Diseases of the Colon & Rectum

, Volume 45, Issue 3, pp 425–428 | Cite as

Ischemic Colitis Caused by Strict Dieting in an 18-Year-Old Female

Report of a Case
  • Michihiko Shibata
  • Hayato Nakamura
  • Shintaro Abe
  • Keiichiro Kume
  • Ichiro Yoshikawa
  • Ikuo Murata
  • Makoto Otsuki
Case Report


Ischemic colitis is typically limited to elderly patients who have concomitant disorders such as cardiovascular disease and chronic renal failure, but rarely affects a young person. The patient was an 18-year-old Japanese female who started dieting to obtain a slim figure three months before admission and presented with a two-month history of constipation and a sudden onset of lower abdominal pain and bloody diarrhea. She underwent colonoscopy, which revealed edema, hemorrhages, and several longitudinal shallow ulcers in the descending colon. Stool and blood culture results were negative for pathogens. She improved rapidly within five days without any specific therapies except intravenous hydration and anticholinergic agents, under the diagnosis of ischemic colitis. In this case constipation and dehydration associated with dieting seemed to be responsible for the development of ischemic colitis. We recommend that ischemic colitis should be included in the differential diagnosis of colitis with bleeding, even in patients younger than age 20 who do not have any predisposing factors.


