Ischemic Colitis

Ischemic colitis is inflammation in your colon that’s caused by ischemia, which means reduced blood flow. Blood supplies oxygen to the tissues in your body. If something interrupts or diminishes the blood supply to certain tissues, they suffer damage from the lack of oxygen. Inflammation is your body’s response to this injury. It causes discomfort, swelling and bleeding, but it means your tissues are trying to repair themselves. Ischemic colitis mainly affects the inner lining of your colon (mucosa), usually in one section of it. But ischemia that’s more severe or lasts longer may do deeper damage to your colon.

What’s the difference between colitis and ischemic colitis?

Colitis means inflammation in your colon. Ischemic colitis is one of the less common ways that can happen. People often think of colitis in terms of chronic inflammatory bowel diseases, such as ulcerative colitis or Crohn’s disease. These are conditions that begin in the tissues of your colon itself. Ischemic colitis, on the other hand, is a problem that begins in your circulatory system. It may be related to low blood pressure or blood vessel diseases. Reduced blood flow in the arteries that supply blood to your colon causes inflammation in the tissues as a secondary effect. But your colon is otherwise well.

Who does ischemic colitis (ischemic bowel disease) affect?

It most commonly affects people older than 60 and with a history of arterial disease.

Other potential risk factors include:

• Type 2 diabetes.
• Kidney failure and dialysis.
• Low blood pressure.
• Hypoalbuminemia.
• Peripheral artery disease.
• Ischemic cardiomyopathy.
• Blood clotting disorders.
• Chronic constipation with fecal impaction.
• Cocaine use.
• Abdominal aortic aneurysm.

How does ischemic colitis affect my body?

For most people, it’s a temporary problem affecting only a small part of your large bowel (colon). Inflammation causes temporary discomfort, but it clears up on its own when the cause of the ischemia resolves. Less commonly, it can be a more serious problem. 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.