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Ischemic colitis in young adults: a single-institution experience
O A Preventza1, K Lazarides, M D Sawyer
1Department of Gastroenterologic and General Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, U.S.A.
Summary
Ischemic colitis is uncommon in young adults but presents with abdominal pain and bloody diarrhea. A female predominance was observed, with oral contraceptive use a potential factor, though etiology often remains unknown.
Area of Science:
- Gastroenterology
- Colorectal Surgery
- Internal Medicine
Background:
- Ischemic colitis is less understood in young adults compared to older populations.
- This study addresses the limited characterization of ischemic colitis in individuals under 50.
Purpose of the Study:
- To investigate the demographics, causes, clinical presentation, and outcomes of ischemic colitis in young adults.
- To identify risk factors and understand the disease course in this specific age group.
Main Methods:
- Retrospective analysis of 39 young adult patients (<50 years) diagnosed with ischemic colitis between 1990 and 1998.
- Data collected included patient demographics, potential etiologies, clinical symptoms, diagnostic methods (colonoscopy), and treatment outcomes.
Main Results:
- The mean age was 38 years, with a female predominance (1.8:1 ratio).
- Oral contraceptive use was noted in 52% of female patients.
- Common symptoms included abdominal pain (77%) and bloody diarrhea (54%).
- Nearly half (49%) had no identifiable predisposing factors.
- Most patients (77%) were managed non-surgically; 10 required surgery, with one death.
Conclusions:
- Ischemic colitis in young adults shows a female predominance, with oral contraceptive use as a potential association.
- Etiology is often unclear in this demographic.
- The condition has a low mortality rate in young adults, with most cases managed conservatively.