Materiały źródłowe

• #1 Ischemic colitis – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/ischemic-colitis/symptoms-causes/syc-20374001

  Ischemic colitis happens when blood flow to part of the large intestine, called the colon, is reduced. The condition can affect any part of the colon but is most common in the upper left segment. […] Ischemic colitis most commonly causes pain on the left side of the belly area. […] Symptoms of ischemic colitis can include: Pain, tenderness or cramping in the belly, which can happen suddenly or happen over time. Bright red or maroon blood in the stool or, at times, passage of blood alone without stool. A feeling of urgency to move the bowels. Diarrhea. Nausea. […] The risk of serious complications is higher when symptoms happen on the right side of the belly. This is less commonly seen compared with left-sided colitis. People with right-sided colitis tend to have more underlying medical conditions, such as high blood pressure, atrial fibrillation and kidney disease. They more often have to undergo surgery and also have a higher risk of death.

• #2 Ischemic Colitis: Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/24513-ischemic-colitis

  Ischemic colitis is inflammation in your colon thats caused by ischemia, which means reduced blood flow. Inflammation causes temporary discomfort, but it clears up on its own when the cause of the ischemia resolves. […] For most people, its a temporary problem affecting only a small part of your large bowel (colon). […] Some people have repeat or chronic episodes of ischemic colitis in one area, which can cause scarring that narrows the colon (stricture). And if ischemia is severe enough, it can cause tissue death (gangrene). This raises the risk of life-threatening complications, such as perforation (a hole), infection and sepsis, and it requires emergency surgery to fix. […] You might have: Abdominal pain and cramping. Abdominal swelling and tenderness. Diarrhea and urgency to poop. Bloody poop. Low fever. Nausea or loss of appetite. […] Most people with acute ischemic colitis (75%) have a relatively mild and transient case that affects only the mucous lining in one segment. Most will recover fully with conservative treatment. A smaller percentage of people have a more complicated case that requires surgery.

• #3 Ischemic Colitis: Symptoms, Causes, Diagnosis, Treatment

  https://www.webmd.com/ibd-crohns-disease/ulcerative-colitis/facts-about-ischemic-colitis

  Ischemic colitis is the most common type of blood flow blockage in your intestines. Most cases are mild, but serious complications are possible. The most common symptoms of ischemic colitis are: Abdominal pain, usually on your left side (often described as cramping pain), Bloody poop, but not severe, Diarrhea. You may also have: An urgent need to poop, often during cramping, Nausea, Lack of appetite, Low fevers, less than 100 F, Swollen belly, Severe abdominal pain on your right side, often with rectal bleeding (right-side pain is often linked to worse outcomes), Vomiting. Most people with ischemic colitis have mild cases and recover well with treatment. About 15% of people with ischemic colitis can develop complications, which can turn fatal. Most cases of ischemic colitis are mild. But 10%-20% of people develop complications such as gangrene and colonic necrosis, or tissue death. You can also develop a perforation or tear in your colon. When this happens, you’ll need surgery to repair your bowel or remove the dead tissue. While medical management of ischemic colitis is linked to a 6% chance of death, surgical intervention — needed for more serious cases — is linked to a 40% chance of death. If you have ischemic colitis along with pain on your right side, or sudden belly pain that’s so severe you can’t find a comfortable position, head to the ER or call 911.

• #4 Ischemic Colitis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2780155/

  Ischemic colitis is the most common form of gastrointestinal ischemia. Most commonly, patients develop abdominal discomfort and bloody diarrhea. Diagnosis is confirmed with colonoscopy. Treatment is contingent on the severity of disease: mucosal/nongangrenous ischemia requires only supportive measures and medical management, whereas transmural/gangrenous ischemia may require prompt surgical intervention. Ischemic colitis can also become a chronic process with persistent segmental colitis or colonic stricturing. The patient’s outcome depends on the severity of disease, prompt recognition, and appropriate treatment. […] Despite variable causes, patients with colonic ischemia tend to present similarly. Patients typically complain of the sudden onset of crampy, mild abdominal pain. In fact, abdominal pain is one of the most commonly associated symptoms and is present in two thirds of all patients. Abdominal pain is soon followed by an urge to defecate and subsequent passage of either bright red blood or maroon blood mixed with stool, typically within 24 hours of onset.

