Ischemic colitis medical therapy

Jump to navigation Jump to search

Colitis Main Page

Ischemic colitis Microchapters


Patient Information


Historical Perspective




Differentiating Ischemic colitis from other Diseases

Epidemiology and Demographics

Risk Factors


Natural History, Complications and Prognosis


History and Symptoms

Physical Examination

Laboratory Findings

Abdominal X Ray




Other Imaging Findings

Other Diagnostic Studies


Medical Therapy


Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Ischemic colitis medical therapy On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides


American Roentgen Ray Society Images of Ischemic colitis medical therapy

All Images
Echo & Ultrasound
CT Images

Ongoing Trials at Clinical

US National Guidelines Clearinghouse

NICE Guidance

FDA onIschemic colitis medical therapy

CDC on Ischemic colitis medical therapy

Ischemic colitis medical therapy in the news

Blogs on Ischemic colitis medical therapy

Directions to Hospitals Treating Ischemic colitis

Risk calculators and risk factors for Ischemic colitis medical therapy

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Hamid Qazi, MD, BSc [2]


Ischemic colitis is usually treated with supportive care. Treatment is determined by its severity and include intravenous fluids, bowel rest, nasogastric tube, and total parenteral nutrition. Patients with colonic dilatation are managed with insertion of a rectal tube or endoscopic decompression. There is no evidence about the role of anticoagulation or antiplatelet therapy. Steroids have not been shown to improve outcomes.

Medical Therapy

The medical therapy for ischemic colitis is as follows:[1][2][3][4][5][6]

Intravenous Fluids

Optimize Cardiac Output

Nasogastric Tube


  • Antibiotic use in animal studies has demonstrated reduced duration and severity of ischemic colitis, and prevention of bacterial translocation through damaged mucosa.
    • A study involving dogs demonstrated reduction in vessel thrombosis and increased survival.
  • The role of antibiotic therapy in humans requires further research.

Contraindicated medications

Algorithm of management of ischemic colitis

  • The following algorithm represents the management of ischemic colitis.
Abdominal pain, diarrhea, lower GI bleeding
Diagnosis by CT scan or colonoscopy
Stable or improving
Peritonitis signs or gangrenous bowel
Continuation of symptoms
Repeat colonoscopy after 2 weeks
Emergency laparatomy
Resection of diseased bowel
Segmental colitis
Segment colectomy


  1. PATH, EJ, McCLURE, JN Jr. Intestinal obstruction; the protective action of sulfasuxidine and sulfathalidine to the ileum following vascular damage. Ann Surg 1950; 131:159.
  2. Plonka A, Schentag J, Messinger S, Adelman M, Francis K, Williams J (1989). "Effects of enteral and intravenous antimicrobial treatment on survival following intestinal ischemia in rats". J Surg Res. 46 (3): 216–20. PMID 2921861.
  3. Bennion R, Wilson S, Williams R (1984). "Early portal anaerobic bacteremia in mesenteric ischemia". Arch Surg. 119 (2): 151–5. PMID 6696611.
  4. Redan J, Rush B, Lysz T, Smith S, Machiedo G (1990). "Organ distribution of gut-derived bacteria caused by bowel manipulation or ischemia". Am J Surg. 159 (1): 85–9, discussion 89-90. PMID 2403765.
  5. Feldman: Sleisenger & Fordtran's Gastrointestinal and Liver Disease, 7th ed., 2002 Saunders, p. 2334.
  6. Nikolic, Amanda L.; Keck, James O. (2017). "Ischaemic colitis: uncertainty in diagnosis, pathophysiology and management". ANZ Journal of Surgery. doi:10.1111/ans.14237. ISSN 1445-1433.

Template:WH Template:WS