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.

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.

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Ischemic Colitis

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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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Ischemic Colitis

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