What is Microscopic Colitis?

Microscopic colitis takes two forms: collagenous colitis and lymphocytic colitis. Collagenous colitis and lymphocytic colitis are two types of bowel inflammation that affect the colon (large intestine). They are not related to Crohns disease or ulcerative colitis, which are more severe forms of inflammatory bowel disease (IBD).

Collagenous colitis and lymphocytic colitis are referred to as microscopic colitis because colonoscopy usually shows no signs of inflammation on the surface of the colon. Instead, tissue samples from the colon must be examined under a microscope to make the diagnosis.

The cause of Microscopic colitis is currently unknown. One theory is that the use of non-steroidal-anti-inflammatory drugs (such as ibuprofen) may contribute to the development of Microscopic colitis. Another theory is that Microscopic colitis is caused by an autoimmune response, where the body’s immune system attacks other tissues in the body.

It is also thought that bacteria or viruses may play a role in the development of Microscopic colitis, but the exact relationship is unknown.

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Microscopic colitis Information

Ischemic Colitis

Microscopic colitis is a medical condition that afflicts the bowels and colon. The disorder occurs when excessive amounts of collagen and white blood cells build up on the lining of the large intestine, causing inflammation and abdominal pain. The most common symptom of microscopic colitis is chronic diarrhea, which introduces additional symptoms such as dehydration, stomach cramps, bloating, and nausea. Microscopic colitis is not normally a serious condition, and it can usually be treated with home remedies, over-the-counter anti-diarrheal formulas, or medications prescribed by a licensed physician.

Research shows that microscopic colitis is a result of the immune system attacking bacteria living in the colon. Scientists are still unsure, however, about what instigates the attack to these bacteria. It is suggested that consumption of certain antibiotics or certain types of foods may trigger the attack. It is likewise believed that the body's immune system attacks non-foreign elements in the intestine after erroneously identifying them as foreign elements. Why this anomaly happens is uncertain.

Tests have also suggested that a certain gene present in the body may be the cause of the attack, but due to the lack of consistency in the results, there is no conclusion that can be drawn from the test.

Studies have also suggested that estrogen could be the cause of microscopic colitis. Research has yielded convincing findings that there are more women affected by this disease than men, and that these women are usually affected much later their in life when the supply of estrogen in the body is much higher.

Although it is not the actual cause of microscopic colitis, the body's reaction to glutinous food products could be the trigger for the inflammation of the colon. Gluten is the protein found in wheat, barley, rye and oats.

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Pseudomembranous Colitis (Ischemic Colitis)

Ischemic Colitis

Pseudomembranous colitis (PMC) is an acute colitis characterized by the formation of an adherent inflammatory membrane (pseudomembrane) overlying sites of mucosal injury.

PMC is a well recognised cause of diarrhea in patients following a course of broad-spectrum antibiotic therapy. Clostridium difficile infection is the most important infectious cause of PMC.

Ampicillin, clindamycin, and cephalosporins are the most common antibiotics associated with this disease in children. Pseudomembranous colitis is rare in infants younger than 12 months old because they have protective antibodies from the mother and because the toxin does not cause disease in most infants.

Most cases of pseudomembranous colitis happen when a person is in the hospital, because the bacteria can spread from one patient to another.

Risk factors include:

• Advanced age
• Antibiotic use
• Chemotherapy
• Medications that suppress the immune system
• Recent surgery
• Personal history of pseudomembranous colitis

Ischemic Colitis

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Blood-Starved Colon (Ischemic Colitis)

Ischemic Colitis

The term "ischemic colitis" can be broken down into ischemia (referring to lack of oxygen) and colitis (referring to inflammation of the colon). In people suffering from ischemic colitis, the inner lining of the colon becomes irritated, inflamed and ulcerated due to a shortage of oxygen-rich blood in the affected area.

Strange as it may seem, ischemic colitis is similar in nature to coronary artery disease: Both conditions are caused by poor blood flow -- one in the colon and the other in the heart. Thus, some of the major risk factors for ischemic colitis are similar to those for heart disease: high blood pressure, smoking and high cholesterol. All of these factors lead to blockages in various blood vessels, including the coronary vessels in the heart, the vessels of the legs, the vessels in the neck leading to the brain, and the vessels in the abdomen leading to the intestine and colon. Other risk factors include diabetes (which accelerates blood-vessel disease), abnormal heart rhythms (which can dislodge blood clots from the heart, leading to blockage of the abdominal vessels) and certain medications, such as digoxin, which decrease blood flow to the intestine and colon.

