Ischemic Colitis – Symptoms and Causes
Overview
Ischemic colitis occurs when blood flow to the colon decreases temporarily. This reduction in blood flow means the cells in the large intestine don’t receive enough oxygen, which can lead to tissue damage and inflammation. The condition may result from narrowed blood vessels or low blood pressure.
While ischemic colitis can affect any part of the colon, it typically causes pain on the left side of the abdomen.
The condition can be challenging to diagnose because its symptoms often resemble other digestive disorders.
Most cases of ischemic colitis resolve on their own without specific treatment. However, some patients may need:
- Medications to treat the condition
- Antibiotics to prevent infection
- Surgical intervention if colon damage is severe
Common causes of reduced blood flow:
- Narrowed blood vessels
- Low blood pressure
- Blood clots
- Certain medications
Doctors must carefully evaluate symptoms since ischemic colitis shares similarities with many other digestive problems.
Symptoms
Ischemic colitis can cause several noticeable symptoms in your body. You might experience pain, tenderness, or cramping in your abdomen that develops either quickly or gradually over time.
Many people notice bright red or maroon-colored blood in their stool, or sometimes pass blood without any stool. You may feel an urgent need to use the bathroom, have diarrhea, or experience nausea.
Symptoms that occur on the right side of the abdomen can indicate a more serious situation. Right-sided colitis is less common than left-sided colitis.
People with right-sided symptoms often have other health conditions like high blood pressure, atrial fibrillation, or kidney disease.
When to Get Medical Help
Seek emergency medical attention if you experience sudden, severe abdominal pain. If you’re unable to sit still or find a comfortable position because of the pain, this is considered a medical emergency and requires immediate care.
Contact a healthcare provider if you notice concerning symptoms like bloody diarrhea. Getting diagnosed and treated early can help prevent serious complications from developing.
Causes
Ischemic colitis occurs when blood flow to the colon decreases. While the exact cause isn’t always clear, several risk factors can contribute to this condition. These include:
- Atherosclerosis (fatty deposits building up on artery walls)
- Hypotension (low blood pressure), often related to dehydration, heart failure, or shock
- Bowel blockages from hernias, scar tissue, or tumors
- Recent surgery involving blood vessels or digestive organs
- Blood disorders like lupus or sickle cell anemia
- Vasculitis (blood vessel inflammation)
- Use of illicit substances such as cocaine or methamphetamine
More rarely, colon cancer may play a role in developing this condition.
Medications That May Cause Issues
Some medications can increase the risk of developing ischemic colitis, though this happens infrequently. Medications that might contribute include:
| Medication Type | Examples |
|---|---|
| Heart and migraine drugs | Various types |
| Hormone treatments | Estrogen and birth control |
| Antimicrobial drugs | Various antibiotics |
| Decongestants | Pseudoephedrine |
| Pain medications | Opioids |
| Gastrointestinal drugs | Some IBS medications |
| Cancer treatments | Certain chemotherapy drugs |
Illicit drugs, particularly cocaine and methamphetamines, can also trigger this condition.
Risk Factors
Several factors can increase your chances of developing ischemic colitis:
Age and Sex
- People over 60 years old face a higher risk
- Women develop this condition more frequently than men
Blood-Related Issues
- Blood clotting disorders (like factor V Leiden)
- Sickle cell disease
- High cholesterol leading to atherosclerosis
Reduced Blood Flow Conditions
- Heart failure
- Low blood pressure
- Diabetes
- Rheumatoid arthritis
Other Risk Factors
| Factor | How It Affects Risk |
|---|---|
| Previous abdominal surgery | Scar tissue may restrict blood flow |
| Intense exercise | Marathon running can divert blood away from the colon |
| Certain surgical procedures | Operations on the heart, digestive, or reproductive systems |
Young adults who develop ischemic colitis might have an underlying blood-clotting problem or blood vessel inflammation (vasculitis).
Complications
Ischemic colitis typically resolves within 2-3 days, but severe cases may lead to serious problems. These complications include:
- Tissue death (gangrene) from reduced blood flow to the colon.
- Intestinal perforation where holes form in the colon wall.
- Bowel blockage (ischemic stricture) causing obstruction.
These complications require immediate medical attention and may need surgical intervention.
Prevention
There is no guaranteed way to prevent ischemic colitis since the exact cause isn’t always clear. Most people recover quickly and don’t experience it again.
If you’ve had ischemic colitis, healthcare providers might suggest:
- Stopping medications that could trigger the condition
- Staying well-hydrated, especially during outdoor activities
- Being extra careful about hydration in warm climates
For cases without an obvious cause, doctors may recommend testing for blood clotting disorders that could contribute to the problem.
If you’ve experienced symptoms before, make sure to follow your doctor’s specific recommendations to reduce your risk of future episodes.
