Ischemic colitis, which is the most common of the diseases under the umbrella of bowel ischemia, is a condition in which the bowel experiences a shortage of blood supply, frequently causing damage to the intestines and colon. Many patients who develop ischemic colitis suffer from other bowel diseases and conditions, such as Crohn’s disease and ulcerative colitis. In most cases, ischemic colitis clears up after supportive treatment.
Even though ischemic colitis can be easily treated, however, the symptoms are frequently misdiagnosed as something else or dismissed by the patient. This is especially true of people with inflammatory bowel disease to begin with because they are used to the symptoms of ischemic colitis and may not recognize them as something new. This is why patients who experience these symptoms should seek medical help immediately to avoid further complications.
The first phase of ischemic colitis is the one in which it is usually identified, and is called the hyperactive phase. The symptoms in this phase include abdominal pain, abdominal tenderness, diarrhea and bloody stool. In most cases, the blood found in the stool will be dark and thick, rather than thin and bright like arterial blood. It may pass in waves, or it may come every time the patient has a bowel movement.
The abdominal pain, however, is the most indicative symptom of ischemic colitis, and can range from mild to severe. In most cases, the pain is concentrated in the lower abdomen, near the bowels, and may increase during bowel movements or when the patient is lying still. Furthermore, the pain will be more concentrated than a gas cramp or diarrheal cramp, and will almost always remain constant rather than fading intermittently.
The second phase of ischemic colitis is called the paralytic phase, and involves worsening of the aforementioned symptoms as well as an absence of bowel sounds. The pain will move to other areas of the abdomen and the lower stomach may even hurt to the touch. In most cases, the blood in the bowel movements will have stopped, though bowel motility will not. In this phase, the symptoms will signal that something is definitely wrong, and bloating may result.
The final phase, called “shock”, of ischemic colitis, is rarely reached, and can result in severe complications. The patient might experience a severe decline in blood pressure, dehydration, disorientation and even shock. During this phase, a hole can be punctured in the lining of the colon, resulting in the seepage of fluids, and in many cases bacterial infections and even gangrene can develop.
Overall, however, the most common symptoms of ischemic colitis are bloody stools and abdominal pain, and the pain will frequently be concentrated on the left side of the abdomen. If you experience these symptoms, your physician can confirm the diagnosis with an edoscopy and immediately begin your treatment, which should force the symptoms to subside in two or three days. Often, hospitalization is required.
