Acute Ischemic Colitis due to Oral Phenylephrine

Oral phenylephrine is a commonly used over-the-counter nasal decongestant drug. It is usually taken for symptomatic relief (in combination drug products) for upper respiratory tract infections, allergic rhinitis, or sinusitis. Adverse cardiovascular effects of intravenous phenylephrine, including organ ischemia, are well known; however, oral phenylephrine is rarely associated with significant adverse effects. We describe the first case of acute ischemic colitis in a young patient due to over-the-counter oral phenylephrine, which was taken as a nasal decongestant. We reviewed the literature of colonic ischemia related to the use of systemic nasal decongestants phenylephrine and pseudoephedrine.