Ischemic Bowel Disease
(Ischemic Colitis)
Definition
Ischemic bowel disease is a lack of blood flow to the bowel (intestine). It needs care right away.
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Causes
This problem happens when an artery that supplies blood becomes blocked or narrowed. Causes may be:
- Blockage in the arteries due to a tumor or blood clot
- Narrowing of an artery from atherosclerosis
- Obstruction in the colon
- Low blood pressure
- Certain medicines, such as diuretics, chemotherapy drugs, or nonsteroidal anti-inflammatory drugs (NSAIDs)
Risk Factors
This problem is more common in older adults. Other things that may raise the risk are:
- Shock from health problems, such as a blood stream infection or blood loss
- Recent heart attack
- Long term heart arrhythmias
- Heart failure
- Peripheral artery disease (PAD)
- Coronary artery bypass surgery (CABG) or other blood vessel surgeries
- Colon cancer
- Certain medicines that cause arteries to narrow
- Diabetes
- Hemodialysis
- Sickle cell disease
- Dehydration
- Pregnancy
Symptoms
Problems can range from mild to severe. It depends on how much damage has been done. Problems may be:
- Cramping and belly pain
- Belly swelling
- Frequent need to pass stool
- Loose stools
- Bloody stools
- Nausea and vomiting
Diagnosis
The doctor will ask about your symptoms and health history. A physical exam will be done.
Blood and stool tests may be taken.
Abdominal images may be taken. This can be done with:
A colonoscopy may be done. A long, flexible tube will be inserted through the rectum to inspect the intestines.
Treatment
Care is needed right away. The goal of treatment is to restore blood flow to the bowel. Choices are:
- Supportive care, such as IV fluids to rest the bowel
- Antibiotics to lower the risk of infection
People who are not helped by these methods may need surgery. It can remove the diseased part of the bowel.
Prevention
There are no known guidelines to prevent this health problem.
RESOURCES:
American College of Gastroenterology
http://gi.org
American Society for Gastrointestinal Endoscopy
https://www.asge.org
CANADIAN RESOURCES:
Canadian Association of Gastroenterology
https://www.cag-acg.org
HealthLink BC
https://www.healthlinkbc.ca
REFERENCES:
Brandt LJ, Feuerstadt P, et al; American College of Gastroenterology. ACG clinical guideline: epidemiology, risk factors, patterns of presentation, diagnosis, and management of colon ischemia (CI). Am J Gastroenterol. 2015 Jan;110(1):18-44; quiz 45.
Colon ischemia. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/colon-ischemia. Accessed February 10, 2021.
Last reviewed December 2020 by EBSCO Medical Review Board James P. Cornell, MD Last Updated: 2/10/2021