Causes and risk factors
The exact cause is unknown. Ischemic colitis can be occlusive or non occlusive. Occlusive is cause due to a blood clot which cuts off the blood supply to the colon. Non occlusive is due to low blood pressure or constriction of vessels supplying the colon. It is usually asymptomatic. Ischemia is caused due to many conditions like atherosclerosis, low blood pressure associated with heart disease, trauma, shock, thrombosis, intestinal obstruction, colon cancer; medical conditions like SLE, Vasculitis, inflammatory bowel disease and sickle cell anaemia are also associated with ischemic colitis. Certain medications like antibiotics, NSAIDs, hormonal medications, chemotherapy can also cause ischemic colitis.
Clinical presentation
Patient presents with pain, tenderness or cramping in abdomen, pain in the abdomen after eating, vomiting, an urgent need to defecate, diarrhoea, blood in stools.
Investigation
Medical history by the patient and Clinical examination by the doctor helps in diagnosis. Routine blood tests and stool examination are recommended. Imaging studies such as USG abdomen, colour Doppler, CT scan are useful for further evaluation. MR angiography can be done in some cases.
Treatment
Treatment of underlying cause is essential. Further treatment involves administration of antibiotics, analgesics. Administration of IV fluids may be required to treat dehydration. Acute ischemic colitis is a medical emergency and needs hospitalisation. Thrombolytics, vasodilators are used. In severe cases surgical intervention in needed. Blood transfusion and iron supplement will also help in managing the condition. Surgical correction is required in severe cases which involves removal of dead tissues or bowel resection i.e. removal of affected part of colon.