischemia Acute Mesenteric Ischemia Acute mesenteric ischemia is sudden blockage of blood flow to part of the intestines, which may lead to gangrene and perforation (puncture). Severe abdominal pain develops suddenly. Angiography... read more , a more dangerous condition in which blood flow to part of the intestine is completely and irreversibly blocked.
Doctors usually do CT Computed Tomography and Magnetic Resonance Imaging of the Digestive Tract Computed tomography (CT—see also Computed Tomography (CT)) and magnetic resonance imaging (MRI—see also Magnetic Resonance Imaging (MRI)) scans are good tools for assessing the size and location... read more or sometimes also colonoscopy Endoscopy Endoscopy is an examination of internal structures using a flexible viewing tube (endoscope). Endoscopy can also be used to treat many disorders because doctors are able to pass instruments... read more (examination of the large intestine with a flexible viewing tube) to distinguish ischemic colitis from other forms of inflammation, such as infection or inflammatory bowel disease Overview of Inflammatory Bowel Disease (IBD) In inflammatory bowel diseases, the intestine (bowel) becomes inflamed, often causing recurring abdominal pain and diarrhea. The two primary types of inflammatory bowel disease (IBD) are Crohn... read more .
Prognosis for Ischemic Colitis
Nearly all people with ischemic colitis improve and recover over a period of 1 to 2 weeks. However, when the interruption to the blood supply is more severe or more prolonged, the affected portion of the large intestine may have to be surgically removed. Rarely, people get better but later on develop scar tissue in the affected area.
Treatment of Ischemic Colitis
Fluids by vein
Rarely surgical repair
People with ischemic colitis are hospitalized. Initially, the person is given neither fluids nor food by mouth so that the intestine can rest. Fluids, electrolytes Overview of Electrolytes Well over half of the body's weight is made up of water. Doctors think about the body's water as being restricted to various spaces, called fluid compartments. The three main compartments are... read more , antibiotics, and nutrients are given by vein (intravenously). Within a few days, eating is resumed.
If people develop scar tissue, surgical repair may be needed.