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Journal of Clinical and Experimental Gastroenterology

ISSN: 2833-1133

Mini Review Open Access
Volume 1 | Issue 1 | DOI: https://doi.org/10.46439/gastro.1.005

Ischemic colitis as a cause of severe hematochezia: A mini review

Usah Khrucharoen1,2,3,4,*, Dennis M. Jensen1,2,3,4
  • 1CURE Hemostasis Research Unit and the UCLA Digestive Diseases Research Core Center (UCLA: DDRCC), Los Angeles, CA, USA
  • 2David Geffen School of Medicine at University of California, Los Angeles, CA, USA
  • 3Vatche and Tamar Manoukian Division of Digestive Diseases and Department of Medicine, Ronald Reagan UCLA Medical Center, Los Angeles, CA, USA
  • 4Division of Digestive Diseases and Department of Medicine, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
+ Affiliations - Affiliations

Corresponding Author

Dennis M. Jensen, djensen@mednet.ucla.edu

Received Date: June 19, 2022

Accepted Date: June 30, 2022

Citation:

Khrucharoen U, Jensen DM. Ischemic colitis as a cause of severe hematochezia: A mini review. J Clin Exp Gastroenterol. 2022;1(1):22-26.


Copyright: © 2022 Khrucharoen U, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Ischemic colitis (IC) is a common cause of severe lower gastrointestinal bleeding (LGIB) in the elderly. There are very few studies of patients with IC as a cause of severe LGIB in the literature. This article aims to review diagnosis, colonoscopic findings, medical treatment, and outcomes of patients with IC as a cause of severe hematochezia. The majority of IC patients with severe hematochezia can be successfully managed with medical treatment. Colonoscopic hemostasis with hemoclips is safe and feasible in treating major stigmata of recent hemorrhage in focal ischemic ulcers. Colon surgery is indicated in patients who fail medical treatment and/or have severe ongoing bleeding, clinical deterioration, or peritoneal signs. Overall, the morbidity rates in patients with IC range from 10% to 79%. Clinical outcomes in patients who need colon surgery for IC are worse than those treated with medical management. Patients who develop hematochezia from IC during hospitalization for other medical conditions have worse clinical outcomes than those with an outpatient start of bleeding. Further research is warranted for the prevention, early diagnosis, and treatment of patients with severe hematochezia from IC.

Keywords

Ischemic colitis, Severe hematochezia, Colonoscopic hemostasis, Outcomes

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