• #5 Ischemic Colitis – Digestive Disorders – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/digestive-disorders/gastrointestinal-emergencies/ischemic-colitis

  Abdominal pain and bloody stools are common. […] Usually, the person has abdominal pain. The pain is felt more often on the left side, but it can occur anywhere in the abdomen. […] The person frequently passes loose stools that are often accompanied by dark red clots. Sometimes bright red blood is passed without stool. […] Low fevers (usually below 100 F [37.7 C]) are common. […] Nearly all people with ischemic colitis improve and recover over a period of 1 to 2 weeks. However, when the interruption to the blood supply is more severe or more prolonged, the affected portion of the large intestine may have to be surgically removed. […] Occasionally, people get better but later on develop scar tissue in the affected area.

• #6 Treat the Early Signs of Ischemic Colitis to Protect Your Overall Health | Colon & Rectal Surgical Specialists

  https://www.crssny.com/conditions/ischemic-colitis/

  Ischemic colitis can cause abdominal cramping, nausea, and diarrhea. […] Common side effects can include: Radiating abdominal pain and cramping, especially after eating, Pressing and reoccurring need to have a bowel movement, Loose stools, Diarrhea, Nausea and vomiting, Bloody stool with dark red clots, Fever. […] Because symptoms of ischemic colitis can often be confused with other digestive issues and inflammatory bowel diseases, it is vital to schedule an appointment with a colorectal specialist if you experience signs or discomfort. […] When ischemic colitis is caught early, most patients can expect a full recovery after undergoing treatment.

• #7 Ischemic Colitis: Symptoms, Causes, and Treatment

  https://resources.healthgrades.com/right-care/digestive-health/ischemic-colitis

  Ischemic colitis is a type of swelling and injury in your large intestine. Symptoms can include bloody diarrhea and stomach pain. […] Ischemic colitis symptoms can develop suddenly or over time. Symptoms of ischemic colitis include: passing blood in stool or without having a bowel movement, bloody diarrhea, dehydration due to diarrhea, abdominal pain or cramping, hypoperfusion, or decreased circulation, which can lead to shock, bloating or a swollen, tight feeling in your abdomen, difficulty breathing, vomiting, fever, changes in mental status, such as confusion, lack of responsiveness, or fainting. […] In some cases, ischemic colitis can lead to death. However, many people recover. […] Still, ischemic colitis can come back. Factors that may link to a less favorable outcome include having ischemic colitis on the right side of your colon and needing surgery for ischemic colitis.

• #8 Ischemic colitis – Wikipedia

  https://en.wikipedia.org/wiki/Ischemic_colitis

  Ischemic colitis is usually suspected on the basis of the clinical setting, physical examination, and laboratory test results; the diagnosis can be confirmed by endoscopy or by using sigmoid or endoscopic placement of a visible light spectroscopic catheter. […] Ischemic colitis can span a wide spectrum of severity; most patients are treated supportively and recover fully, while a minority with very severe ischemia may develop sepsis and become critically, sometimes fatally, ill. […] Symptoms of ischemic colitis vary depending on the severity of the ischemia. The most common early signs of ischemic colitis include abdominal pain (often left-sided), with mild to moderate amounts of rectal bleeding. […] Three progressive phases of ischemic colitis have been described: A hyperactive phase occurs first, in which the primary symptoms are severe abdominal pain and the passage of bloody stools. Many patients get better and do not progress beyond this phase. A paralytic phase can follow if ischemia continues; in this phase, the abdominal pain becomes more widespread, the belly becomes more tender to the touch, and bowel motility decreases, resulting in abdominal bloating, no further bloody stools, and absent bowel sounds on exam. Finally, a shock phase can develop as fluids start to leak through the damaged colon lining. This can result in shock and metabolic acidosis with dehydration, low blood pressure, rapid heart rate, and confusion. Patients who progress to this phase are often critically ill and require intensive care.

