Definition

Ischemic colitis is a condition in which the inner layer of the colon wall experiences injury due to a lack of blood flow through the tiny vessel of the bowel.  The lining develops ulcerations and sloughs off, resulting in abdominal pain, diarrhea, and rectal bleeding.

Causes

This condition most commonly occurs in patients who have pre-existing vascular disease or in the setting of dehydration.  These patients may have narrowing or hypoperfusion of the arteries that bring blood to the bowel, resulting in bowel wall injury.

Symptoms

The symptoms of this condition include rectal bleeding, frequently passing blood clots with stools, diarrhea and abdominal pain. 

Diagnosis & Treatment

A CT scan aids the diagnosis and a sigmoidoscopy or colonoscopy will often be performed to assess the degree of damage to the bowel, or follow up a few weeks after treatment to evaluate for recovery.  Treatment consists of IV antibiotics, rehydrating the patient and treating the underlying cause of their ischemia.  In most cases, the bowel wall will heal if adequate blood flow is restored.  A patient may require an urgent operation to remove the injured segment of the colon if the full thickness of the bowel wall has developed injury.