Ischemic colitis is a condition that occurs when blood flow to the colon is reduced or blocked, leading to damage or death of the colon tissue. It is most common in older adults and is usually caused by a sudden decrease in blood flow to the colon, often due to a blood clot or constriction of the blood vessels supplying the colon.

Symptoms of ischemic colitis may include abdominal pain, cramping, and tenderness, bloody diarrhea, nausea, vomiting, and fever. The severity of symptoms can range from mild to severe, and in some cases, ischemic colitis can lead to life-threatening complications, such as sepsis or colon perforation.

Diagnosis of ischemic colitis may involve a combination of physical examination, blood tests, and imaging tests such as a CT scan or colonoscopy. Treatment may involve supportive care, such as fluid and electrolyte replacement, as well as medications to manage symptoms such as pain or diarrhea. In more severe cases, hospitalization and surgery may be required to remove damaged tissue or repair blood vessels.

Prevention of ischemic colitis may involve addressing risk factors such as smoking, hypertension, and high cholesterol, and managing underlying conditions such as diabetes or heart disease that can increase the risk of developing the condition.

Overall, ischemic colitis can be a serious condition that requires prompt medical attention to avoid complications. With appropriate treatment and management, most people with ischemic colitis can recover fully and avoid recurrence of the condition.

The precise cause of diminished blood flow to the colon isn't always clear. But several factors can increase your risk of ischemic colitis:

• Buildup of fatty deposits on the walls of an artery (atherosclerosis)
• Low blood pressure (hypotension) associated with dehydration, heart failure, surgery, trauma or shock
• Bowel obstruction caused by a hernia, scar tissue or a tumor
• Surgery involving the heart or blood vessels, or the digestive or gynecological systems
• Other medical disorders that affect your blood, such as inflammation of the blood vessels (vasculitis), lupus or sickle cell anemia
• Cocaine or methamphetamine use
• Colon cancer (rare)

The role of medications

The use of certain medicines also can lead to ischemic colitis, though this is rare. These medications include:

• Some heart and migraine medications
• Hormone medications, such as estrogen
• Antibiotics
• Pseudoephedrine
• Opioids
• Certain medications for irritable bowel syndrome
• Chemotherapy medications

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.

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:

• Antibiotics, to prevent infections
• Intravenous fluids, if you are dehydrated
• Treatment for any underlying medical condition, such as congestive heart failure or an irregular heartbeat
• Avoiding medications that constrict your blood vessels, such as migraine drugs, hormone medications and some heart drugs

Your doctor may also schedule follow-up colonoscopies to monitor healing and look for complications.

Surgery

If your symptoms are severe, or your colon has been damaged, you may need surgery to:

• Remove dead tissue
• Repair a hole in your colon
• Remove part of the colon that has narrowed because of scarring and is causing a blockage

The likelihood of surgery may be higher if you have an underlying condition, such as heart disease, atrial fibrillation or kidney failure.