• #9 Ischemic Colitis | Enhanced Dental CPD Online

  https://www.dentaljuce.com/shorts-ischemic-colitis

  Three progressive phases of ischaemic colitis have been identified: […] Hyperactive Phase: Characterised by severe abdominal pain and the passage of bloody stools. Many patients recover and do not progress beyond this phase. […] Common early signs include left-sided abdominal pain and mild to moderate rectal bleeding. Other findings among patients include abdominal pain (78%), lower gastrointestinal bleeding (62%), diarrhoea (38%), and fever (34%). […] Shock Phase: Fluids leak through the damaged colon lining, leading to shock and metabolic acidosis with dehydration, low blood pressure, rapid heart rate, and confusion. Patients are often critically ill in this phase and require intensive care. […] Most patients recover fully, though the prognosis depends on the ischaemia’s severity. Non-gangrenous ischaemic colitis has a mortality rate of approximately 6%. In contrast, gangrenous colitis has a higher mortality rate of 50-75% with surgical treatment. […] Approximately 20% of patients may develop chronic ischaemic colitis, treated with surgical removal of the diseased bowel portion.

• #10 Identifying Ischemic Colitis Symptoms | Colon & Rectal Surgical Specialists

  https://www.crssny.com/identifying-ischemic-colitis-symptoms/

  Ischemic colitis is a potentially painful condition that occurs as a result of decreased oxygen in the digestive system. This deprivation of oxygen is directly caused by reduced blood flow to the colon, often due to narrowed or blocked arteries. […] Unfortunately, ischemic colitis usually causes varying degrees of discomfort, and can occur gradually or rapidly. This condition can be indicated by: Abdominal pain, tenderness, or cramping, Blood in your stool, Passage of blood, Diarrhea, Fever, Nausea or vomiting, Reoccurring need for a bowel movement. […] Typically, ischemic colitis causes pain and discomfort on the left side of the abdomen. Patients who experience symptoms on the right side of the abdomen are at higher risk of complications. […] If left untreated, ischemic colitis can lead to several complications. These include: Obstruction of the bowels, Inflammation, Persistent intestinal bleeding, Perforation of the intestines.

• #11 Ischemic Colitis: ED Presentations, Evaluation, and Management – emDocs

  https://www.emdocs.net/ischemic-colitis-ed-presentations-evaluation-and-management/

  Most episodes of IC will resolve spontaneously without specific therapy. However, several factors have been associated with more severe disease and a poorer outcome. Factors indicating severe disease include: male gender, hypotension, tachycardia, abdominal pain without rectal bleeding, BUN >20 mg/dl, Hgb <12 g/dl, LDH >350 U/I, serum sodium <136 mEq/l, WBC >15 cells/cmm with the higher odds ratio associated with increased requirement for surgery and/or mortality. Patients with IC should be admitted for optimization of underlying medical conditions as well as a colonoscopy to confirm the diagnosis. […] Isolated right colon ischemia (IRCI) is associated with much poorer outcomes and significant mortality. Patients with IRCI are five times more likely to need surgical intervention and have a twofold increased mortality.

• #12 Gangrenous ischemic colitis localized to the cecum: a case report | Surgical Case Reports | Full Text

  https://surgicalcasereports.springeropen.com/articles/10.1186/s40792-023-01587-x

  Ischemic colitis affects the left colon in elderly individuals and localization on the right side, especially in the cecum, is rare. […] The manifestations of right-sided ischemic colitis include lower right abdominal pain, vomiting, and loss of appetite. These symptoms closely resemble those of appendicitis, encumbering accurate diagnosis. […] The symptomatic presentation and disease course of ischemic colitis of the right colon differ from those of ischemic colitis of the left colon, and the former often requires surgery. […] In ischemic colitis of the left colon, constipation often triggers ischemia, resulting in bloody diarrhea. Ischemic colitis in the right colon rarely presents with bloody diarrhea; however, vomiting, diarrhea, and right abdominal pain are typical manifestations.

• #13 Gangrenous ischemic colitis localized to the cecum: a case report | Surgical Case Reports | Full Text

  https://surgicalcasereports.springeropen.com/articles/10.1186/s40792-023-01587-x

  The duration of hospitalization was longer (median length of stay, 10 days vs 6 days), and the frequency of surgery (44.3% vs 11.5%) and mortality rate were higher in patients with right-sided colonic involvement compared to those with left-sided colonic involvement. […] Therefore, right-sided ischemic colitis requires more careful treatment, including surgical intervention. […] Studies have reported a relationship between chronic renal failure or hemodialysis and ischemic colitis. […] Therefore, it is worth noting that hemodialysis patients could develop right-side ischemic colitis and may be prone to serious disease. […] This patient had multiple arteriosclerosis comorbidities, such as hypertension, dyslipidemia, and diabetic nephropathy. We postulated that the hemodynamic changes attributable to hemodialysis were responsible for gangrenous ischemic colitis of the cecum, which is anatomically prone to ischemia. […] It is important to consider the possibility of ischemic colitis of the right colon in cases of renal failure requiring dialysis, to ensure that opportunities for surgical intervention are not missed.

