Causes, incidence, and risk factors: Interference with blood flow to the colon is the cause of ischemic colitis. It affects people over 50, and many have a history of peripheral vascular disease. Other risk factors include use of oral contraceptives; previous aortic surgery with inadvertent damage to the artery supplying the colon; history of stroke; history of low blood pressure; and abdominal radiation exposure. The incidence is 3 out of 10,000 people.

Prevention: Awareness of risk may allow early diagnosis and treatment. Absolute prevention may not be possible.

Symptoms: severe abdominal pain, fever, vomiting, bright red blood via the rectum (blood in the stool), diarrhea, and back pain, low.

Signs and tests: colonoscopy with biopsy that shows intestinal ischemia and angiography that shows a vascular (blood vessel) lesion.

Treatment: No treatment is needed for mild transient ischemia. Chronic ischemia leading to stricture formation is treated by resection (surgical removal) of the stricture. Severe ischemia leading to gangrene is treated with replacement of blood volume, antibiotics, and resection of the affected bowel.

Expectations (prognosis): The death rate is high when gangrene occurs as a result of inadequate blood supply.

Complications: gangrene of the bowel and sepsis.

Last updated May 25, 1999

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