ischemic colitis

I am 43 year old , female with two children , for about two months i complain of acute pain at the left lower abdomen related to eating , with constipation ( Now i can't defecate without an enema for the last two weeks ), for the last 20 days I noticed bright red blood with mucus with stool , I performed a colonscope which revealed multiple aphthus ulcers alover the colon and multiple acute angled fixed splenic flexure, the biobsies taken revealed ischemic active colitis  . my doctor said he didn't know the exact cause of this but he insist that it is not an inflammatory bowel disease. I didn't receive any treatments until now . 3 years ago I noticed the same character of pain but on the right upper abdomen ,  a laparoscopic exploration was done which revealed very dense adhesions around the liver and multiple areas of fibrosis in the liver ,the jejunum also shows multiple white strikes , biopsies revealed sclerosing cholangitis in the liver and mild inflammation in the jejunum . My doctor fail to diagnose my case and referred me to a surgeon to do laparoscopic lysis of the adhesions, Now I didn't eat for one month because I'm afraid of pain and I have lost 10 kg of my weight in one month. Could you please tell me the possible causes of my case , the next step I have to do and whether the operation will be benifitial for me.    thanks for help

[Ratnakar Kini, MD]

Hi,
Since you have been diagnosed with sclerosing cholangitis, it is more likely that the bowel lesions are due to IBD as both these conditions are related.
I would suggest a repeat colonoscopy with biopsy.
Most often IBD is confused with colon ischemia.  Also ischemic colitis usually presents as an acute condition.