Tuesday 3 December 2013

Ischemic colitis - Treatments in Conventional medicine

Colitis is defined as a condition of inflammation of the large intestine, including the colon, caecum and rectum.
Treatments
A. In conventional medicine perspective
Ischemic colitis
Ischemic colitis is the most common type of intestinal ischemia
 A.4.1. Non surgical treatments
Supportive care with intravenous fluids, optimization of hemodynamic status, avoidance of vasoconstrictive drugs, bowel rest, and empiric antibiotics will produce clinical improvement within 1 to 2 days in most patients, according to the study by Duke University Medical Center(95).

A.4.2. Surgical treatments
1. Colectomy
According to the study by , although conservative therapy is effective in most cases, surgery still plays a key role in the treatment of ischemic colitis. Here, we describe a case of a 73-year-old man in whom laparoscopy-assisted left colectomy was performed 80 d after the onset of ischemic colitis. He recovered completely after surgery, and the pathological findings were consistent with ischemic colitis(96).

2. Colonoscopy
In the study of 15 patients with ischemia of the colon, researchers found that rigid proctoscopy was normal or demonstrated nonspecific proctitis in 12 of 15 patients studied. Colonoscopic biopsies demonstrated superficial inflammatory changes in all patients. Thirteen patients had complete mucosal healing endoscopically in 2 weeks to 3 months with stricture developing in four patients. Because ischemic colitis is a distinct subtype of ischemic bowel disease most often limited to the superficial mucosa, colonoscopy is an alternative and usually safe modality in the diagnosis of this entity and proved more accurate that conventional x-ray and proctoscopy(97).
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Sources
(95) http://www.ncbi.nlm.nih.gov/pubmed/15759953
(96) http://www.ncbi.nlm.nih.gov/pubmed/23293734
(97) http://www.ncbi.nlm.nih.gov/pubmed/7297823 

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