• #14 Ischemic Colitis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2780155/

  In most cases of ischemic colitis, the signs and symptoms of disease disappear within 24 to 48 hours. The submucosal and intramural hemorrhages are reabsorbed, and complete clinical and radiologic resolution occurs within 1 to 2 weeks, after which time no further therapy is required. More severe initial ischemic insults may result in necrosis of the overlying mucosa, resulting in a subsequent segmental ulcerating colitis.

• #15 A Beginner’s Guide to Ischemic Colitis: Symptoms, Treatment and Diet | Diet vs Disease

  https://www.dietvsdisease.org/ischemic-colitis-symptoms-treatment-diet/

  In most cases, however, symptoms should cease within two to three days. […] IC most often occurs in people over 60 years old, particularly those with underlying conditions like atherosclerosis, low blood pressure, IBS, blood clots or diabetes. The most common symptoms include abdominal pain and cramping and loose and bloody stools. Symptoms should typically go away within a few days. […] Treatment for IC typically includes a round of antibiotics, IV fluids and a liquid diet. […] For mild IC, some people may not even require any medical attention, but in severe cases, surgery is necessary if the lack of blood flow leads to tissue death in the colon. […] Overall, IC is most often a temporary condition that can resolve within a few days. […] Unlike other forms of inflammatory bowel disease or colitis, IC is typically short-term. It can, however, turn into a chronic problem if a buildup of plaque in the arteries (atherosclerosis) worsens.

• #16 Ischemic colitis – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/ischemic-colitis/symptoms-causes/syc-20374001

  Ischemic colitis usually gets better on its own within 2 to 3 days. In more-serious cases, complications can include: Tissue death, also called gangrene, resulting from diminished blood flow. Hole formation, also known as perforation, in the intestine or persistent bleeding. Bowel obstruction, also called ischemic stricture.

• #17 Factors influencing hospital stay duration for patients with mild ischemic colitis: a retrospective study | European Journal of Medical Research | Full Text

  https://eurjmedres.biomedcentral.com/articles/10.1186/s40001-022-00665-4

  Ischemic colitis is the most prevalent ischemic injury of the gastrointestinal tract. The majority of patients with mild ischemic colitis usually achieve complete clinical recovery shortly. […] More than three-fourths of IC cases are the milder, nongangrenous form; however, IC can progress to necrosis with a risk of mortality up to 50%. […] Symptoms typically resolve within 2-3 days, with the colon completely healing within 12 weeks. […] The duration of symptoms in patients with IC is difficult to ascertain, considering the usual mild and benign course of the disease. The evolution of IC is significantly determined by the degree of ischemic damage to the colonic wall. Most patients show a good response to conservative treatment; their symptoms are expected to improve within 2-3 days, and complete clinical recovery is typically achieved within 2 weeks, with mucosal regeneration and healing occurring simultaneously. […] The length of hospital stay of patients with higher d-dimer levels or positive FOBT results was significantly longer than that of patients with lower d-dimer levels or negative FOBT results. […] Probiotic use helped shorten the hospital stay duration for the patients.

• #18 Types of Colitis: Symptoms, Causes, and Treatment

  https://www.verywellhealth.com/types-of-colitis-5198817

  If blood flow to the large intestine is blocked or slowed down, it can cause ischemic colitis. This can happen for many reasons, a few of which are high cholesterol, blood clots, surgery, or the use of cocaine or methamphetamine. This condition can occur in people of any age but is most common in those over age 60. […] Ischemic colitis can come on suddenly, but more often the condition develops over a period of time. In milder cases, treatment in the hospital might include antibiotics, a liquid diet, intravenous fluids, and pain management. […] Medications that treat blood clots may also be used. For severe cases, surgery on the colon to remove any tissue that has died might be needed.

