What exactly is ischemic colitis?

D.P.D.

The term "ischemic colitis" can be broken down into ischemia (referring to lack of oxygen) and colitis (referring to inflammation of the colon). In people suffering from ischemic colitis, the inner lining of the colon becomes irritated, inflamed and ulcerated due to a shortage of oxygen-rich blood in the affected area.

Strange as it may seem, ischemic colitis is similar in nature to coronary artery disease: Both conditions are caused by poor blood flow -- one in the colon and the other in the heart. Thus, some of the major risk factors for ischemic colitis are similar to those for heart disease: high blood pressure, smoking and high cholesterol. All of these factors lead to blockages in various blood vessels, including the coronary vessels in the heart, the vessels of the legs, the vessels in the neck leading to the brain, and the vessels in the abdomen leading to the intestine and colon. Other risk factors include diabetes (which accelerates blood-vessel disease), abnormal heart rhythms (which can dislodge blood clots from the heart, leading to blockage of the abdominal vessels) and certain medications, such as digoxin, which decrease blood flow to the intestine and colon.

Patients with ischemic colitis typically complain of painful abdominal cramps -- the colonic equivalent of heart-related chest pain, or angina. The attacks of pain are often accompanied by passage of blood from the rectum.

If a patient's symptoms and medical history point to ischemic colitis, a sigmoidoscopy or colonoscopy is done to examine the inner lining of the colon and to rule out other possible causes of bleeding. If ischemic colitis is present, deteriorating, ulcerated sections of colon are usually seen. A biopsy is also sometimes ordered to look for abnormalities that are consistent with poor blood flow.

Treatment for ischemic colitis is limited to therapy for the underlying cause, such as treating any heart disease or blood-vessel disease with appropriate medications or surgery. After that is done, the bleeding associated with ischemic colitis will usually stop spontaneously and the damage to the colon wall will heal in a matter of weeks. However, in some patients, the inflamed section of colon may heal with a scar and a stricture may form. Also, in rare cases, the inflamed section of colon perforates and emergency surgery is needed to remove the damaged area.