ischemic colitis


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colitis

 [ko-li´tis]
inflammation of the colon. There are many types of colitis, each with different etiologies; the differential diagnosis involves the clinical history, stool examinations, sigmoidoscopy, and radiologic studies such as a lower gastrointestinal series. One of the most common types is idiopathic ulcerative colitis, which is characterized by extensive ulcerations along the mucosa and submucosa of the bowel. Other types often can be traced to such etiologic factors as bacteria and viruses, drugs such as antibiotics, and radiation from x-rays or radioactive materials. Strong emotions can cause hypermotility of the gut and thereby produce symptoms typical of colitis. True colitis should be distinguished from irritable bowel syndrome (formerly referred to by other names such as mucous colitis, irritable colon, and spastic colon); in the latter condition there is no actual inflammation of the gastrointestinal mucosa. Almost all forms of colitis cause lower abdominal pain, bleeding from the bowel, and diarrhea. The patient may have as many as 20 bowel movements a day, resulting in serious depletion of body fluids and electrolytes. Treatment is aimed at eliminating or mitigating the underlying cause of the inflammatory process, resting and soothing the inflamed bowel, and restoring the nutritional status and fluid and electrolyte balance to normal.
antibiotic-associated colitis colitis associated with antimicrobial therapy, most commonly with lincomycin or clindamycin, but also with other broad-spectrum antibiotics, such as ampicillin and tetracycline. It can range from mild nonspecific colitis and diarrhea to severe fulminant pseudomembranous colitis with profuse watery diarrhea, abdominal cramps, and fever. The inflammation may be caused by a toxin produced by Clostridium difficile, a microorganism that is normally present in the resident bowel flora of infants, but is rarely found in adults. Presumably, the disruption of the normal flora allows the growth of C. difficile.
collagenous colitis a type of colitis of unknown etiology characterized by deposits of collagenous material beneath the epithelium of the colon, with crampy abdominal pain and watery diarrhea.
Crohn's colitis Crohn's disease.
diversion colitis inflammation in a nonfunctioning colonic pouch created by corrective surgery; it resolves following restoration of intestinal continuity.
ischemic colitis acute vascular insufficiency of the colon, usually involving the portion supplied by the inferior mesenteric artery; symptoms include pain at the left iliac fossa, bloody diarrhea, low-grade fever, abdominal distention, and abdominal tenderness. The classic radiologic sign is thumbprinting, due to localized elevation of the mucosa by submucosal hemorrhage or edema. Ulceration may follow.
pseudomembranous colitis a severe acute inflammation of the bowel mucosa, with the formation of pseudomembranous plaques; it is usually associated with antimicrobial therapy (antibiotic-associated colitis). The common symptoms are watery diarrhea, abdominal cramps, and fever. The pathologic lesions are yellow-green pseudomembranous plaques of mucinous inflammatory exudate distributed in patches over the colonic mucosa and sometimes also in the small intestine. Called also pseudomembranous enterocolitis.
radiation colitis colitis resulting from radiation therapy to the abdominal region; it is manifested clinically by tenesmus, pain, rectal bleeding, diarrhea, and telangiectases. Malabsorption, ulceration, and partial or complete obstruction may follow.
ulcerative colitis see ulcerative colitis.

ischemic colitis

GI disease A condition characterized by intermittent abdominal colic, accompanied by nausea, tenesmus, fever, bloody diarrhea, due to ASHD of the mesenteric arteries which primarily impacts on the descending colon Prognosis Relatively good, due to the high rate of turnover of glandular epithelium. See Intestinal angina.
References in periodicals archive ?
sup][1] To date, the diagnosis in clinical practice is possible by excluding the other conditions that may cause ischemic colitis including inflammatory bowel disease, atrial fibrillation, valvular heart disease, and hypercoagulable conditions.
18) Other differential diagnoses include ischemic colitis, lupus vasculitis of the gastrointestinal tract, actinomycosis, lymphoma, and amoebiasis.
Ischemic colitis during interferon-alpha treatment for chronic active hepatitis C.
The clinical course of the ischemic colitis is divided in two major groups of patients with gangrene form (15-20%) and patients with non-gangrene form (80-85%).
This sign is seen in roughly 75% of cases of transient, nongangrenous ischemic colitis.
The CT findings of colitis distributed throughout multiple vessels, sparing of the terminal ileum, and good contrast flow in the major mesenteric vessels made a diagnosis of ischemic colitis much less likely; therefore, bacterial pancolitis became the leading diagnosis.
Another IBS drug, Lotronex[R] (alosetron), was approved for diarrhea-predominant IBS in February 2000; it was withdrawn before the end of that year because it was linked to ischemic colitis.
There have been postmarketing reports of hypovolemia, hypotension, and syncope associated with diarrhea, and of ischemic colitis and other forms of intestinal ischemia in patients on tegaserod.
Multiple endoscopic studies demonstrating ischemic colitis or gastritis support this mechanism as a source of blood loss in athletes with bleeding after prolonged endurance exercise (3).
Although nonspecific, these findings suggested either ischemic colitis (unlikely in a 22-year-old patient) or possible E.
Although constipation and ischemic colitis were observed in preapproval clinical trials involving the drug, serious complications were not detected until after marketing, when significantly more patients were exposed to the medication.