• #19 Ischemic Colitis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4442720/

  Most clinicians associate ischemic colitis with elderly patients who have underlying cardiovascular comorbidities. […] The classic presentation of ischemic colitis is an elderly patient presenting with bloody bowel movements, abdominal pain, and leukocytosis. Patients typically present with the acute onset of crampy abdominal pain and usually pass blood mixed with stool within 24 hours. […] Ischemic colitis is typically associated with abdominal pain and blood in the stool. […] Acute ischemic colitis usually resolves with medical care but morbidity and mortality rates remain high for patients requiring surgery. A recent meta-analysis revealed that 80.3% of the patients were managed medically with a mortality rate of 6.2%. Surgery was associated with a 39.3% mortality rate. […] The long-term prognosis for these patients is more favorable. A retrospective review of 135 patients with ischemic colitis reported that recurrence rates were 2.9 and 9.7% at 1 and 5 years, respectively. Five-year survival was 69%, but most patients died because of other causes.

• #20 Ischemic colitis | Health Library | Memorial Health System

  https://www.mhsystem.org/health-library/con-20373984/

  Ischemic colitis can be hard to diagnose because it can easily be confused with other digestive problems. […] Symptoms of ischemic colitis can include: Pain, tenderness or cramping in the belly, which can happen suddenly or happen over time. Bright red or maroon blood in the stool or, at times, passage of blood alone without stool. A feeling of urgency to move the bowels. Diarrhea. Nausea. […] The risk of serious complications is higher when symptoms happen on the right side of the belly. This is less commonly seen compared with left-sided colitis. People with right-sided colitis tend to have more underlying medical conditions, such as high blood pressure, atrial fibrillation and kidney disease. They more often have to undergo surgery and also have a higher risk of death. […] Ischemic colitis usually gets better on its own within 2 to 3 days. In more-serious cases, complications can include: Tissue death, also called gangrene, resulting from diminished blood flow. Hole formation, also known as perforation, in the intestine or persistent bleeding. Bowel obstruction, also called ischemic stricture.

• #21 Ischemic colitis | Beacon Health System

  https://www.beaconhealthsystem.org/library/diseases-and-conditions/ischemic-colitis?content_id=CON-20373984

  Ischemic colitis can be hard to diagnose because it can easily be confused with other digestive problems. […] Symptoms of ischemic colitis can include: Pain, tenderness or cramping in the belly, which can happen suddenly or happen over time. […] The risk of serious complications is higher when symptoms happen on the right side of the belly. […] Ischemic colitis usually gets better on its own within 2 to 3 days. In more-serious cases, complications can include: Tissue death, also called gangrene, resulting from diminished blood flow. […] If symptoms are serious, or the colon has been damaged, surgery may be needed to: Remove dead tissue.

• #22 Caregiving Network Blog | Foods to Avoid with Ischemic Colitis: A Comprehensive Guide – Caregiving Network Blog

  https://caregivingnetwork.com/blog/reading-room/foods-to-avoid-with-ischemic-colitis-a-comprehensive-guide/?post_type=reading-room

  Ischemic colitis occurs when there is a significant reduction in blood flow to the colon, leading to inflammation and a host of symptoms. […] Symptoms can range from mild abdominal pain and discomfort to severe issues like diarrhea and bloody stools. If not managed effectively, the condition can lead to severe complications, including tissue death and life-threatening infections like sepsis. […] A diet low in fiber can lead to constipation, which can exacerbate the symptoms of ischemic colitis. On the other hand, a high-fiber diet can aid in digestion and alleviate symptoms. […] Staying well-hydrated is crucial for anyone, especially those dealing with ischemic colitis. Proper hydration aids in digestion and can help prevent complications. […] Balanced, well-portioned meals can provide nutrients without overloading the digestive system. This is especially important for managing symptoms effectively. […] Regular check-ins with a healthcare provider can help adapt your diet for elderly individuals or anyone affected by ischemic colitis. This is crucial for effective long-term management.

• #23 Ischemic colitis – Wikipedia

  https://en.wikipedia.org/wiki/Ischemic_colitis

  About 20% of patients with acute ischemic colitis may develop a long-term complication known as chronic ischemic colitis. Symptoms can include recurrent infections, bloody diarrhea, weight loss, and chronic abdominal pain. Chronic ischemic colitis is often treated with surgical removal of the chronically diseased portion of the bowel.