Ischemic colitis Strict dieting Constipation 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Clark, AW, Lloyd-Mostyn, RH, de Sadler, MR 1972“Ischaemic” colitis in young adults.BMJ47072Google Scholar
  2. 2.
    Barcewicz, PA, Welch, JP 1980Ischemic colitis in young adult patients.Dis Colon Rectum23109114Google Scholar
  3. 3.
    Lambert, M, de Peyer, R, Muller, AF 1982Reversible ischemic colitis after intravenous vasopressin therapy.JAMA247666667Google Scholar
  4. 4.
    Boley, SJ, Schwartz, S, Lash, J, Sternhill, V 1963Reversible vascular occlusion of the colon.Surg Gynecol Obstet1165360Google Scholar
  5. 5.
    Marston, A, Pheils, MT, Thomas, ML, Morson, BC 1966Ischaemic colitis.Gut7115Google Scholar
  6. 6.
    Harima, K, Fujita, K, Furutani, H,  et al. 1987Ischemic colitis in a young women:Yamaguchi Med J36179183Google Scholar
  7. 7.
    Okawa, K, Watanabe, K, Kioka, K,  et al. 1994Two cases of ischemic colitis in teen-agers without underlying disease [in Japanese].Nippon Shokakibyo Gakkai Zasshi919599Google Scholar
  8. 8.
    Tsushima, H, Mori, H, Ohori, Y, Koike, Y, Takahashi, N, Kusakabe, T 1996A juvenile case of ischemic colitis occurring without basal disease [in Japanese].J Jpn Soc Coloproctol49242245Google Scholar
  9. 9.
    Ando, M, Kitae, H, Tsujiguchi, H,  et al. 1998A case of ischemic colitis in young female [in Japanese].Nippon Shokakibyo Gakkai Zasshi9513951396Google Scholar
  10. 10.
    Matsumoto, T, Iida, M, Kimura, Y, Nanbu, T, Fujishima, M 1994Clinical features in young adult patients with ischaemic colitis.J Gastroenterol Hepatol9572575Google Scholar
  11. 11.
    Scowcroft, CW, Sanowski, RA, Kozarek, RA 1981Colonoscopy in ischemic colitis.Gastrointest Endosc27156161Google Scholar
  12. 12.
    Habu, Y, Tahashi, Y, Kiyota, K,  et al. 1996Reevaluation of clinical features of ischemic colitis. Analysis of 68 consecutive cases diagnosed by early colonoscopy.Scand J Gastroenterol31881886Google Scholar
  13. 13.
    Dalal, BI, Krishnan, C, Laschuk, B, Duff, JH 1987Sporadic hemorrhagic colitis associated with Escherichia coli, type O157:Can J Surg30207208Google Scholar
  14. 14.
    Griffin, PM, Olmstead, LC, Petras, RE 1990Escherichia coli 0157:Gastroenterology99142149Google Scholar
  15. 15.
    Beyer, KL, Bickel, JT, Butt, JH 1991Ischemic colitis associated with dextroamphetamine use.J Clin Gastroenterol13198201Google Scholar
  16. 16.
    Miyata, T, Tamechika, Y, Torisu, M 1988Ischemic colitis in a 33-year-old woman on danazol treatment for endometriosis.Am J Gastroenterol8314201423Google Scholar
  17. 17.
    Halldorsson, A, Hunter, GC, Zukoski, CF, Putnam, CW 1991The possible role of cyclosporine in nonocclusive mesenteric ischemia in a renal transplant patient.Transplantation5112981301Google Scholar
  18. 18.
    Wright, A, Benfield, GF, Felix-Davies, D 1984Ischaemic colitis and immune complexes during gold therapy for rheumatoid arthritis.Ann Rheum Dis43495497Google Scholar
  19. 19.
    Olson, KR, Pond, SM, Verrier, ED, Federle, M 1984Intestinal infarction complicating phenobarbital overdose.Arch Intern Med144407408Google Scholar
  20. 20.
    Gollock, JM, Thomson, JP 1984Ischaemic colitis associated with psychotropic drugs.Postgrad Med J60564565Google Scholar
  21. 21.
    Carratu, R, Parisi, P, Agozzino, A 1993Segmental ischemic colitis associated with nonsteroidal antiinflammatory drugs.J Clin Gastroenterol163134Google Scholar
  22. 22.
    Hayashi, S, Ema, U, Ichikawa, K, Kobayashi, E, Koike, M, Yoshitomi, H 1981Three cases of ischemic colitis probably induced by stercoral condition [in Japanese].Nippon Shokakibyo Gakkai Zasshi7816631667Google Scholar
  23. 23.
    Kozarek, RA, Earnest, DL, Silverstein, ME, Smith, RG 1980Air-pressure-induced colon injury during diagnostic colonoscopy.Gastroenterology78714Google Scholar
  24. 24.
    Church, JM 1995Ischemic colitis complicating flexible endoscopy in a patient with connective tissue diseaseGastrointest Endosc41181182Google Scholar
  25. 25.
    Cremers, MI, Oliveira, AP, Freitas, J 1998Ischemic colitis as a complication of colonoscopy.Endoscopy3054182Google Scholar
  26. 26.
    Yoshikawa, T, Sasaki, K, Kunimoto, M, Sasaki, K, Hirata, K 1999Two cases of ischemic colitis caused by colonoscopy examination [in Japanese].Nippon Shokakibyo Gakkai Zasshi9613811385Google Scholar
  27. 27.
    Kunimoto, M, Nishi, M, Sasaki, K 1998The relation between irregular bowel movement and the lifestyle of working women.Hepatogastroenterology45956960Google Scholar
  28. 28.
    Krahn, D, Kurth, C, Nairn, K, Redmond, L, Drewnowski, A, Gomberg, E 1996Dieting severity and gastrointestinal symptoms in college women.J Am Coll Health456771Google Scholar

Copyright information

© The American Society of Colon and Rectal Surgeons 2002

Authors and Affiliations

  • Michihiko Shibata
    • 1
  • Hayato Nakamura
    • 1
  • Shintaro Abe
    • 1
  • Keiichiro Kume
    • 1
  • Ichiro Yoshikawa
    • 1
  • Ikuo Murata
    • 1
  • Makoto Otsuki
    • 1
  1. 1.Third Department of Internal Medicine, University of Occupational and Environmental Health; School of Medicine, Kitakyushu; and the Department of Pharmacotherapeutics, Nagasaki University Graduate School of Pharmaceutical Science, NagasakiJapan

Personalised recommendations