Open Access, Peer-reviewed
pISSN 2233-7385
eISSN 2233-7393
    Chonnam Med J. 2008 Dec;44(3):144-150. Korean.
    Published online Dec 18, 2008.
    https://doi.org/10.4068/cmj.2008.44.3.144
    Copyright © 2008 Chonnam National University Medical School
    Original Article

    Clinical Features of Ischemic Colitis: Related to Age, Constipation, Irritable Bowel Syndrome

    Nam-Chul Jin, Yeon-Ju Kim, Young-A Song, Kyung-Won Yoon, Sun-Young Park, Sung-Bum Cho, Wan-Sik Lee,1 Chang-Hwan Park,1 Hyun-Soo Kim,1 Sung-Kyu Choi,1 and Jong-Sun Rew1
      • Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea.
      • 1Chonnam National University Research Institute of Medical Sciences, Gwangju, Korea.
    • Corresponding author (Email: dshskim@jnu.ac.kr )
    Accepted November 19, 2008.

    Abstract

    Ischemic colitis (IC) is a frequent disorder in older person but it is usually self-limiting disease responding to conservative treatment. Recently, incidence of IC increase in gradual at broad range of age, especially to young age, relatively. The aims of this study are to evaluate clinical characteristics of patients with IC treated in Chonnam National University Hospital (CNUH). Between January 2000 and May 2007 in CNUH, 67 patients (30 males, 37 females) with IC were enrolled. We compared clinical features between young and elderly, group with IC accompanied with constipation, irritable bowel syndrome (IBS), or not. Among the 67 IC patients, most patients (79.1%) are older than fifty years and suffer from abdominal pain (71.6%), hematochezia (59.7%) and diarrhea (38.8%). Most of all are diagnosed through colonoscopy (79.1%) or abdominal CT (65.6%) and recovered by conservative treatment (89.6%). Risk factors for IC are atherosclerotic vascular diseases (56.7%), vasoactive medicine (31.3%), IBS (11.9%) and constipation (13.4%). Older age with IC has more frequently associated with risk factors. At the comparison associated with IBS, 3 patients (37.5%) with IBS and 4 patients (6.8%) without IBS have surgery (p=0.008). At the comparison associated with constipation, 45 patients (77.6%) without constipation and 3 patients (33.3%) with constipation have abdominal pain. The results suggest that the presence of IBS or constipation may not be associated with frequency or severity of IC. But more large scaled epidemiologic study was needed.

    Keywords
    Colitis; Ischemic; Constipation; Irritable bowel syndrome

    Tables

    Table 1
    Clinical features of ischemic colitis patients*

    Table 2
    Irritable bowel syndrome*and its subtype among Ischemic colitis

    Table 3
    Clinical features of ischemic colitis patients: comparison between young and elderly groups

    Table 4
    Clinical features of ischemic colitis patients: comparison between IBS (irritable bowel syndrome) and non-IBS groups

    Table 5
    Clinical features of ischemic colitis patients: comparison between constipation*and non-constipation groups

    References

      1. Brandt LJ, Boley SJ. Colonic ischemia. Surg Clin North Am 1992;72:203–229.
      1. Lim YJ, Son HJ, Kang TW, Kim GC, Lee MS, Lee JH, et al. Clinical patterns and prognostic factors of ischemic colitis. Korean J Gastrointest Endosc 2001;22:76–82.
      1. Suh DC, Kahler KH, Choi IS, Shin H, Kralstein J, Shetzliner M. Patients with irritable bowel syndrome or constipation have an increased risk for ischaemic colitis. Aliment Pharmacol Ther 25:681–692.
      1. MacDonald PH. Ischemic colitis. Best Pract Res Clin Gastroenterol 2002;16:51–61.
      1. MacDonald PH. Ischaemic colitis. Best Pract Res Clin Gastroenterol 2002;16:51–61.
      1. Knudsen JF, Friedman B, Chen M, Goldwasser JE. Ischemic colitis and sumatriptan use. Arch Intern Med 1998;158:1946–1948.
      1. Toursarkissian B, Thompson RW. Ischemic colitis. Surg Clin North AM 1997;77:461–470.
      1. Gomella LG, Gehrken GA, Hagihara PF, Flanigan RC. Ischemic colitis and immunosupression. An experimental model. Dis Colon Rectum 1986;29:99–101.
      1. Miller WT, De Poto DW, Scholl HW, Raffensperger EC. Evanescent colitis in the young adult: a new entity? Radiology 1971;100:71–78.
      1. Greenwald DA, Brandt LJ. Colonic ischemia. J Clin Gastroenterol 1998;27:122–128.
      1. Gen T, Seiju H, Ken-ichi S, Hitoshi S, Chikako K, Teruyuki K. Evaluation of clinical features of ischemic colitis: comparison between young and elderly. Digestive Endoscopy 2005;17:123–130.
      1. Cole AJ, Cook SF, Sands BE, Ajene AN, Miller DP, Walker AM. Occurrence of colon ischemia in relation to irritable bowel syndrome. Am J Gastroenterol 2004;99:486–491.
      1. Walker AM, Bohn RL, Cali C, Cook SF, Ajene AN, Sands BE. Risk factors for colon ischemia. Am J Gastroenterol 2004;99:1333–1337.
      1. Suh DC, Kahler KH, Choi IS, Shin Hc, Kralstein J, editors. Patients less than 65 years of age suffering from irritable bowel syndrome or constipation have a high risk of being diagnosed with ischemic colitis; American College of Gastroenterology Annual Meeting; 2005 Oct 29-Nov 2; Honolulu, Hawaii. 2005.
      1. Añón R, Boscá MM, Sanchiz V, Tosca J, Almela P, Amorós C, et al. Factors predicting poor prognosis in ischemic colitis. World J Gastroenterol 2006;12:4875–4878.
      1. Higgins PD, Davis KJ, Laine L. Systematic review: the epidemiology of ischaemic colitis. Aliment Pharmacol Ther 2004;19:729–738.
      1. Longstreth GF. Definition and classification of irritable bowel syndrome: current consensus and controversies. Gastroenterol Clin North Am 2005;34:173–187.
      1. Whitehead WE, Palsson O, Jones KR. Systematic review of the comorbidity or irritable bowel syndrome with other disorders: what are the causes and implications? Gastroenterology 2002;122:1140–1156.
      1. Longstreth GF, Thompson WG, Chey WD, Houghton LA, Mearin F, Spiller RC. Functional bowel disorders. Gastroenterology 2006;130:1480–1491.
      1. MacDonald PH. Ischaemic colitis. Best Pract Res Clin Gastroenterol 2002;16:51–61.
      1. Habu Y, Tahashi Y, Kiyota K, Matsumura K, Hirota M, Inokuchi H, et al. Reevaluation of clinical features of ischemic colitis. Analysis of 68 consecutive cases diagnosed by early colonoscopy. Scand J Gastroenterol 1996;31:881–886.
      1. Park CJ, Jang MK, Shin WG, Kim HS, Kim HS, Lee KS, et al. Can we predict the development of ischemic colitis among patients with lower abdominal pain? Dis Colon Rectum 2007;502:232–238.
    MeSH Terms
    Abdominal Pain
    Aged
    Colitis
    Colitis, Ischemic
    Colonoscopy
    Constipation
    Diarrhea
    Epidemiologic Studies
    Gastrointestinal Hemorrhage
    Humans
    Incidence
    Irritable Bowel Syndrome
    Male
    Risk Factors
    Vascular Diseases
    Metrics
    Share
    Tables
    slide
    slide
    slide
    slide
    slide

    1 / 5

    PERMALINK