Ischemic colitis

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Causes

By Mayo Clinic staff

Ischemic colitis involves inadequate blood supply reaching your colon. In acute cases, the most frequent cause is blood clots in the arteries supplying blood to your colon. Chronic cases are usually associated with the buildup of fatty deposits (atherosclerosis) in the blood vessels leading to your colon.

In some people, ischemic colitis may be caused by or related to other medical conditions, including:

  • Inflammation of the blood vessels (vasculitis)
  • Protrusion of an organ or tissue into the surrounding tissue (hernia), interfering with the arterial as well as the venous blood supply to the intestine
  • Elevated sugar (glucose) levels in the blood (diabetes)
  • Easy blood clotting (hypercoagulable state)
  • Radiation treatment to the abdomen
  • Colon cancer
  • Recent abdominal surgery, particularly when it involves repair of a bulging arterial wall (aneurysm) in the region
  • Infections, such as shigella, Escherichia coli 0157:H7 and Clostridium difficile
  • Dehydration

The role of medications
Certain medicines also rarely cause ischemic colitis as a side effect. These include:

  • Nonsteroidal anti-inflammatory drugs
  • Estrogen replacement medications
  • Migraine medications in the triptan or ergot class
  • Blood pressure lowering drugs
  • Certain antipsychotic drugs
  • Pseudoephedrine (a decongestant found in many cold and allergy medications)
  • The irritable bowel syndrome medication alosetron (Lotronex)
References
  1. McQuaid KR. Gastrointestinal disorders. In: McPhee SJ, et al. Current Medical Diagnosis and Treatment. 49th ed. New York, N.Y: McGraw-Hill; 2010. http://www.accessmedicine.com/content.aspx?aID=6395. Accessed May 27, 2010.
  2. Stoffel EM, et al. Mesenteric ischemia. In: Greenberger NJ, et al. Current Diagnosis and Treatment: Gastroenterology, Hepatology, & Endoscopy. New York, N.Y: McGraw-Hill; 2009. http://www.accessmedicine.com/content.aspx?aID=6200589. Accessed May 27, 2010.
  3. Sun MY, et al. Ischemic colitis. Clinics in Colon and Rectal Surgery. 2007;20:5.
  4. Koutroubakis IE. Ischemic colitis: Clinical practice in diagnosis and treatment. World Journal of Gastroenterology. 2008;14:7302.
  5. Sotiriadis J, et al. Ischemic colitis has a worse prognosis when isolated to the right side of the colon. American Journal of Gastroenterology. 2007;102:2247.
  6. Grubel P, et al. Colonic ischemic. http://www.uptodate.com/home/index.html. Accessed May 28, 2010.
DS00794 July 24, 2010

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