India ink tattoo for pseumatosis coli

[rafmd]

I am 57 years old and in good health. I have long had a manageable hemorrhoid problem but recent profuse bleeding sent me to my gastroenterologist, who recommended a colonoscopy. During the procedure he found a small area of pneumatosis coli which bled upon contact. He tattooed the section with india ink, on the assumption that a laparotomy might be required. The biopsy showed no abnormality.  Anoscopic examination and infrared coagulation confirmed that the bleeding I experienced was indeed from the hemorrhoids only.
  Since surgery is very rarely indicated for pneumatosis, was he justified in subjecting me to the risk of a permanent colonic tattoo? Was he justified in using a tattoo agent that is not FDA-approved rather than one that is? And was he justified in treating the hemorrhoids after, rather than before, the colonoscopy?

[Kevin Pho, MD]

There are several small studies suggesting treatment for pneumatosis coli.  This can include hyperbaric oxygen which can be beneficial in symptommatic cases.

Some gas-producing bacteria may be associated with symptoms.  Small studies with antibiotics (specifcally Flagyl) can result in some symptommatic relief.

Endoscopic therapy can also be considered.  Sclerosing agents are typically used to treat the area of concern.  I am not aware of india ink being one of the sclerosing agents.  However, as I am not a gastroenterologist, this may be entirely possible.

Surgery is normally considered should these more conservative measures fail.  

You can discuss these options with your personal physician or gastroenterologist.

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.
http://www.straightfromthedoc.com