• #24 A Beginner’s Guide to Ischemic Colitis: Symptoms, Treatment and Diet | Diet vs Disease

  https://www.dietvsdisease.org/ischemic-colitis-symptoms-treatment-diet/

  Ischemic colitis is one of these conditions, and its often confused with other inflammatory bowel diseases. […] Most often symptoms are short-term, but about 20% of patients will develop chronic IC that may require surgery. […] Acute ischemic colitis involves sudden and serious abdominal pain; in this case, immediate medical attention and surgery is necessary. […] The most common symptom of IC involves abdominal pain and cramping, often on the left side of the abdomen. […] You may also experience: Loose and bloody stools, and sometimes only blood with no stool (if bleeding occurs in excessive amounts, it may be another condition like Crohns or colon cancer). […] If youre experiencing severe and sudden pain on the right side of your abdomen, this could indicate a more serious problem that may also involve blockage to your small intestine.

• #25 Ischemic colitis: Causes, symptoms, and treatment

  https://www.medicalnewstoday.com/articles/322162

  Ischemic colitis occurs when there is not enough blood flowing to the colon or large intestine. It can lead to stomach cramps and pain. […] Symptoms of ischemic colitis include pain, tenderness, and digestive problems. It is often mistaken for inflammatory bowel disease (IBD) or other gastrointestinal issues. […] The most typical symptom of ischemic colitis is stomach cramping and pain. The pain may be mild or moderate, and it often occurs suddenly. Typically, pain occurs on the left side of the abdomen. […] Other symptoms of ischemic colitis include stomach pain after meals, tenderness in the stomach, an urgent need to pass stool, bloating, lightheadedness, diarrhea, vomiting, nausea, and fever. […] The risk of complications is higher when symptoms develop on the right side of the stomach, and pain in this area may be more severe as well. Pain on the right side suggests a blockage in the arteries leading to the small intestine as well as the colon.

• #26 Ischemic Colitis: ED Presentations, Evaluation, and Management – emDocs

  https://www.emdocs.net/ischemic-colitis-ed-presentations-evaluation-and-management/

  Ischemic colitis (IC) is the underlying etiology in 16-24% of acute lower gastrointestinal bleeds (LGIBs). As individuals with IC often present with non-specific symptoms, approximately 80% of cases are missed during the initial patient encounter. In the ED, IC is correctly diagnosed in only 9% of the cases (when compared to final inpatient diagnoses). With a 10-15% mortality rate and increasing incidence in the U.S., IC is a diagnosis that should not be missed. […] Symptoms usually include acute abdominal pain, mild rectal bleeding, and diarrhea. In cases of isolated right colon ischemia, patients often present with abdominal pain in the absence of hematochezia or melena. Abdominal pain was one of the clinical features in approximately 87% of patients with IC. While rectal bleeding was present in 84% and diarrhea in 57% according to a study that retrospectively analyzed hospital stays of patients who were discharged with International Classification of Diseases codes that were consistent with IC. Both abdominal pain and rectal bleeding occurred in 72% of the hospitalizations analyzed. The differential diagnosis for abdominal pain and bloody diarrhea is broad with infection, diverticulosis, hemorrhoids, neoplasia, inflammatory bowel disease, and vascular ectasia all representing causes of LGIB. Distinguishing between these conditions based upon history, physical exam, laboratory testing, and imaging is frequently necessary.

• #27 Ulcerative Colitis vs. Ischemic Colitis: 5 Differences To Know | MyCrohnsAndColitisTeam

  https://www.mycrohnsandcolitisteam.com/resources/ulcerative-colitis-vs-ischemic-colitis-differences-to-know

  Ulcerative colitis and ischemic colitis both cause inflammation and damage to the colon. This can cause a host of GI problems and symptoms like abdominal pain or cramping, diarrhea, and blood in the feces. […] Ischemic colitis, on the other hand, is an acute condition. This means its a short-term disease that comes on suddenly. For most people with IC, symptoms go away after a couple of days and never return. […] The inflammation and tissue damage caused by ulcerative colitis and ischemic colitis can lead to several long-term complications. Both diseases can increase the risk of perforation (holes) in the large intestine. […] Some severe cases of IC may cause serious problems like gangrene of the colon. With gangrene, the tissue starts to die because of a lack of blood supply. IC can also cause ischemic stricture (a bowel obstruction) that prevents the large intestine from working properly.

