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Ischemic Bowel Disease

(Ischemic Colitis)

Definition

Ischemic bowel disease is a lack of blood flow to the bowel (intestine). It needs care right away.

The Intestines

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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:

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