Ischemic Colitis – Diagnosis and Treatment
Ischemic colitis occurs when parts of the colon do not receive enough blood, causing injury and symptoms that can range from mild to severe. Common signs include abdominal pain, diarrhea, rectal bleeding, and sometimes nausea or vomiting.
Some people may also notice a fever, constipation, or an acute abdomen, which means sudden, severe belly pain. Hematochezia, or passing blood through the rectum, often prompts people to seek medical help.
The causes of ischemic colitis can vary, but typically reduced blood flow to the colon leads to the condition. Reduced oxygen damages the colon’s lining.
Early recognition of symptoms helps doctors diagnose and treat the condition, as some cases can become serious if not addressed promptly.
Diagnosis
Doctors identify ischemic colitis (IC) through several steps to ensure they find the correct problem. They start with a physical exam and ask about a patient’s symptoms.
Blood tests, such as a complete blood count, check for signs like leukocytosis, which indicates infection or inflammation.
Key diagnostic tools include:
- Abdominal CT Scans: Doctors use these to spot swollen areas in the colon and rule out other diseases.
- Colonoscopy: This procedure provides direct images inside the colon, allowing doctors to see damage and take a small tissue sample (biopsy).
- Stool Analysis: This test checks for infections that can cause similar symptoms.
| Test | Purpose |
|---|---|
| CT Scan | Looks for colon problems |
| Colonoscopy | Direct view and biopsy |
| Blood Tests | Finds signs of inflammation |
| Stool Analysis | Rules out infections |
Treatment
Surgical Approaches
Surgeons operate when ischemic colitis causes severe damage, such as necrosis (tissue death), perforation, or severe infection (sepsis). They may perform emergency procedures if bowel infarction or gangrene develops.
Common surgical treatments include:
- Removing Damaged Sections: Surgeons take out parts of the colon with dead tissue or serious ulcerations.
- Repairing Holes in the Colon: Surgeons repair a tear or hole (perforation) in the colon lining immediately.
- Dealing with Narrowing: Surgeons remove areas with chronic scarring and narrowing to prevent blockage.
Surgeons may perform a laparotomy (open surgery) for direct access to the colon. After surgery, patients usually require hospitalization for close monitoring and management.
Providers may give additional treatment such as antibiotics, intravenous fluids, or even a blood transfusion, especially if the patient is in shock.
Individuals with underlying health problems like heart or kidney disease, or chronic conditions at the splenic flexure, face a higher likelihood of needing surgical intervention.
Getting Ready for Your Visit
Steps You Can Take Beforehand
Patients can take several steps to prepare for a doctor’s visit about possible ischemic colitis or similar stomach problems:
- Follow Pre-Visit Instructions: Doctors may instruct patients not to eat or drink after a certain time, especially if tests are planned. Often, this means no food after midnight.
- Keep Track of Symptoms: Record when symptoms started, what they feel like, and if they have changed over time.
- Bring Medical Information: Prepare a list of all health problems, allergies, and surgeries. Include past test results if available.
- List All Medicines: Make a record of all prescription and over-the-counter medicines, vitamins, or herbal supplements currently taken.
- Prepare Questions: Write down anything you want to ask the doctor. Bring this list to your appointment for reference.
- Review Diet and Risk Factors: Note if certain foods, drinks, or habits seem to affect your symptoms.
Table: Items to Bring
| Item | Example |
|---|---|
| List of all medications | Pills, injections, vitamins |
| Past medical records | Reports, test results |
| Symptom log | Dates, severity, changes |
| Notes on diet and routines | Foods eaten, beverages |
Important Topics to Discuss With Your Provider
Patients may want to ask:
- What might be causing my symptoms?
- What tests will I need, and what do they check for?
- Are there risks that make my problem worse?
- Are there side effects to the treatments or medicines I might take?
- If surgery is needed, what will the recovery look like?
- Will my diet or lifestyle have to change after treatment?
- What steps should I take for follow-up care?
- How can I best manage any other health issues I have at the same time?
Writing down these questions helps during the appointment. Bringing a family member or a friend can also help you remember the answers.
Information Your Healthcare Provider May Need
During the visit, the doctor will ask detailed questions about the patient’s health and symptoms. Clear, honest answers help doctors plan diagnosis and treatment.
Common topics the provider may ask about include:
- When and how symptoms started.
- How often symptoms occur and how severe they are.
- Where pain or discomfort is located.
- Whether anything (like certain foods or activities) makes symptoms better or worse.
- Personal or family history of blood vessel, stomach, or colon problems.
- Current diet, habits, and known risk factors (for example, smoking or certain medicines).
Doctors use this information to suggest tests or treatments. They will also discuss possible side effects and help plan any changes needed in diet or lifestyle.
