Digestive Disorders / Gastroenterology Expert Forum
Recurrent Ischemic Colitis
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Recurrent Ischemic Colitis

I am an otherwise healthy 52 yr. old female and have just experienced my third attack of ischemic colitis. I have been hospitalized with all three bouts, they have been identical in symptoms and diagnosis each time via colonoscopy. My problem area is the "watershed" area, just below the spleen. All three times the ischemic attack has been in exactly the same area of colon and is thought to involve about 6-8" of colon. After the second attack, I was told that if it occurred a third time I could expect a bowel resection. Now that the third attack has occurred, my GI Dr., PCP, and a general surgeon have all agreed that it is time to consider surgery and have presented the scenario that waiting could be somewhat dangerous. I am feeling particularly worried about the surgery, as the surgeon who would perform it presented all of the possible complications and for some reason, I am focused on the cons of the surgical process more than I seem to be able to focus on the cons of waiting to do it. I appear to be having difficulty healing this time, as the attack was a week ago and until this evening, was still unable to retain fluids or food of any type, including clear liquids. I seem to be somewhat better tonight, in that I have retained both water and Ensure, for the first time in a week, but the surgeon and I agreed that I would make a decision by tomorrow morning about whether to have the surgery this coming week or not. I want to be absolutely certain that I truly do need to have this surgery and that I am not rushing into something so serious. Am I at risk for having even more ischemic attacks? Is each recurrent attack more dangerous? If I have the bowel resection, will I be able to eventually eat normally again, or will I forever be limited in what I can eat? The length of hospital stay (one week) and recovery time (6-8 wks) is daunting and I would like to avoid it if it makes any sense. I would greatly appreciate any and all thoughts on my situation. I have had several prior surgeries of other types and have never been so worried as I am about this one. Thanks.
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I am not a surgeon, so my insight into this question is limited.

Agree that surgery is a reasonable option, given you have had three attacks already.  The risk of not doing the surgery is the possibly of further attacks - maybe leading to bowel infarction, which is a life-threatening condition.  

If the surgery is without complication, there should be little change in your diet nor lifestyle.  

If you continue to be concerned about the surgery, I would obtain a second surgical opinion - preferably at a major academic medical center.  

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
kevinmd_
3 Comments
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It's now the following day and I have managed not to have diarrhea since yesterday afternoon. I have also spoken with my surgeon who told me that there is no way of knowing just how damaged, if at all, this stretch of colon is, since colonoscopies have not been done following the healing process after one of my ischemic attacks. He does believe there is a 70-85% chance of another recurrent attack. My primary question is do I need to have this surgery now? I would also appreciate hearing from anyone who has had this particular surgery and what it was like. Thanks.
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My frient has ulceritive colitis.  He is allergic to all the medications prescribed to him (they cause nausea, insomnia, headaches, and diahrea).  The only thing he can take is steriods, which he doesn't like to.

Does anyone know anything else he can try?
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I have recently been told that I have colitis.  Does any one know if there is any special diet that I should be on that will help me with this problem?  I can't get a straight answer from any of the Dr's that I have seen.  They just say no milk products and and no soda's but don't say why.  Are there any other foods that I should be eating or not eating that will help me deal with this upsetting problem that I am sure far too many of you already know about.  Please help !!!   Thanks.
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A related discussion, Diet Tips for Ischemic Colitis was started.
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