Colitis isquémica y colitis microscópica

Abstract

Ischemic colitis (IC) is a condition that arises when blood flow in the colon is reduced such that it is insufficient for maintaining adequate cellular metabolic function. Microscopic colitis (MC) is a chronic disease characterized by colon mucosa that has a normal appearance on an endoscopy, watery diarrhea, and distinctive histologic features. The pathophysiology of IC is not clearly established. The etiopathogenesis of MC is considered multifactorial and not clearly known; genetic and luminal factors as well as a component of abnormal immune regulation have been described. The symptoms and severity of IC are highly variable, although the classic clinical symptoms consists of abdominal pain, fecal urgency, and, subsequently, rectorrhagia. The most characteristic manifestation of MC is watery diarrhea. The diagnostic test of choice for IC is computed tomography, while for MC it is a colonoscopy with biopsy collection. Most cases of IC require conservative management with a liquid diet, fluid replacement therapy, and empiric antibiotic therapy. In regard to the treatment of MC, drugs with a temporal relationship should be suspended and oral budesonide is the treatment of choice.