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Treatments and drugs
By Mayo Clinic staffThe choice of treatment for ischemic colitis depends on the severity of your condition.
When ischemic colitis is mild, your doctor may prescribe medications to keep your blood pressure at normal levels, which will help facilitate blood flow to your colon. You may also need to take antibiotics to prevent infections from developing. Your doctor will treat any underlying health problems, such as heart failure.
With such conservative measures, symptoms often diminish in 24 to 48 hours in mild cases, without the need for hospitalization.
However, if you're dehydrated, you may need hospitalization to provide fluids and nutrients through your veins (intravenously). You may also need restrictions on food intake for a few days to let your intestines rest.
Your doctor will continue to monitor you regularly with follow-up colonoscopies to determine whether your colon has healed or the disease has progressed, and whether complications have developed. In mild cases, healing may occur in two weeks or less. In more-severe cases, recovery can take longer, and relapses can occur.
If you develop ischemic colitis before the age of 50 or have a history of blood clots, you could have a disorder that increases the tendency of your blood to clot (factor V Leiden). Your doctor may treat this disorder with a blood thinner such as warfarin (Coumadin), which could help prevent the likelihood of future ischemic colitis episodes.
Surgery
Some people with severe or prolonged ischemic colitis need surgical treatment to remove (resect) the affected part of the colon.
You may need surgery for ischemic colitis if your condition is associated with:
- Abdominal tenderness and fever that are severe and persistent, even after initial treatment with fluids and medications.
- A hole (perforation) in your colon.
- Gangrene and blood infection (sepsis). Treatment for this severe complication also includes broad-spectrum antibiotics and blood replacement.
- 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.
- 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.
- Sun MY, et al. Ischemic colitis. Clinics in Colon and Rectal Surgery. 2007;20:5.
- Koutroubakis IE. Ischemic colitis: Clinical practice in diagnosis and treatment. World Journal of Gastroenterology. 2008;14:7302.
- 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.
- Grubel P, et al. Colonic ischemic. http://www.uptodate.com/home/index.html. Accessed May 28, 2010.
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