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{{Ischemic colitis}}
{{Ischemic colitis}}
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==Overview==
Causes of reduced blood flow leading to ischemic colitis include changes in the systemic circulation such as [[hypotension|low blood pressure]] (hypotension) or local factors such as [[vasoconstriction|constriction of blood vessels]], a [[blood clot]], or drugs. In most cases, no specific cause can be identified.


==Causes==
==Causes==
Ischemic colitis is often classified according to the underlying cause. ''Non-occlusive'' ischemia develops because of low blood pressure or constriction of the vessels feeding the colon; ''occlusive'' ischemia indicates that a [[blood clot]] or other blockage has cut off blood flow to the colon.
The causes of ischemic colitis are as follows:<ref name="HassKozuch2007">{{cite journal|last1=Hass|first1=David J.|last2=Kozuch|first2=Patricia|last3=Brandt|first3=Lawrence J.|title=Pharmacologically Mediated Colon Ischemia|journal=The American Journal of Gastroenterology|volume=102|issue=8|year=2007|pages=1765–1780|issn=0002-9270|doi=10.1111/j.1572-0241.2007.01260.x}}</ref><ref name="TheodoropoulouΚoutroubakis2008">{{cite journal|last1=Theodoropoulou|first1=Αngeliki|last2=Κoutroubakis|first2=Ioannis E|title=Ischemic colitis: Clinical practice in diagnosis and treatment|journal=World Journal of Gastroenterology|volume=14|issue=48|year=2008|pages=7302|issn=1007-9327|doi=10.3748/wjg.14.7302}}</ref><ref>Feldman: Sleisenger & Fordtran's Gastrointestinal and Liver Disease, 7th ed., 2002 Saunders, p. 2332.</ref>


===Non-occlusive ischemia===
*Ischemic colitis is often classified according to the underlying cause.
**Non-occlusive [[ischemia]] develops because of [[low blood pressure]] or constriction of the [[Blood vessel|vessels]] supplying [[blood]] to the [[Colon (anatomy)|colon]].
**[[Thromboembolism|Occlusive]] [[ischemia]] indicates that a [[blood clot]] or other blockage has cut off [[blood]] flow to the [[colon]].


In hemodynamic instable patients (i.e. shock) the mesenteric perfusion may be compromised. This condition is commonly asymptomatic, and usually only apparent through a systemic inflammatory response.
===Non-occlusive Ischemia===
* In [[Hemodynamics|hemodynamically]] unstable patients the [[mesenteric]] perfusion can be compromised.


===Occlusive ischemia===
===Occlusive Ischemia===
Occlusive is ischemia is due to either:
*[[Cardiovascular disease|Obstructive]] [[Atherosclerosis|atherosclerotic]] disease
**[[Superior mesenteric artery]] occlusion


1. Obstructive Atherosclerotic Disease
* [[Thromboembolism]]
** Most commonly the [[embolism]] is due to [[atrial fibrillation]]
** [[Valvular heart disease]] including [[endocarditis]]
** [[Myocardial infarction]]
** [[Cardiomyopathy]]


2. Thromboembolism
*[[Hernia]]
 
*[[Tumor]]
Mostly the result of a [[thromboembolism]]. Commonly the embolism is caused by [[atrial fibrillation]], valvular disease, [[myocardial infarction]], or [[cardiomyopathy]].


===Drugs===
===Drugs===
The following drugs cause vasoconstriction which may compromise blood supply to the colon.
*[[Alosetron]]
*[[Alosetron]]
*[[Cilansetron]]
*[[Cilansetron]]
*[[Interferon alfacon-1]]
*[[Pegylated interferon alfa-2b]]
*[[Ramosetron]]
*[[Ramosetron]]
*[[Vasopressors]]
*[[Ergotamine]]


==References==
==References==
{{reflist|2}}
{{Reflist|2}}


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Latest revision as of 14:16, 5 February 2018

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

Overview

Causes of reduced blood flow leading to ischemic colitis include changes in the systemic circulation such as low blood pressure (hypotension) or local factors such as constriction of blood vessels, a blood clot, or drugs. In most cases, no specific cause can be identified.

Causes

The causes of ischemic colitis are as follows:[1][2][3]

Non-occlusive Ischemia

Occlusive Ischemia

Drugs

The following drugs cause vasoconstriction which may compromise blood supply to the colon.

References

  1. Hass, David J.; Kozuch, Patricia; Brandt, Lawrence J. (2007). "Pharmacologically Mediated Colon Ischemia". The American Journal of Gastroenterology. 102 (8): 1765–1780. doi:10.1111/j.1572-0241.2007.01260.x. ISSN 0002-9270.
  2. Theodoropoulou, Αngeliki; Κoutroubakis, Ioannis E (2008). "Ischemic colitis: Clinical practice in diagnosis and treatment". World Journal of Gastroenterology. 14 (48): 7302. doi:10.3748/wjg.14.7302. ISSN 1007-9327.
  3. Feldman: Sleisenger & Fordtran's Gastrointestinal and Liver Disease, 7th ed., 2002 Saunders, p. 2332.

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