• #28 Bowel Ischaemia | Doctor

  https://patient.info/doctor/bowel-ischaemia

  Ischaemic colitis symptoms may be difficult to diagnose, with nonspecific symptoms of an 'acute abdomen’, such as acute-onset abdominal pain. […] The pain is most frequently located in the left iliac fossa. Nausea and vomiting often occur and, in the later stages, loose motion containing dark blood. Marked tenderness may be found in the left iliac fossa but the presence of peritonitis suggests full thickness ischaemia, perforation, or alternative diagnosis. […] The acute onset of the symptoms is a useful distinguishing factor between ischaemic colitis and inflammatory or infective colitis, where abdominal pain often has a more insidious onset. […] Symptoms of ischaemic colitis manifest in a matter of hours and, unlike infective or inflammatory colitis, continue to worsen with systemic instability.

• #29

  https://link.springer.com/article/10.1007/s00384-020-03739-z

  Ischemic colitis (IC) is the most prevalent ischemic injury of the gastrointestinal tract. Clinical features of IC such as acute abdominal pain, hematochezia, and diarrhea are similar to those of acute mesenteric ischemia, inflammatory bowel disease, or infectious bowel disease, and their relative ambiguity can delay diagnosis and treatment. […] Colonoscopy combined with histopathological biopsy is the standard of diagnosis for the IC. Most patients respond well to the conservative treatment, and surgical consultation is needed when conservative treatment is ineffective. […] Accurate diagnoses and effective treatments have helped reduce the mortality rate and improve prognoses for patients afflicted with IC, and corresponding drug therapies have been constantly updated as new research has emerged.

• #30 Ischemic Colitis Presented as Pseudomembranous Colitis: An Untypical Case from Vietnam

  https://www.kjg.or.kr/journal/view.html?volume=80&number=2&spage=93

  Ischemic colitis (IC) is an underreported chronic disease characterized by the hypoperfusion of the bowel mucosa. The diagnosis and treatment may be challenging because its clinical course resembles other colitis or even colorectal malignancies. […] A 68-year-old man was referred to the Gia-Dinh Peoples Hospital for a 6-month history of left lower quadrant abdominal pain associated with diarrhea, intermittent bloody mucus per rectum, and fecal incontinence. […] A diagnosis of IC is based on multi-aspects (history, physical examination, risk factors, imaging modalities, endoscopic and pathologic evidence). IC had diverse manifestations, ranging from acute colitis (including PMC) to chronic colitis or complications (stricture, gangrenous bowel, and fulminant pancolitis. […] Colonoscopy has been regarded as the gold standard diagnostic approach by directly observing the colonic mucosa and obtaining biopsy specimens, which can overcome the difficulty of recognizing IC.

• #31 Ischemic Colitis Imaging: Practice Essentials, Radiography, Computed Tomography

  https://emedicine.medscape.com/article/366808-overview

  Ischemic colitis is the most prevalent ischemic injury of the GI tract and includes features such as acute abdominal pain, hematochezia, and diarrhea. […] Patients may present with colicky abdominal pain, which becomes continuous. It may be associated with vomiting, diarrhea, or rectal bleeding. […] Cocaine-related ischemic colitis is associated with a high mortality. The authors’ findings suggest that cocaine-related ischemia should be considered in young patients presenting with acute abdominal pain and/or rectal bleeding with evidence of bowel wall thickening or pneumatosis on either imaging or colonoscopy. […] The specific CT signs for establishing the diagnosis of bowel ischemia depend on the degree of ischemia, the length of bowel loops involved, and whether both the large bowel and small bowel are affected. Findings may include the following: thromboembolism in the mesenteric vessels, intramural or portal venous gas, segmental thickening of the bowel wall, absence of bowel wall enhancement with contrast-enhanced CT, irregular narrowing of the bowel lumen as a result of mucosal edema (thumbprinting), and possible bowel dilatation proximal to the ischemic segment of the bowel. […] The plain radiographic findings may be entirely normal, particularly early in the disease. However, the results of barium enema are abnormal in 90% of patients with ischemic colitis.

