Although ischemic colitis is often considered a condition of elderly persons or persons with vascular disease, it also occurs in healthy adults under age 60. While some patients may have gangrenous forms of ischemic colitis, others may have a benign, self-limited form of the disorder. This disorder should be included in the differential diagnosis in patients presenting with abdominal pain and hematochezia or bloody diarrhea. Estrogen or oral contraceptive therapy is associated with transient ischemic colitis, so its use should further raise suspicion. The effectiveness of discontinuation of estrogen therapy is controversial, but this measure should be considered.
Conservative management includes repeated careful assessment, pain management and fluid replacement.
Complications are rare and the prognosis is excellent. Occasionally, patients have recurrences. M.D. University of Alabama at Birmingham Birmingham, Alabama Patients who have experienced an isolated afebrile seizure often present to a primary care physician. A detailed history and carefully performed physical examination aid the physician in determining whether the event was actually a seizure and whether it was the patient's first seizure. Studies assessing the risks of recurrence, remission and relapse, as well as treatment strategies, provide objective data on which the primary care physician and the patient can base treatment decisions.