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 ?
Edakkanambeth Varayil et al., "A population-based study of incidence, risk factors, clinical spectrum, and outcomes of ischemic colitis," Clinical Gastroenterology and Hepatology: The Official Clinical Practice Journal of the American Gastroenterological Association, vol.
Classic ischemic colitis is seen in elderly patients in the watershed area of the colonic splenic flexure, in those who usually have right-sided heart failure and a low-blood flow state.
Histology was characterized primarily by crypt atrophy and lamina propria hyalinization, which supports a diagnosis of chronic ischemic colitis (Figure 3).
The histologic features of enterohemorrhagic E coli are typically similar to the pattern of injury associated with acute ischemic colitis. The presence of fibrin thrombi within lamina propria capillaries may be a clue to the diagnosis.
Gary Della 'Zanna of the FDA's division of drug risk evaluation in Rockville said that additional cases of ischemic colitis or other forms of intestinal ischemia had been reported the label change.
Ischemic colitis secondary to xanthogranulomatous pyelonephritis.
Los Angeles -- Patients with irritable bowel syndrome are eight times more likely than are other patients to develop ischemic colitis, according to a database study presented in poster form at the annual Digestive Disease Week.
LOS ANGELES -- Patients with irritable bowel syndrome are eight times as likely as other patients to develop ischemic colitis, according to a database study presented in poster form at the annual Digestive Disease Week.
Sidney Wolfe, director of Public Citizen Health Research Group, said that the eight cases of ischemic colitis and eight cases of constipation complications were "alarming." He added that because the drug does not have unique, clinically significant benefits, it should once again be taken off the market and made available only as an investigational new drug.
The differential diagnosis, however, includes diverticulosis, angiodysplasia, carcinoma, ischemic colitis, and others.(1) Risk factors for colonic carcinoma include age greater than 50 years, inflammatory bowel disease, familial polyposis coli, family history, and personal history of colonic neoplasia.(2) Unexplained gastrointestinal symptoms of more than 2 weeks' duration also are associated with increased risk.
Because severe GI toxicity (constipation, ischemic colitis) has been reported in adults, it should be avoided during lactation.
Complications include renal failure, ischemic colitis, MI, respiratory failure, and spinal cord ischemia.