Ischemic colitis occurs when blood flow to part of the large intestine (colon) is temporarily reduced, usually due to constriction of the blood vessels supplying the colon or lower flow of blood through the vessels due to low pressures. The diminished blood flow doesn't provide enough oxygen for the cells in your digestive system, which can result in tissue damage to the affected area of intestine.
Any part of the colon can be affected, but ischemic colitis most commonly causes pain on the left side of the belly area (abdomen).
Ischemic colitis can be misdiagnosed because it can easily be confused with other digestive problems. You may need medication to treat ischemic colitis or prevent infection, or you may need surgery if your colon has been damaged. Most often, however, ischemic colitis heals on its own.
Ischemic colitis occurs when blood flow to part of the large intestine is reduced. The condition can affect any part of the colon but is most common in the upper left segment.
Signs and symptoms of ischemic colitis can include:
The risk of severe complications is higher when you have symptoms on the right side of your abdomen. This is less commonly seen compared with left-sided colitis. People with right-sided colitis tend to have more underlying medical problems, such as high blood pressure, atrial fibrillation and kidney disease. They more frequently have to undergo surgery and also have a higher mortality risk.
Seek immediate medical care if you have sudden, severe abdominal pain. Abdominal pain that makes you so uncomfortable that you can't sit still or find a comfortable position is a medical emergency.
Contact your doctor if you develop worrisome signs and symptoms, such as bloody diarrhea. Early diagnosis and treatment can help prevent serious complications.
The precise cause of diminished blood flow to the colon isn't always clear. But several factors can increase your risk of ischemic colitis:
The use of certain medicines also can lead to ischemic colitis, though this is rare. These medications include:
Risk factors for ischemic colitis include:
Ischemic colitis usually gets better on its own within two to three days. In more-severe cases, complications can include:
Since the cause of ischemic colitis isn't always clear, there's no certain way to prevent the disorder. Most people who have ischemic colitis recover quickly and may never have another episode.
To prevent recurrent episodes of ischemic colitis, some doctors recommend eliminating any medication that might cause the condition. Making sure to stay adequately hydrated, especially when doing vigorous outdoor activities, is also important — especially for those living in warm climates. A test for clotting abnormalities may be recommended as well, especially if no other cause for ischemic colitis is apparent.
Ischemic colitis can often be confused with other disorders because their symptoms overlap, especially inflammatory bowel disease (IBD). Based on your signs and symptoms, your doctor may recommend these imaging tests:
Treatment for ischemic colitis depends on the severity of your condition.
Signs and symptoms often diminish in two to three days in mild cases. Your doctor may recommend:
Your doctor may also schedule follow-up colonoscopies to monitor healing and look for complications.
If your symptoms are severe, or your colon has been damaged, you may need surgery to:
The likelihood of surgery may be higher if you have an underlying condition, such as heart disease, atrial fibrillation or kidney failure.
Go to the emergency room if you have severe abdominal pain that makes you so uncomfortable that you can't sit still. You may be referred for immediate surgery to diagnose and treat your condition.
If your signs and symptoms are moderate and occasional, call your doctor for an appointment. After an initial evaluation, you may be referred to a doctor who specializes in digestive disorders (gastroenterologist) or blood vessel disorders (vascular surgeon).
Here's some information to help you get ready for your appointment, and what to expect from your doctor.
Your doctor is likely to ask you questions about your symptoms, such as: