Usually we think of a stroke as resulting from the interruption of blood flow to the brain. However, there is another type of stroke called a colon stroke, so named because it is triggered by the interruption of blood flow to the colon.

Colon strokes often go undiagnosed…yet without appropriate treatment, some patients die from gangrene!

Among the risk factors for colon stroke are three very common yet preventable health problems. Here’s how to tell whether your colon might be headed for a stroke…and what you can do to protect yourself.

MISDIAGNOSIS DANGER

The official term for a colon stroke is ischemic colitis. Though symptoms sometimes come on gradually, typically a person experiencing a colon stroke develops sudden cramping abdominal pain, abdominal tenderness and diarrhea. At the same time or within the next 24 hours, as the colon becomes inflamed and ulcerated, bright red or maroon rectal bleeding is seen, sometimes alone and sometimes in the stool.

Problem: These symptoms often are confused with those of other digestive disorders, including gastroenteritis, a broad term for irritation or infection of the digestive tract (including food poisoning)…infectious colitis (colon inflammation caused by infection) and Crohn’s disease (an inflammatory bowel disease). “The patient may end up being treated for the wrong disease, while the real problem goes undetected,” said Lawrence J. Brandt, MD, a professor in the department of medicine, gastroenterology and liver diseases at Montefiore Medical Center in the Bronx, New York, who has conducted extensive research on colon stroke. Why is that so dangerous? Because even though most colon strokes are not life-threatening, about 10% to 15% of patients develop bowel perforation (a hole in the bowel) or gangrene (tissue death caused by insufficient blood supply)—conditions that require immediate surgery if the patient is to survive.

WHICH FOLKS GET COLON STROKES

Though no one knows exactly why one person might suffer a colon stroke while another person doesn’t, various factors are known to increase risk. Some of these risk factors are not under your control—but simply knowing that you have them can motivate you to keep a watchful eye out for possible symptoms of a colon stroke. Factors that increase your risk include…

  • Age. Risk generally increases with age, with about 90% of colon strokes occurring after age 60.
  • Gender. Though people of both sexes do get colon strokes, the condition occurs somewhat more often among women.
  • Irritable bowel syndrome (IBS). For unknown reasons, IBS—which is characterized by cramping, abdominal pain, bloating, gas, diarrhea and constipation—appears to triple the risk for colon stroke.
  • Cardiovascular disorders. Blood flow to the colon can be compromised by conditions such as vascular disease, congestive heart failure, heart rhythm disorders, blood-clotting problems, sickle cell anemia or diabetes.
  • Bowel obstruction. A hernia, tumor or scar tissue in the colon can impede blood flow.
  • Surgical history. An operation involving the aorta (the body’s largest artery) or the blood vessels that supply the bowel may have resulted in damage that affects blood flow to the colon.
  • Certain medications. Medications that constrict blood vessels or otherwise alter blood flow can reduce the amount of blood that reaches the colon. These include migraine medications, nonsteroidal anti-inflammatory drugs (NSAIDs), chemotherapy drugs, estrogen and some heart medications.

Fortunately, several important colon stroke risk factors are under your control, Dr. Brandt pointed out. To tilt the odds in your favor, take steps to guard against…

  • Constipation. Frequent bouts of constipation may increase colon pressure, which in turn decreases blood flow, Dr. Brandt said. Self-defense: Include plenty of high-fiber fruits, vegetables, legumes and whole grains in your diet. (Click here for more on preventing constipation.) If this is not sufficient to produce a bowel movement at least once every two days, ask your doctor whether any of the medications or supplements you take could be causing your constipation, and discuss nonconstipating alternatives.
  • High cholesterol. This can lead to atherosclerosis (plaque buildup in the arteries), which can disrupt blood flow throughout the body—including to the colon. Recommended: Keep your cholesterol under control by getting regular exercise…following a healthful, cholesterol-lowering diet (click here for details) …and taking cholesterol-lowering medication if it is needed.
  • Dehydration. Getting too dehydrated increases your risk of suffering a colon stroke because it thickens the blood. It also fosters spasms of certain blood vessels so as to increase the amount of blood flowing to vital organs such as the brain and heart—but this reduces blood flow to the colon. Best: Keep yourself well-hydrated by drinking nine to 13 cups of water each day.

Fascinating fact: People who run marathons are at increased risk for colon stroke—perhaps because long-distance running can lead to dehydration and because the leg muscles’ extreme demands for blood and oxygen divert circulation away from other parts of the body, including the colon. If you’re a marathoner, there’s no need to give up the sport, but do stay well-hydrated, particularly on race days.

GETTING HELP

What should you do if you have symptoms that suggest a possible colon stroke? If you have mild-to-moderate abdominal pain and slight rectal bleeding, call your doctor without delay…if you have severe abdominal pain and/or significant rectal bleeding, go to the ER. Either way, ask the doctor taking care of you, “Could this be a colon stroke?”

Colon stroke diagnosis is made based on symptoms, blood and stool tests and a colonoscopy. Often a CT scan is done before colonoscopy to check for colon stroke complications and rule out other disorders.

In severe cases, patients are hospitalized and given IV fluids to promote hydration and maximize blood flow and antibiotics to prevent sepsis and lower the risk for colon damage. If the bowel is perforated or if gangrene develops, immediate surgery is essential.

Fortunately, though, the majority of colon strokes are relatively mild and neither hospitalization nor surgery is needed. After going on a liquid diet for a few days to give the poor colon a rest, symptoms generally clear up and most patients recover completely within two weeks—and recurrence rates, thank goodness, are low.