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Ischemic bowel disease in the elderly.

D A Greenwald1, L J Brandt, J F Reinus

  • 1Division of Gastroenterology, Department of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, New York, USA. dgreenwa@montefiore.org

Gastroenterology Clinics of North America
|July 4, 2001
PubMed
Summary

Ischemic bowel diseases, including colonic ischemia and acute mesenteric ischemia, affect the bowel due to reduced blood flow. Early diagnosis and aggressive management are crucial for better outcomes in these serious conditions.

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Area of Science:

  • Gastroenterology
  • Vascular Surgery
  • Geriatrics

Background:

  • Ischemic bowel diseases encompass a range of disorders characterized by ischemic damage to the bowel.
  • These conditions are predominantly observed in elderly individuals, presenting diverse clinical syndromes and prognoses.
  • Colonic ischemia, the most frequent type, generally has a favorable prognosis.

Purpose of the Study:

  • To review the heterogeneous group of ischemic bowel diseases.
  • To highlight the differences in prognosis between colonic ischemia and acute mesenteric ischemia.
  • To emphasize the importance of prompt diagnosis and aggressive management strategies.

Main Methods:

  • Literature review of ischemic bowel diseases.
  • Analysis of clinical presentations and outcomes.

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  • Discussion of diagnostic and management approaches.

    • Main Results:

    • Acute mesenteric ischemia, often embolic from the superior mesenteric artery, carries a poor prognosis.
    • Nonocclusive mesenteric ischemia is a severe complication of other critical illnesses, frequently linked to atherosclerosis.
    • Colonic ischemia typically presents with a more favorable outlook.

    Conclusions:

    • Effective management of ischemic bowel disease necessitates physician vigilance.
    • An aggressive diagnostic and therapeutic plan is essential in appropriate clinical settings.
    • Understanding the heterogeneity and specific characteristics of these conditions is key to patient care.