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 Ischemic colitis - frightening but rarely serious

How is it that we can be confident as to a diagnosis of ischemic colitis just by hearing the story? Well, as with many cases in medicine, the diagnosis follows a well-defined set of symptoms in most patients — a sort of pattern recognition. The pattern that describes ischemic colitis is really quite typical...

Articles of Interest

Beyond Low Flow: How I Manage Ischemic Colitis

Colon ischemia (CI) is a common disease diagnosed in 16–24% of patients presenting to the hospital with acute lower gastrointestinal bleeding and accounting for ~16–18 per 100,000 hospital admissions. Indeed, it is the most common ischemic disorder of the GI tract, and it and infectious colitis are the most common colitides seen in patients older than 65 years of age.

How does ischemic colitis cause rectal bleeding?

So, I was reading about ischemic colitis and was curious as to the exact mechanism by which it can cause rectal bleeding. I checked Uptodate, harrisons, a couple of path books, and a couple of Databases (MD Consult, AccessMedicine) and I haven't found the answer.

Ischemic Colitis in an Endurance Runner

Ischemic colitis in endurance runners is characterized by frequent, loose bowel movements during or immediately after a run. “Runner’s diarrhea” is most common in long-distance or marathon runners. The cause of runner’s diarrhea is not clear. One theory is that extreme exercise directs blood flow away from the intestines—contributing to diarrhea.

Management of Ischemic Colitis

Ischemic colitis is a commonly misunderstood clinical condition. Although the colon is the most common region of ischemia in the gastrointestinal tract, many surgeons have difficulty with diagnosis and treatment of ischemic colitis.

Resources

Clinical Advisor

Ischemic colitis most commonly presents with the sudden onset of mild cramping abdominal pain and the urgent desire to defecate. The patient usually passes bright red or maroon blood per rectum with diarrhea within 24 hours of symptom onset.

Indian Journal of Surgery

Ischemic diseases of the gastrointestinal tract are some of the commonly encountered gastrointestinal diseases which are difficult to diagnose and still more difficult to treat. Presentation of colon ischemia is even more subtle, and this review article details about the various presentation patterns of ischemic colitis and their management.

MayoClinic.org

The condition can be misdiagnosed because it can easily be confused with other digestive problems. Ischemic colitis may heal on its own. But you may need medication to treat ischemic colitis or prevent infection, or you may need surgery if your colon has been damaged.

Patient.info

The presentation of the various types is similar, with moderate-to-severe colicky or constant and poorly localised pain. A striking feature is that the physical findings are out of proportion to the degree of pain and, in the early stages, there may be minimal or no tenderness and no signs of peritonitis.