Diagnostic methods and drug therapies in patients with ischemic colitis

Abstract

Purpose Ischemic colitis (IC) is the most prevalent ischemic injury of thegastrointestinal tract. Clinical features of IC such as acute abdominal pain, hematochezia,and diarrhea are similar to those of acute mesenteric ischemia, inflammatorybowel disease, or infectious bowel disease, and their relative ambiguity candelay diagnosis and treatment. To comprehensively detail the current state ofdiagnostic methods and available drug therapies for detecting and treating IC,this review aims to provide a concise and practical summary of thecorresponding literature. Methods PubMed and Cochrane Library were searched toretrieve all published studies reporting the diagnostic methods and drugtherapies in patients with ischemic colitis. The search strategy of drugtherapy includes human and animal data. Results Colonoscopy combined with histopathologicalbiopsy is the standard of diagnosis for the IC. Most patients respond well tothe conservative treatment, and surgical consultation is needed when conservativetreatment is ineffective. Studies of potential drug therapy have beendeveloped, including phosphodiesterase type 5 inhibitors, pentoxifylline,rebamipide, prostaglandin E1, and polydeoxyribonucleotide. Conclusion Accurate diagnoses and effective treatmentshave helped reduce the mortality rate and improve prognoses for patientsafflicted with IC, and corresponding drug therapies have been constantlyupdated as new research has emerged.

Ischemic Colitis Presented as Pseudomembranous Colitis: An Untypical Case from Vietnam

“…IC had diverse manifestations, ranging from acute colitis (including PMC) to chronic colitis or complications (stricture, gangrenous bowel, and fulminant pancolitis. 2,3,9 Like previous case reports, the patient, who was elderly with various comorbidities related to atherosclerosis, such as hypertension, ischemic strokes, and diabetes, had affected colon segments on the left side.…”

“…Colonoscopy has been regarded as the gold standard diagnostic approach by directly observing the colonic mucosa and obtaining biopsy specimens, which can overcome the difficulty of recognizing IC. 2,3 Common features include darkened or pale, edematous and fragile mucosa, segmental erythema, petechial hemorrhages, longitudinal ulcer, and lesions that are particularly segmented and distributed patchily. [1][2][3] The endoscopic examination revealed nonspecific pseudomembranous colitis with ulcers from the rectum to the splenic flexure.…”

“…2,3 Common features include darkened or pale, edematous and fragile mucosa, segmental erythema, petechial hemorrhages, longitudinal ulcer, and lesions that are particularly segmented and distributed patchily. [1][2][3] The endoscopic examination revealed nonspecific pseudomembranous colitis with ulcers from the rectum to the splenic flexure. PMC is distinguished by raised yellow-white nodules or plaque on the mucosal surfaces of the colon that form pseudomembranes.…”

“…Ischemic colitis (IC) is one of the most frequent forms of ischemic bowel disease, with various presentations depending on the injury's onset, duration, and extent of involvement in colon segments. [1][2][3] A submucosal mass and a narrowed colon segment with an ulcerated mucosa have been reported…”

Lactulose-Induced Ischemic Colitis: A Rare Presentation and an Overview of Possible Etiologies of the Disease

“…The diagnostic affirmation of ischemic colitis; however, depends on computed tomography (CT) and magnetic resonance (MR) imaging modalities that effectively track portal venous gas, pneumatosis, bowel dilation, colonic wall thickening, edema, and thumbprinting [ 9 ]. In addition, colonoscopy is the gold standard for diagnosing ischemic colitis based on its capacity to visualize colonic mucosa and facilitate histological sampling [ 10 ]. The CT findings for non-gangrenous ischemic colitis include pericolonic stranding, thumbprinting, and bowel wall thickening; however, the medical management relies on nasogastric tube placement, bowel rest, supplemental oxygen, cardiac output optimization, and intravenous fluid resuscitation.…”