Patients with ischemic colitis typically complain of painful abdominal cramps -- the colonic equivalent of heart-related chest pain, or angina. The attacks of pain are often accompanied by passage of blood from the rectum.

SOurce: yourtotalhealth.ivillage.com

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Hematochezia Information (Ischemic Colitis)

Ischemic Colitis

Hematochezia or blood could be caused by harmless conditions like hemorrhoids or serious ailments like cancer. Hematochezia or rectal bleeding refers to the passage of blood in the stools. Most rectal bleeding originates from the anus, colon or rectum.

Hematochezia is the presence of bright red, fresh blood in the feces. Hematochezia usually occurs with bleeding in the lower intestines (colon, rectum). Hematochezia should not be confused with melena , which is the passage of dark, tarry, black feces. Melena represents the passage of old, digested blood that has occurred with bleeding higher up in the intestinal tract.

The color of the blood depends more on the site of origin of the bleeding. The closer the bleeding site to the anus, the brighter is the color of the blood. Thus, bleeding from the anus, rectum, and the sigmoid colon tend to be bright red, whereas bleeding from the transverse colon and the right colon tend to be dark red or maroon colored. In some patients bleeding can be black and “tarry” (sticky) and foul smelling.

Ischemic Colitis

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Ischemic Colitis Treatment (Ischemic Colitis)

Ischemic Colitis

Treatment of the patient is dictated by the severity of the ischemia. In the absence of colonic gangrene or perforation, supportive care is appropriate. Patients should be placed on bowel rest and given intravenous fluids to ensure adequate colonic perfusion. Optimization of cardiac function and oxygenation is important. Empiric broad-spectrum antibiotics are often administered in patients with moderate to severe colitis to minimize bacterial translocation and sepsis.

Although there is a lack of prospective, clinical data on humans, this practice is generally justified because of the difficulty in predicting who will progress to gangrenous colitis. A nasogastric tube should be placed if an ileus is present. A rectal tube may also be helpful if the colon is distended. In critically ill patients with uncertain hemodynamic status, Swan-Ganz catheterization may assist in guiding fluid status and cardiac function. Any medications that are associated with ischemia should be withheld. Careful monitoring is necessary for signs of necrosis, such as persistent fever, leukocytosis, peritoneal irritation, or protracted pain or bleeding. Serial abdominal radiographs may be helpful if colonic distension or thumbprinting are present. Cathartics should be avoided because they may rarely precipitate colonic perforation. Most patients with ischemic colitis will clinically improve within 24 to 48 hours, and endoscopic and radiologic abnormalities resolve within several weeks.

Approximately 20% of patients with ischemic colitis will require surgery because of peritonitis or clinical deterioration despite conservative management. At laparotomy margins. Questionably viable areas of colon are generally resected unless extensive areas of small and large bowel are affected, in which case these areas are left intact and a second-look operation is planned 12 to 24 hours later. Primary anastomosis is usually not performed because of the risk of anastomotic leaks. A colostomy is formed with the proximal colonic loop and the distal loop is either exteriorized as a mucous fistula or closed to form a Hartman pouch. Despite resection, the mortality rates exceed 50% in those with infarcted bowel.

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The Causes of Ischemic Colitis? (Ischemic Colitis)

Ischemic Colitis

Ischemic colitis occurs mainly due to a reduction or obstruction in the blood supply to the cells and tissues of the colon. The reduction in blood supply may be associated with a wide variety of reasons.

Clots formation in the blood vessels
Abrupt occurrence of ischemic colitis may be due to the formation of clots in the blood vessels that supply the colon. This results in a sudden obstruction in the blood supply leading to the symptoms of ischemia. In cases of long standing conditions, the blood supply to the colon is reduced gradually owing to a condition known as atherosclerosis. This condition is characterized by accumulation of fats along the walls of the blood vessels that reduce the amount of blood flowing through the blood vessels.

Certain medical conditions
Ischemic colitis can also arise as a result of certain underlying medical conditions. These include inflammatory conditions of the blood vessels (referred to as vasculitis), block in the blood vessels due to hernias, heart failure, low blood pressure, elevated blood sugar levels (diabetes mellitus), and cancer of the colon.

