Study Identifies Risk Factors for Colon Ischemia

Colon ischemia, the term applied broadly to allforms of ischemic injury to the colon, has gainedprominence as a complication of alosetron treatmentfor irritable bowel syndrome with diarrhea(IBS-D). A barrier to the interpretation of this finding,however, is the paucity of quantitative informationon the incidence or determinants of colonischemia.

As reported in the July 2004 issue of TheAmerican Journal of Gastroenterology, AlexanderWalker, MD, DrPH, and colleagues examineddemographic and clinical characteristics of, andprevious health care use by, patients with presumedcolon ischemia to identify predictors of thiscondition. Insurance data between 1995 and 1999were used to identify 700 individuals with presumedcolon ischemia and 6440 controls.

Analysis showed that patients with colonischemia were nearly 3 times as likely as controlsto have IBS. In addition, a history of nonspecificcolitis, lower gastrointestinal tract hemorrhage,systemic rheumatic disorders, ischemicheart disease during the preceding 6 months, orabdominal surgery during the past month wasmuch more common among patients with colonischemia than among controls. The most prevalentrisk factor for colon ischemia was use ofdrugs associated with constipation as anadverse effect.

The authors concluded that clinically evidentcolon ischemia occurs preferentially in individualswith previous abdominal complaints, IBS, or both.In addition, drugs that reduce bowel motility mayconstitute a widespread and potentially avoidablerisk factor.