Ischemic colitis is acute inflammation of the colon caused by restricted blood flow, often affecting older people with peripheral artery disease. Symptoms include abdominal discomfort, nausea, diarrhea, and bloody stools. Treatment depends on severity and may involve antibiotics and hospitalization. Complications include gangrene and sepsis. Diagnosis involves imaging tests and blood and stool samples. Prognosis depends on prompt treatment and lifestyle changes to reduce risk factors.
Acute inflammation of the colon resulting from impaired blood flow through the lower digestive system is known as ischemic colitis. While the condition can be triggered by a variety of factors, it commonly affects older people who have been diagnosed with peripheral artery disease (PAD). The restricted blood flow associated with ischemic colitis can result in potentially life-threatening conditions that require immediate medical attention, including gangrene and sepsis. Treatment for this condition depends on the severity of the symptoms, usually involves the administration of antibiotics and may require hospitalization in severe cases.
Frequently, arterial constriction is initiated by the presence of blood clots that form due to plaque-coated arterial walls. Insufficient blood flow resulting from arterial constriction ultimately deprives colon tissue of oxygen and impairs its ability to function properly. The reduction or absence of oxygenated blood causes the onset of acute inflammation of the colon tissue and intestinal disorders.
There are several factors that can contribute to the development of ischemic colitis. Individuals who have been diagnosed with a hernia or who have a history of colon cancer may be at an increased risk of developing this form of colon inflammation. Some systemic conditions, such as vasculitis and rheumatoid arthritis, can also increase an individual’s chance of becoming symptomatic. In some cases, a parasitic presence or bacterial infection can lead to sudden inflammation of the colon. Additionally, regular use of certain medications, such as synthetic hormones and nonsteroidal anti-inflammatory drugs (NSAIDs), can put an individual at risk of developing acute inflammation of the colon.
Frequently, those diagnosed with ischemic colitis are older in age and have been diagnosed with a chronic medical condition that contributes to arterial dysfunction and compromises proper blood flow, such as peripheral artery disease. Individuals with a history of cardiovascular problems, including arrhythmias or damage to the coronary arteries, may be at an increased risk for this form of colitis. Other chronic conditions, including chronic obstructive pulmonary disease (COPD) and high blood pressure, can also contribute to the development of symptoms. Signs indicative of the onset of acute inflammation of the colon are usually patterned in their presentation.
Individuals will often experience abdominal discomfort which may be accompanied by sudden urges to defecate. Typically, symptomatic individuals may also experience nausea, diarrhea, and vomiting. It is not unusual for individuals with this form of colitis to develop bloody stools that are deep or bright red in color. Abdominal discomfort that occurs primarily on the right side may be indicative of a blockage that compromises small bowel function which can result in tissue necrosis or death. Considered a life-threatening situation, intestinal blockages must be surgically removed to prevent gangrene or other serious complications.
To confirm a diagnosis, an individual may be referred for further testing after an initial physical exam. A colonoscopy may be performed to evaluate the condition of the colon. The procedure involves inserting a small, flexible tube into the rectum that has a tiny camera that transmits images to a video monitor. Imaging tests of the abdominal region, including a computed tomography (CT), X-ray, and magnetic resonance imaging (MRI), may be done to further evaluate arterial function and the condition of the colon. Additionally, a blood test may be administered to evaluate the individual’s white blood cell count, which rises in the presence of inflammation, and a stool sample may be obtained for further laboratory testing.
Treatment for ischemic colitis depends entirely on the severity of symptoms and the individual’s overall health. Mild cases usually do not require hospitalization and subside within a few days with appropriate treatment. An antibiotic is usually given as a precautionary measure to prevent infection, and additional medications are used to regulate blood pressure and restore proper blood circulation. Moderate to severe cases often require more extensive treatment.
Dehydrated individuals who experience severe symptoms may be hospitalized to stabilize their condition. Supplemental nutrients are usually given intravenously, and the individual’s diet may be restricted until proper colon function is restored. Some individuals may also require an analgesic drug to ease the discomfort. Those who have been diagnosed with intestinal obstruction may undergo immediate surgery to remove the blockage and restore proper bowel function.
The prognosis associated with ischemic colitis depends on the presentation of the condition, as well as prompt and appropriate treatment. If the symptoms are not treated, the risk of developing the infection increases significantly and can be life threatening. Complications associated with ischemic colitis include gangrene, sepsis, and intestinal perforation. To reduce the risk of recurrent ischemic colitis, individuals are generally instructed to eat a healthy, balanced diet and get plenty of exercise. It may also be recommended that people abstain from risky behaviors, such as smoking, and take proactive steps to reduce cholesterol.
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