Surgery and radiation
Surgery involving the colon and radiation therapy to the abdominal region can also result in the reduction of blood supply to the colon in certain instances. Chronic smoking, high blood pressure and elevated cholesterol levels in the body are some of the factors associated with increased risk of ischemic colitis.

Prolonged use of certain drugs
Prolonged use of certain medicines that belong to the group of pain killers (NSAIDs), hormone replacement drugs, anti-hypertensives and anti-psychotics are also associated with an increased risk of ischemic colitis.

Infections
Infections of the colon may also trigger ischemia (restriction of blood supply) in the colon in some rare instances.

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Ischemic Colitis Diet (Ischemic Colitis)

Ischemic Colitis

A Step By Step Management Process

In an ischemic colitis diet, a step by step process should be followed to manage the problem. First, the diarrhea in an inflammatory bowel disease can cause dehydration; therefore, it is vital to reverse the condition by having an ischemic colitis diet plan which requires you a more-than-adequate fluid intake. Next, the diet should contain intravenous supplements especially if the problem is severe. This can be done through hospital admission only.

Third, an ischemic colitis diet should include a high caloric count. This is most especially important to children who have lost quite an amount of fluid. Fourth, avoid foods which only make your symptoms worse. You have to know the right kinds of food to eat and you have to be aware of the food items that you should avoid. Lastly, take vitamins to complete your daily nutritional requirement. Just like medicine, they are essential to keep you healthy and safe from any disease.

Ischemic Colitis Diet – Importance of Structured Meal Times

While it is very essential to follow a detailed ischemic colitis diet plan, it is also necessary to follow them on a proper schedule. Those who have crohn's disease or other bowel inflammatory disease can begin to have three large meals per day. Aside from this, the patients are requested to have small frequent feedings to suffice the nutritional requirement which they need. It is therefore imperative to follow a structured meal time to avoid reoccurrence of the disease problem.

If all these tips will be followed, you can be guaranteed of a healing process that is smooth sailing and effective. You can get relief from the symptoms of ulcerative colitis if you participate in your treatment plan carefully and religiously.

Ischemic Colitis

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Ischemic Colitis Signs and Symptoms (Ischemic Colitis)

Ischemic Colitis

Three progressive phases of ischemic colitis have been described:

A hyperactive phase occurs first, in which the primary symptoms are severe abdominal pain and the passage of bloody stools. Many patients get better and do not progress beyond this phase.

A paralytic phase can follow if ischemia continues; in this phase, the abdominal pain becomes more widespread, the belly becomes more tender to the touch, and bowel motility decreases, resulting in abdominal bloating, no further bloody stools, and absent bowel sounds on exam.

Finally, a shock phase can develop as fluids start to leak through the damaged colon lining. This can result in shock and metabolic acidosis with dehydration, low blood pressure, rapid heart rate, and confusion. Patients who progress to this phase are often critically ill and require intensive care.

Symptoms of ischemic colitis vary depending on the severity of the ischemia. The most common early signs of ischemic colitis include abdominal pain (often left-sided), with mild to moderate amounts of rectal bleeding. The sensitivity of findings among 73 patients were:[18]

abdominal pain (78%)
lower digestive bleeding (62%)
diarrhea (38%)
Fever higher than 38°C (34%) (38°C equals approximately 100.4°F)

Physical examination

abdominal pain (77%)
abdominal tenderness (21%)

Ischemic Colitis

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What is Ischemic Colitis? (Ischemic Colitis)

Ischemic Colitis

Ischemic colitis. That's clearly a medical term, the kind that can confuse some lay people, but actually it's fairly simple. Most of us know that anything medical ending in "itis" means an inflammation, so this is partly an inflammation of the colon. Ischemia means impaired blood flow to an organ or tissue. So in simple terms, ischemic colitis means that your colon is inflamed, or irritated, because it, or some part of it, is not receiving enough blood.

Ischemic Colitis mainly occurs in older people, over 50. There are certain risk factors that can increase your chance of getting ischemic colitis. The most obvious is a heart condition, or some of the other conditions involved with coronary heart disease, like high blood pressure and a high cholesterol level. Smoking also increases the chance that you will get ischemic colitis. There are also some other illnesses or conditions that can increase your risk; if you've had an abdominal surgery, or low blood pressure and/or shock, or if you've suffered heart failure, you're more likely than the average person to get ischemic colitis at some point in your life.

Source: www.associatedcontent.com

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