Establish an Understanding of Ischemic Colitis
Colitis is a general term used to describe conditions that involve the inflammation of the colon. Anyone living with colitis knows how big of an impact it can make on one’s life. The most common symptom of all types of colitis is abdominal discomfort. People with colitis also frequently experience bloating and diarrhea, fatigue, and joint swelling. The effect that colitis has on one’s stomach can make it very hard to live a normal life out of fear of when a flare up will occur. Unfortunately, there is no “cure,” but rather ways to better manage the condition and ways to try to live symptom-free.
Read further to learn about the differences between ulcerative colitis and ischemic colitis.
Ulcerative colitis
The chronic form of colitis that comes to mind for many people is really a subtype of the condition, ulcerative colitis. Ulcerative colitis, along with Crohn’s disease, is one of the diseases that encompasses irritable bowel disease (IBD).
Ulcerative colitis is classified as the inflammation of the large intestine and rectum. Though these areas are the source of the disease, someone suffering from ulcerative colitis may experience related inflammation in the joints, skin, liver, and elsewhere in the body. The inflammation also can cause small sores to develop around the affected areas.
Close to one million people are currently diagnosed with ulcerative colitis in the United States. Still, experts are not sure what causes the condition. However, there may be a genetic or ethnic component, as people who have a family member with the disease are more likely to also have ulcerative colitis. Researchers believe the onset of ulcerative colitis may be related to an overreaction of the immune system to bacteria in the digestive system, though there’s no definite cause.
Ischemic colitis
Ischemic colitis is a completely separate condition from ulcerative colitis, and although it also involves inflammation of the colon, it is different in many ways. Ulcerative colitis is a chronic condition. While there are ways to manage the symptoms, such as antibiotics or diet modifications, there is no cure, and people with ulcerative colitis will most likely be dealing with the symptoms and flare ups for their entire lives. Ischemic colitis, on the other hand, is usually treatable. Ischemic colitis is not one of the conditions included in the IBD classification.
Symptoms of ischemic colitis
One common thread between ulcerative and ischemic colitis is that they both cause abdominal pain, especially after eating. They both also can cause someone to have diarrhea, or see small amounts of blood in the stool (if there are large amounts of blood in the stool, it may be a sign of something more serious, like colon cancer). People with ischemic colitis may also feel that they urgently need to use the bathroom, and they may also feel tenderness around the abdomen.
These symptoms are things that most people probably experience at some time in their life, and it does not mean that they have ischemic colitis. But, if these things happen more than just a one-off occurrence, or if you’re over the age of 60, it’s wise to go see a doctor about the symptoms.
Even when someone does seek medical attention for these symptoms, ischemic colitis can be hard to diagnose. It’s oftentimes mistaken for IBS or ulcerative colitis. In order to properly diagnose ischemic colitis, your doctor will need information about your medical history and will conduct at least one diagnostic test. This may include an ultrasound or CT scan to look at your blood vessels or intestines, x ray images to try to locate the blockage in your arteries, or blood tests. A high white blood cell count, combined with other symptoms and risk factors, is oftentimes indicative of acute ischemic colitis.
What causes ischemic colitis?
Ischemic colitis also differs from ulcerative colitis in the nature of its origin. The causes for ulcerative colitis are generally unknown; researchers have yet to find a source for the inflammation that plagues people who live with condition. The picture surrounding ischemic colitis is much clearer.
Ischemic colitis occurs when the blood flow to the colon is reduced or blocked altogether. This blockage happens when mesenteric arteries, the arteries that deliver blood to the gastrointestinal tract, are hardened. Mesenteric arteries (in fact, all arteries) can be clogged by buildup of fatty acids or plaques in the artery walls. The plaque narrows the arteries, limiting the volume of blood that is able to flow through the arteries. When enough of the plaque has built up, it leads to a complete blockage of the artery, entirely restricting blood flow.
The buildup of plaques in the arteries is known as atherosclerosis. Atherosclerosis in other areas of the body is associated with conditions such as kidney disease, coronary artery disease, and peripheral artery disease. The condition can be extremely dangerous, and in extreme cases can lead to heart attack or stroke. However, atherosclerosis of the mesenteric arteries will not lead to these extreme outcomes. Rather, it leads to the intestinal issues and inflammation that characterize ischemic colitis.
The buildup that leads to ischemic colitis usually occurs over time. However, sudden cases of ischemic colitis can sometimes arise as the result of a blood clot. Unlike typical cases of ischemic colitis, acute cases are considered medical emergencies and require immediate treatment to avoid any serious outcomes. In any case, ischemic colitis definitely needs to be treated and resolved because prolonged blockage and limitation of blood to the intestines can lead to gangrene. Gangrene is when body tissue dies due to lack of blood to the tissue, and it can be fatal. Mortality rates for ischemic colitis are high when someone also develops gangrene.
Who is at risk for ischemic colitis?
The demographics of who is affected by ischemic colitis is another area in which it differs from ulcerative colitis. People with ulcerative colitis often experience symptoms from a young age. Most people with ulcerative colitis are diagnosed before the age of 30.
Ischemic colitis is associated with an older age group. The majority of people who develop ischemic colitis are over the age of 60. It would be extremely rare for someone to experience atherosclerosis, or hardening of the arteries, early in life. As people age, their arteries, heart, and blood vessels have been working for that much longer than their younger counterparts. Weaker arteries are more susceptible to atherosclerosis, and thus the large intestine is more susceptible to ischemic colitis.
Heart related conditions, such as low blood pressure or a past of congestive heart failure, also put you at risk for ischemic colitis because these can weaken the flow of blood through the mesenteric arteries. Medications that have a side effect of constipation also increase the risk of developing ischemic colitis. Unlike ulcerative colitis, there does not appear to be any genetic patterns or risk related to developing the condition.
Treatment
The good news is that ischemic colitis is usually treatable. The most common forms of treatment for standard cases are antibiotics, pain medications, IV fluids to prevent dehydration, and, sometimes, a liquid diet. In acute, urgent cases, or if all of these other treatment methods fail, surgery to remove the blockage may be necessary. Someone with acute ischemic colitis may also need medications to dissolve the blood clot and widen the arteries.
Final thoughts
Though living through ischemic colitis and undergoing the treatment is unpleasant, it’s very fortunate that there are effective treatments available. And, by maintaining a healthy lifestyle after treatment, you can prevent the ischemic colitis from returning. This involves quitting smoking and increasing exercise, which have health benefits far beyond just preventing the return of colitis. Try to keep these things in mind to avoid dealing with ischemic colitis a second time around, and maintain an all-around healthy body and mind.
References
https://www.medicinenet.com/colitis/article.htm
https://www.webmd.com/ibd-crohns-disease/ulcerative-colitis/ulcerative-colitis-topic-overview#1
https://www.healthline.com/health/ischemic-colitis#overview1
https://www.nhlbi.nih.gov/health/health-topics/topics/atherosclerosis
https://www.healthline.com/health/gangrene#overview1
https://www.everydayhealth.com/colitis/specialists/what-makes-colitis-ischemic-or-ulcerative.aspx
