What are the differential diagnoses for ischemic colitis?

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Last updated: April 12, 2025View editorial policy

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Differential Diagnosis for Ischemic Colitis

Single Most Likely Diagnosis

  • Ischemic colitis: This is the most likely diagnosis given the presentation, as it is a common condition characterized by inflammation of the colon due to decreased blood flow, which can be caused by various factors such as atherosclerosis, embolism, or vasculitis.

Other Likely Diagnoses

  • Infectious colitis: This includes conditions such as Clostridioides difficile infection, Salmonella, Shigella, or Campylobacter, which can cause similar symptoms to ischemic colitis, including abdominal pain, diarrhea, and bloody stools.
  • Inflammatory bowel disease (IBD): Conditions like Crohn's disease or ulcerative colitis can present with chronic or recurrent abdominal pain, diarrhea, and weight loss, which may be confused with ischemic colitis.
  • Diverticulitis: Inflammation of a diverticulum in the colon can cause abdominal pain, fever, and changes in bowel habits, which may be similar to the symptoms of ischemic colitis.

Do Not Miss Diagnoses

  • Mesenteric ischemia: This is a life-threatening condition that occurs when the blood flow to the intestines is severely reduced, which can lead to bowel infarction and death if not promptly treated.
  • Colon cancer: Although less likely, colon cancer can cause abdominal pain, changes in bowel habits, and bloody stools, which may be similar to the symptoms of ischemic colitis, and is a critical diagnosis not to miss.
  • Vasculitis: Conditions like systemic lupus erythematosus or polyarteritis nodosa can cause ischemic colitis and other systemic symptoms, and are important to consider in the differential diagnosis.

Rare Diagnoses

  • Chronic intestinal ischemia: This is a rare condition characterized by recurring episodes of abdominal pain and weight loss due to chronic reduction in blood flow to the intestines.
  • Eosinophilic colitis: A rare condition characterized by eosinophilic infiltration of the colon, which can cause abdominal pain, diarrhea, and bloody stools.
  • Radiation colitis: A rare condition that occurs after radiation therapy to the abdomen, which can cause chronic diarrhea, abdominal pain, and rectal bleeding.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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