Definition

Ischemic bowel disease results from inadequate flow of oxygenated blood to the intestines. The extent of ischemic bowel disease can range from mild to severe based on the amount of damage from lack of oxygenated blood. This is a potentially serious condition and immediate medical care. The sooner ischemic bowel disease is treated, the more favorable the outcome.

Causes

Ischemic bowel disease occurs when an artery that supplies blood becomes blocked or narrowed. There are several possible causes of ischemic bowel disease, including:

• Blockage in the arteries due to a tumor or blood clot
• Narrowing of the arteries supplying blood to the bowel from atherosclerosis
• Obstruction in the colon (large intestine)

Risk Factors

Ischemic bowel disease is more common in older adults. Other factors that may increase your chances of developing ischemic bowel disease include:

• Shock induced by conditions such as blood stream infection and blood loss
• Recent heart attack
• Sustained abnormal heart beat
• Heart failure
• Peripheral vascular disease
• Coronary artery bypass surgery or other vascular surgeries
• Colon cancer
• Certain medications that cause arteries to narrow
• Diabetes
• Hemodialysis
• Sickle cell disease
• Dehydration
• Pregnancy

Symptoms

Ischemic bowel disease may cause:

• Cramping and abdominal pain
• Bloody stools
• Frequent urge to defecate
• Diarrhea
• Nausea or vomiting
• Abdominal distension

Diagnosis

Your doctor will ask about your symptoms and medical history. A physical exam will be done. Your doctor may suspect ischemic bowel disease based on your symptoms and risk factors. Tests may be done to confirm or rule out a diagnosis.

Tests may include the following:

• Abdominal x-ray
• Abdominal CT scan or MRI scan
• Colonoscopy —a procedure where a long flexible tube is inserted through the rectum to inspect the colon and rectum
• Angiography —an x-ray test used to view the arteries supplying the bowel

Treatment

Treatment options depend on the severity of the ischemia and include the following:

Prevention

To help reduce your chances of developing ischemic bowel disease, take the following steps:

• Stay well hydrated
• Reduce your risk of cardiovascular disease through regular exercise and a balanced diet low in fat and calories
• Consume plenty of fresh fruits, vegetables, and fiber, which may reduce your risk of colon cancer

National Library of Medicine http://www.nlm.nih.gov/

Canadian Association of Gastroenterology (CAG) http://www.cag-acg.org

Greenwald DA, Brandt LJ, Reinus JF. Ischemic bowel disease in the elderly. Gastroenterol Clin North Am. 2001;30:445-465.

Ischemic colitis. EBSCO DynaMed website. Available at:
http://www.ebscohost.com/dynamed
Updated September 25, 2013. Accessed August 13, 2014.