Ischemic Bowel Disease
Ischemic bowel disease is a lack of blood flow to the bowel (intestine). It needs care right away.
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This problem happens when an artery that supplies blood becomes blocked or narrowed. Ischemic bowel disease may be caused by:
- Blockage in the arteries due to a tumor or blood clot
- Narrowing of an artery from atherosclerosis
- Obstruction in the colon
- Low blood pressure
- Some medicines, such as diuretics, chemotherapy drugs, or nonsteroidal anti-inflammatory drugs (NSAIDs)
Ischemic bowel disease is more common in older adults. Other things that may raise the risk are:
- Shock from health problems, such as a blood stream infection or blood loss
- Recent heart attack
- Long term heart arrhythmias
- Heart failure
- Peripheral artery disease (PAD)
- Coronary artery bypass surgery (CABG) or other blood vessel surgeries
- Colon cancer
- Some medicines that cause arteries to narrow
- Sickle cell disease
Problems can range from mild to severe. It depends on how much damage has been done. A person with ischemic bowel disease may have:
- Cramping and belly pain
- Belly swelling
- Need to pass stool often
- Loose stools
- Bloody stools
- Nausea and vomiting
The doctor will ask about symptoms and health history. A physical exam will be done.
Blood and stool tests may be taken.
Images of the belly may be taken. This can be done with:
A colonoscopy may be done. A long, flexible tube will be inserted through the rectum to check the intestines.
The goal of treatment is to restore blood flow to the bowel. Care is needed right away for ischemic bowel disease. The doctor may advise:
- Supportive care, such as IV fluids to rest the bowel
- Antibiotics to lower the risk of infection
People who are not helped by these methods may need surgery. It can remove the diseased part of the bowel.
Ischemic bowel disease cannot be prevented.
- Ahmed, M. Ischemic bowel disease in 2021. World Journal of Gastroenterology, 2021; 27 (29): 4746-4762.
- Brandt, L.J., Feuerstadt, P., et al. American College of Gastroenterology. ACG clinical guideline: epidemiology, risk factors, patterns of presentation, diagnosis, and management of colon ischemia (CI). Am J Gastroenterol, 2015; 110(1): 18-44; quiz 45.
- Colon ischemia. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/colon-ischemia.
- James P. Cornell, MD
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