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Lower gastrointestinal bleeding and ischemic colitis
Jamie R Newman1, Mary Anne Cooper
1Division of Gastroentorology, Sunnybrook and Women's College Health Sciences Centre, University of Toronto, Toronto, Canada.
Insights
Ischemic colitis is a significant cause of lower gastrointestinal bleeding, particularly in younger women using estrogen. This condition is more prevalent in women than men and was the second leading cause of LGI bleeding in the study.
Area of Science:
- Gastroenterology
- Clinical Medicine
- Epidemiology
Background:
- Lower gastrointestinal (LGI) bleeding is a common clinical presentation.
- Ischemic colitis is one potential cause of LGI bleeding, with varying incidence and characteristics.
- Understanding the specific features of LGI bleeding due to ischemic colitis is crucial for diagnosis and management.
Purpose of the Study:
- To compare the incidence and clinical characteristics of lower gastrointestinal bleeding (LGI) caused by ischemic colitis versus other etiologies.
- To identify demographic and clinical differences between patients with ischemic colitis and those with LGI bleeding from other sources.
Main Methods:
- A retrospective chart review was conducted.
- Patients admitted with LGI bleeding between July 1997 and January 2000 were analyzed.
- Data on patient demographics, bleeding causes, and clinical outcomes were collected.
Main Results:
- Ischemic colitis accounted for 24 of 124 LGI bleeding cases, making it the second most common cause after diverticulosis (62 cases).
- Patients with ischemic colitis were statistically younger than those with diverticular bleeding and other causes.
- A higher proportion of women with ischemic colitis (44.4%) were using estrogen therapy compared to other LGI bleeding groups.
Conclusions:
- Ischemic colitis is a notable cause of lower gastrointestinal bleeding.
- Lower gastrointestinal bleeding affects women more frequently than men.
- Estrogen use was significantly more common among women experiencing ischemic colitis-related LGI bleeding.
Objective:
To compare the incidence and clinical characteristics of lower gastrointestinal (LGI) bleeding due to ischemic colitis with those with LGI bleeding of other causes.
Methods:
A chart review was performed of patients admitted with LGI bleeding to Sunnybrook and Women's College Health Sciences Centre, Toronto, Ontario, between July 1, 1997 and January 31, 2000.
Results:
Of 124 patients with LGI bleeding, 24 cases were due to ischemic colitis, 62 to diverticulosis, 11 to inflammatory bowel disease (IBD) and 27 to all other causes ('others'). The average ages of patients in each group were 66.5, 76.5, 40.5 and 77.5 years, respectively. Patients with ischemic colitis were statistically younger than those with diverticular bleeding and 'others'. Patients with IBD were younger than those in the other three groups. The only statistical difference for vascular disease risks was hypertension, because of its absence from the IBD group. Three patients with ischemic colitis underwent blood transfusions, while 23 with diverticulosis, 15 'others' and none with IBD received blood. Three patients with ischemic colitis and one patient from the 'others' group died. More women (75) than men (49) had LGI bleeding - in total and within each subgroup. Of women with LGI bleeding, many more with ischemic colitis (44.4%) than with diverticulosis (3.0%), IBD (0%) or 'others' (5.6%) were taking estrogen.
Conclusions:
Ischemic colitis was the second most common cause of LGI bleeding. LGI bleeding from all causes was more common in women than in men. Many more women in the ischemic colitis group than in the other groups were using estrogen therapy.