Ischemic colitis

Diagnosis

Ischemic colitis can often be confused with other conditions because their symptoms overlap, especially inflammatory bowel disease (IBD). Based on symptoms, a healthcare professional may recommend these imaging tests:

• Abdominal CT scans, to provide images of the colon that can be helpful in ruling out other disorders, such as IBD.
• Colonoscopy. This test, which provides detailed images of the colon, can be helpful in diagnosing ischemic colitis. Colonoscopy also can be used to check for cancer, and to see how well a treatment worked. A tissue sample, called a biopsy, may be collected to help make a diagnosis.
• Stool analysis, to rule out infection as a cause of symptoms.

Treatment

Treatment for ischemic colitis depends on the severity of the condition.

Symptoms often diminish in 2 to 3 days in mild cases. A healthcare professional may recommend:

• Antibiotics, to prevent infections.
• Intravenous fluids, if the person is dehydrated.
• Treatment for any underlying medical condition, such as congestive heart failure or an irregular heartbeat.
• Not taking medicines that constrict the blood vessels, such as migraine or hormone medicines, and some heart medicines.
• Bowel rest, which may involve temporarily getting nutrients from a feeding tube.

A care professional also may schedule follow-up colonoscopies to monitor healing and look for complications.

Surgery

If symptoms are serious, or the colon has been damaged, surgery may be needed to:

• Remove dead tissue.
• Repair a hole in the colon.
• Remove part of the colon that has narrowed because of scarring and is causing a blockage.

The likelihood of surgery may be higher if the person has an underlying condition, such as heart disease, atrial fibrillation or kidney failure.

Preparing for your appointment

Go to the emergency room if you have bad stomach pain that makes you so uncomfortable that you can't sit still. You may be referred for immediate surgery to diagnose and treat your condition.

If your symptoms are mild and happen only occasionally, call your healthcare team for an appointment. After the first evaluation, you may be referred to a doctor who specializes in digestive disorders, called a gastroenterologist, or a surgeon who specializes in blood vessel disorders, called a vascular surgeon.

Here's some information to help you get ready for your appointment, and what to expect.

What you can do

• Be aware of any pre-appointment restrictions, such as not eating after midnight on the night before your appointment.
• Write down your symptoms, including when they started and how they may have changed or worsened over time.
• Write down your key medical information, including other conditions with which you've been diagnosed.
• Make a list of all medicines, vitamins and supplements that you're taking.
• Write down questions to ask during your appointment.

Questions to ask your doctor

• What is the most likely cause of my condition?
• What kinds of tests do I need?
• I have other health problems. How can I best manage these conditions together?
• If I need surgery, what will my recovery be like?
• How will my diet and lifestyle change after I have surgery?
• What follow-up care will I need?

What to expect from your doctor

Your provider is likely to ask you questions about your symptoms, such as:

• When did you begin experiencing symptoms?
• Have your symptoms been continuous or occasional?
• How severe are your symptoms?
• Where do you feel your symptoms the most?
• Does anything seem to make your symptoms better?
• What, if anything, seems to worsen your symptoms?