• #32

  https://journals.lww.com/acgcr/fulltext/2024/06000/soccer_game_turned_bloody__a_case_of.30.aspx

  In cases of diagnostic uncertainty, colonoscopy is the gold standard diagnostic tool because it has shown to be the most sensitive test for colonic ischemia. […] A range of findings are observed during colonoscopy, including hyperemia, petechia, erosions, mucosal friability and bleeding, strictures, and ulcerations. […] Pathology evaluation of histologic manifestations demonstrates accumulation of neutrophils and other inflammatory cells, edema, necrosis, thrombosis, crypt loss, and hemorrhage. […] Strategies for preventing IC include conditioning with gradual increase in duration and intensity of exercise, limiting exercise intensity, avoiding training in excessive heat, proper hydration before, during, and after exercise, and judicious nonsteroidal anti-inflammatory drug use.

• #33 Ischemic Colitis -The Gastrointestinal Atlas – gastrointestinalatlas.com

  https://www.gastrointestinalatlas.com/english/ischemic_colitis.html

  Severe case of Ischemic Colitis […] This patient was successfully treated by surgery. A small amount of ascites was observed (bacterial culture: negative). The right colon is affected with large area of necrosis. […] Discrepancy between subjective symptoms and objective findings is a hallmark of ischemic colitis. Thus, diagnosis requires a high index of suspicion in the appropriate clinical setting. […] Left-sided ischemic colitis is the most common form of ischemic injury to the gut. Although it is generally considered a condition of elderly persons, it can affect patients of any age. Ischemic colitis is the second or third most common cause of lower gastrointestinal bleeding. […] The endoscopic spectrum of ischemic colitis is broad, ranging from mild patchy subepithelial hemorrhage to extensive necrosis.

• #34 Exercised-Induced Ischemic Colitis in a Recreational Athlete Previously Attributed to Inflammatory Bowel Disease | Lukela | Journal of Medical Cases

  https://www.journalmc.org/index.php/JMC/article/view/839/459

  Ischemic colitis traditionally presents in older patients, many whom have underlying atherosclerotic disease. Although symptoms may be transient and resolve spontaneously, serious complications may develop including stricture formation, bowel perforation, sepsis, or death. […] Recently, otherwise healthy athletes have been reported to develop ischemic colitis during or following strenuous, prolonged exercise. […] Gastrointestinal symptoms including anorexia, nausea, emesis, abdominal pain, diarrhea, and/or blood in the stool are common in endurance athletes during or following strenuous, prolonged physical activity. […] The development of exercise-induced ischemic colitis, however, is rare. […] Abdominal pain, diarrhea, and hematochezia are common presenting symptoms. […] Although the majority of cases in the literature describing exercise-induced ischemic colitis were managed conservatively, severe complications such as bowel perforation may develop and could be easily missed if the correct diagnosis is not entertained. […] This case highlights the importance of recognizing the diagnosis of ischemic colitis in an atypical host, but one in which the disease prevalence is likely to increase as more individuals participate in recreational endurance activities.

• #35

  https://journals.lww.com/acgcr/fulltext/2024/06000/soccer_game_turned_bloody__a_case_of.30.aspx

  Ischemic colitis (IC) should be considered as a cause for gastrointestinal symptoms in patients with recent vigorous physical activity. […] Gastrointestinal (GI) symptoms including abdominal cramps, diarrhea, and bloody stools are reported in 20%50% of endurance athletes, more often in runners. […] Commonly reported symptoms of exercise-induced IC include sudden onset of crampy abdominal pain, sometimes out-of-proportion to physical examination. Patients can also experience bloody stools, bloating, abdominal cramps, diarrhea, fecal incontinence, heartburn, nausea, vomiting, chest pain, and urge to defecate. […] Most of the cases of exercise-induced IC are mild. These milder forms often go undetected because they tend to be transient and self-limiting, thus not requiring further diagnostic procedures.

• #36 Ischemic Colitis Causes, Symptoms, and Treatment Explained – Los Angeles Times

  https://www.latimes.com/doctors-scientists/medicine/specialized-care/story/ischemic-colitis-causes-symptoms-treatment

  Ischemic colitis prognosis varies with severity and treatment timeliness. Mild cases often recover fully with supportive care (IV fluids, bowel rest, antibiotics). Severe cases have high mortality and may require surgery. […] Prompt care generally leads to a good prognosis, but delayed intervention increases risks of tissue death, infection, and obstruction. Early diagnosis and treatment are crucial.

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