Diagnostic methods and drug therapies in patients with ischemic colitis
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REVIEW
Diagnostic methods and drug therapies in patients with ischemic colitis YuShuang Xu 1,2 & LiNa Xiong 1 & YaNan Li 1,2 & Xin Jiang 1 & ZhiFan Xiong 1,2 Accepted: 8 September 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose Ischemic colitis (IC) is the most prevalent ischemic injury of thegastrointestinal tract. Clinical features of IC such as acute abdominal pain, hematochezia,and diarrhea are similar to those of acute mesenteric ischemia, inflammatorybowel disease, or infectious bowel disease, and their relative ambiguity candelay diagnosis and treatment. To comprehensively detail the current state ofdiagnostic methods and available drug therapies for detecting and treating IC,this review aims to provide a concise and practical summary of thecorresponding literature. Methods PubMed and Cochrane Library were searched toretrieve all published studies reporting the diagnostic methods and drugtherapies in patients with ischemic colitis. The search strategy of drugtherapy includes human and animal data. Results Colonoscopy combined with histopathologicalbiopsy is the standard of diagnosis for the IC. Most patients respond well tothe conservative treatment, and surgical consultation is needed when conservativetreatment is ineffective. Studies of potential drug therapy have beendeveloped, including phosphodiesterase type 5 inhibitors, pentoxifylline,rebamipide, prostaglandin E1, and polydeoxyribonucleotide. Conclusion Accurate diagnoses and effective treatmentshave helped reduce the mortality rate and improve prognoses for patientsafflicted with IC, and corresponding drug therapies have been constantlyupdated as new research has emerged. Keywords Ischemic colitis . Diagnosis . Drug therapy . Review
Introduction Ischemic colitis (IC) includes a group of clinical syndromes with existence of vascular occlusive or nonocclusive diseases, and is characterized by colonic blood supply deficiencies [1, 2]. The overall aged-adjusted and sex-adjusted incidence rates of IC in the general population were 16.3 cases per 100,000 individuals. IC is more common among individuals older than 65 years and increases in prevalence with age [3], and the incidence of colon ischemia in females is higher than in males [1]. The incidence of IC has increased nearly fourfold within 34 years, especially in relatively older patients with multiple comorbidities [3]. With the greater awareness of the impacts * ZhiFan Xiong [email protected] 1
Division of Gastroenterology, Liyuan Hospital, Tongji Medical College, Huazhong University of Science and Technology, YanHu Avenue & (027)86793043, Wuhan 430077, Hubei, China
2
Institute of Geriatrics of Hubei Province, YanHu Avenue & (027)86785587, Wuhan 430077, Hubei, China
of IC, a rapidly aging population, and the rising incidence of blood vessel diseases, it is estimated that the prevalence of IC will continue to increase, especially over the next few or several years. On the basis of clinical and experimental work in the laboratory, Marston et al. firstly propo
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