Ischemic colitis medical therapy
|
Ischemic colitis Microchapters |
|
Case Studies |
|
Ischemic colitis medical therapy On the Web |
|
American Roentgen Ray Society Images of Ischemic colitis medical therapy |
|
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: Cafer Zorkun, M.D., Ph.D. [2]
Overview
Except in the most severe cases, ischemic colitis is treated with supportive care.
Medical Therapy
Intravenous Fluids
- IV fluids are given to treat dehydration, and the patient is placed on bowel rest (meaning nothing to eat or drink) until the symptoms resolve.
Optimize Cardiac Output
- If possible, cardiac function and oxygenation should be optimized to improve oxygen delivery to the ischemic bowel.
Nasogastric Tube
- A nasogastric tube may be inserted if an ileus is present.
Antibiotics
- Antibiotics are sometimes given in moderate to severe cases. The data supporting this practice dates to the 1950s.[1] More recent animal data suggests that antibiotics may increase survival and prevent bacteria from crossing the damaged lining of the colon into the bloodstream.[2][3][4]
- The use of prophylactic antibiotics in ischemic colitis has not been prospectively evaluated in humans, but many authorities recommend their use based on the animal data.[5]
Contraindicated medications
Ischemic colitis is considered an absolute contraindication to the use of the following medications:
References
- ↑ 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.
- ↑ 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.
- ↑ Bennion R, Wilson S, Williams R (1984). "Early portal anaerobic bacteremia in mesenteric ischemia". Arch Surg. 119 (2): 151–5. PMID 6696611.
- ↑ 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.
- ↑ Feldman: Sleisenger & Fordtran's Gastrointestinal and Liver Disease, 7th ed., 2002 Saunders, p. 2334.