Ischemic colitis

Diagnosis

Ischemic colitis can often be confused with other disorders because their symptoms overlap, especially inflammatory bowel disease (IBD). Based on your symptoms, your doctor may recommend these imaging tests:

• Abdominal CT scans, to provide images of your colon that can be helpful in ruling out other disorders, such as IBD.
• Colonoscopy. This test, which provides detailed images of your colon, can be helpful in diagnosing ischemic colitis. Colonoscopy also can be used to check for cancer, and to see how well a treatment worked.
• Stool analysis, to rule out infection as a cause of your symptoms.

Treatment

Treatment for ischemic colitis depends on the severity of your condition.

Symptoms often diminish in 2 to 3 days in mild cases. Your health care provider may recommend:

• Antibiotics, to prevent infections
• Intravenous fluids, if you are dehydrated
• Treatment for any underlying medical condition, such as congestive heart failure or an irregular heartbeat
• Avoiding medications that constrict your blood vessels, such as migraine drugs, hormone medications and some heart drugs

Your provider also may schedule follow-up colonoscopies to monitor healing and look for complications.

Surgery

If your symptoms are severe, or your colon has been damaged, you may need surgery to:

• Remove dead tissue
• Repair a hole in your colon
• Remove part of the colon that has narrowed because of scarring and is causing a blockage

The likelihood of surgery may be higher if you have an underlying condition, such as heart disease, atrial fibrillation or kidney failure.

Preparing for your appointment

Go to the emergency room if you have severe stomach pain that makes you so uncomfortable that you can't sit still. You may be referred for immediate surgery to diagnose and treat your condition.

If your symptoms are mild and infrequent, call your health care provider for an appointment. After an initial evaluation, you may be referred to a doctor who specializes in digestive disorders, called a gastroenterologist, or a surgeon who specializes in blood vessel disorders, called a vascular surgeon.

Here's some information to help you get ready for your appointment, and what to expect from your provider.

What you can do

• Be aware of any pre-appointment restrictions, such as not eating after midnight on the night before your appointment.
• Write down your symptoms, including when they started and how they may have changed or worsened over time.
• Write down your key medical information, including other conditions with which you've been diagnosed.
• Make a list of all medications, vitamins and supplements that you're taking.
• Write down questions to ask during your appointment.

Questions to ask your doctor

• What is the most likely cause of my condition?
• What kinds of tests do I need?
• I have other health problems. How can I best manage these conditions together?
• If I need surgery, what will my recovery be like?
• How will my diet and lifestyle change after I have surgery?
• What follow-up care will I need?

What to expect from your doctor

Your provider is likely to ask you questions about your symptoms, such as:

• When did you begin experiencing symptoms?
• Have your symptoms been continuous or occasional?
• How severe are your symptoms?
• Where do you feel your symptoms the most?
• Does anything seem to make your symptoms better?
• What, if anything, seems to worsen your symptoms?