Home >
The right to physical integrity and informed refusal: Just how far does a patient’s right to refuse medical treatment go? >
Reader Comments >
Golden Revive Plus-Can you survive ischemic bowel?
CONTACT THE EDITOR
Professor Ames Dhai
This journal is protected by a Creative Commons Attribution - NonCommercial Works License (CC BY-NC 4.0) | Read our privacy policy. Our Journals: South African Medical Journal | African Journal of Health Professions Education | South African Journal of Bioethics and Law | South African Journal of Child Health | Southern African Journal of Critical Care | Strenghtening Health Systems |
Golden Revive Plus-Can you survive ischemic bowel?
by fiona basil (2021-11-01)
The large intestine, also called the colon, is a portion of the intestine of approximately one and a half meters in length, responsible for storing organic waste to later be eliminated through the feces, it also houses the bacteria that are part of the normal flora from the intestine and absorbs some vitamins such as vitamin K.
The blood flow of the colon is guaranteed by the mesenteric vessels, so any disease that affects them can trigger a decrease in oxygen supply to the colonic tissues. When this occurs, ischemia or death of the colon can occur, which is called ischemic colitis, causing severe abdominal pain that can turn into a medical emergency.
What is ischemic colitis?
Ischemic colitis (also known as colonic infarction) is defined as a group of diseases that generate partial or total occlusion and loss of blood flow in the mesenteric vessels, causing the cell death of a segment or the entire colon.
The implication that a tissue does not get enough blood is that cells need oxygen and nutrients from the blood to live. This is how the loss of blood flow causes cell death of the colon epithelium. The same occurs when a coronary artery becomes blocked (causing a myocardial infarction) or when the flow of the middle cerebral artery slows (causing a stroke).
According to its severity, ischemia can be only at the level of the mucosa (superficial) or of all the layers of the colon wall.
The ischemic colitis is most common in people over 60, smokers and people with diseases such as atherosclerosis, chronic obstructive pulmonary disease, high blood pressure, high cholesterol and a history of myocardial infarction or cerebrovascular accident.
Causes of ischemic colitis
The causes for which the mesenteric blood flow can be slowed or occluded are numerous, therefore, most of the cases are due to the presence of an atheroma plaque (fatty structure in the intimal layer of the arteries) or a thromboembolism of the mesenteric artery.
However, there are other common causes, such as an aortic aneurysm, abdominal trauma (blunt and from gunshot wounds), abdominal surgeries, hypovolemic and distributive shock, disseminated intravascular coagulation, large vessel vasculitis, and any prothrombotic state such as presence of cancer, abuse of illicit drugs such as cocaine or methentamines, autoimmune diseases, long-term use of oral contraceptives and chronic smoking, among others.
What are the symptoms of ischemic colitis?
Symptoms vary according to the degree of obstruction and loss of blood flow to the mesenteric vessels. Some symptoms of ischemic colitis are:
When to go to the emergency area?
It is important that the patient is aware of some situations that warrant emergency evaluation. For example, a person who presents a digestive hemorrhage due to any cause, should immediately consult an emergency area to establish the diagnosis, since in a few hours the body can trigger a hemodynamic failure due to blood loss, which can lead to be a deadly condition.
On the other hand, a patient with sudden onset, limiting abdominal pain that sets in and worsens within a few hours should be evaluated immediately to rule out a surgical emergency.
The doctor will rule out other differential diagnoses such as biliary or appendicular starting point peritonitis, acute diverticulitis, colonic abscesses, intestinal perforations, intestinal tumors and intestinal obstruction, among others. For this, he will request complementary studies (radiography, abdominal tomography, abdominal ultrasound, angiography, among others) that allow determining the cause of abdominal pain.
It is important that the person who presents any type of abdominal pain does not self-medicate and always consult the doctor, in order to make an accurate diagnosis of the pathology that is causing the symptoms.
Arthritis pain in even one joint can take a toll on your entire body. For example, a painful neck can prevent you from turning your head properly, placing stress on your shoulders. A painful knee may cause you to walk in a way that affects your hips, back and feet. And holding a joint still to protect it can make moving it more difficult and in some cases almost impossible over time. If joint pain is caused by an inflammatory disease such as rheumatoid arthritis or juvenile idiopathic arthritis, systemic treatment is needed to stop inflammation that can lead to joint damage or destruction. For flares of pain, persistent pain or pain due to other causes, there are many things you can do on your own or ask your doctor or physical therapist about to get relief. Golden Revive Plus