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Clinical Characteristics of Young-Onset Ischemic Colitis

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Abstract

Background

Ischemic colitis (IC) typically develops in the elderly, where hypertension, cerebrocardiovascular disease, and past history of abdominal surgery are regarded as risk factors. Although there have been reports of younger patients with IC, its clinical features remain unclear.

Aim

The aim of this study was to clarify the clinical characteristics of IC in young adults.

Methods

Three hundred fifty-nine patients were diagnosed as having IC at five hospitals across Nagano prefecture, Japan. Clinical data were compared between the young patient group [20–45 years, n = 53 (15%)] and the elderly patient group [>45 years, n = 306 (85%)], as well as with age- and gender-matched healthy individuals (n = 156).

Results

The presence of a smoking habit and hyperuricemia were significantly higher in the young patient group compared with the elderly patient group (42 vs. 19%, P = 0.001 and 8 vs. 1%, P = 0.019, respectively), which was confirmed by multiple logistic regression analysis (P = 0.001, odds ratio 3.239 and P = 0.028, odds ratio 16.907, respectively). Additionally, multiple logistic regression analysis of the young IC patient group and age- and gender-matched healthy individuals demonstrated that these two factors were strongly associated with IC development (P = 0.008, odds ratio 2.49 for smoking habit and P = 0.039, odds ratio 6.37 for hyperuricemia).

Conclusions

High prevalences of a smoking habit and hyperuricemia are characteristic features of IC in the young adult population.

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Abbreviations

BMI:

Body mass index

CRP:

C-reactive protein

IC:

Ischemic colitis

LDH:

Lactate dehydrogenase

References

  1. Boley SJ, Schwartz S, Lash J, Sternhill V. Reversible vascular occlusion of colon. Surg Gynecol Obstet. 1963;116:53–60.

    PubMed  CAS  Google Scholar 

  2. Marston A, Pheils MT, Thomas ML, Morson BC. Ischaemic colitis. Gut. 1966;7:1–15.

    Article  PubMed  CAS  Google Scholar 

  3. Medina C, Vilaseca J, Videla S, Fabra R, Armengol-Miro JR, Malagelada JR. Outcome of patients with ischemic colitis: review of fifty-three cases. Dis Colon Rectum. 2004;47:180–184.

    Article  PubMed  Google Scholar 

  4. Cubiella Fernández J, Núñez Calvo L, González Vázquez E, et al. Risk factors associated with the development of ischemic colitis. World J Gastroenterol. 2010;16:4564–4569.

    Article  PubMed  Google Scholar 

  5. Longo WE, Ballantyne GH, Gusberg RJ. Ischemic colitis—patterns and prognosis. Dis Colon Rectum. 1992;35:726–730.

    Article  PubMed  CAS  Google Scholar 

  6. Arnott ID, Ghosh S, Ferguson A. The spectrum of ischaemic colitis. Eur J Gastroenterol Hepatol. 1999;11:295–303.

    Article  PubMed  CAS  Google Scholar 

  7. Guttormson NL, Bubrick MP. Mortality from ischemic colitis. Dis Colon Rectum. 1989;32:469–472.

    Article  PubMed  CAS  Google Scholar 

  8. Walker AM, Bohn RL, Cali C, Cook SF, Ajene AN, Sands BE. Risk factors for colon ischemia. Am J Gastroenterol. 2004;99:1333–1337.

    Article  PubMed  Google Scholar 

  9. Acosta S, Ogren M, Sternby NH, Bergqvist D, Björck M. Fatal colonic ischemia: a population-based study. Scand J Gastroenterol. 2006;41:1312–1319.

    Article  PubMed  Google Scholar 

  10. Scharff JR, Longo WE, Vartanian SM, Jacobs DL, Bahadursingh AN, Kaminski DL. Ischemic colitis: spectrum of disease and outcome. Surgery. 2003;134:624–629.

    Article  PubMed  Google Scholar 

  11. Green BT, Tendler DA. Ischemic colitis: a clinical review. South Med J. 2005;98:217–222.

    Article  PubMed  Google Scholar 

  12. Habu Y, Tahashi Y, Kiyota K, et al. Reevaluation of clinical features of ischemic colitis—analysis of 68 consecutive cases diagnosed by early colonoscopy. Scand J Gastroenterol. 1996;31:881–886.

    Article  PubMed  CAS  Google Scholar 

  13. Suh DC, Kahler KH, Choi IS, Shin H, Kralstein J, Shetzline M. Patients with irritable bowel syndrome or constipation have an increased risk for ischaemic colitis. Aliment Pharmacol Ther. 2007;25:681–692.

    Article  PubMed  Google Scholar 

  14. Preventza OA, Lazarides K, Sawyer MD. Ischemic colitis in young adults: a single-institution experience. J Gastrointest Surg. 2001;5:388–392.

    Article  PubMed  CAS  Google Scholar 

  15. Barcewicz PA, Welch JP. Ischemic colitis in young-adult patients. Dis Colon Rectum. 1980;23:109–114.

    Article  PubMed  CAS  Google Scholar 

  16. Deana DG, Dean PJ. Reversible ischemic colitis in young-women—association with oral-contraceptive use. Am J Surg Pathol. 1995;19:454–462.

    Article  PubMed  CAS  Google Scholar 

  17. Linder JD, Monkemuller KE, Raijman I, Johnson L, Lazenby AJ, Wilcox CM. Cocaine-associated ischemic colitis. South Med J. 2000;93:909–913.

    PubMed  CAS  Google Scholar 

  18. Holubar SD, Hassinger JP, Dozois EJ, Masuoka HC. Methamphetamine colitis a rare case of ischemic colitis in a young patient. Arch Surg. 2009;144:780–782.

    Article  PubMed  Google Scholar 

  19. Green BT, Branch MS. Ischemic colitis in a young adult during sickle cell crisis: case report and review. Gastrointest Endosc. 2003;57:605–607.

    Article  PubMed  Google Scholar 

  20. Moses FM. Gastrointestinal-bleeding and the athlete. Am J Gastroenterol. 1993;88:1157–1159.

    PubMed  CAS  Google Scholar 

  21. Theodoropoulou A, Sfiridaki A, Oustamanolakis P, et al. Genetic risk factors in young patients with ischemic colitis. Clin Gastroenterol Hepatol. 2008;6:907–911.

    Article  PubMed  Google Scholar 

  22. Tohda G, Higashi S, Sumiyoshi K, Sakumoto H, Kato C, Kane T. Evaluation of clinical features of ischemic colitis: comparison between young and elderly. Dig Endosc. 2005;17:123–130.

    Article  Google Scholar 

  23. Matsumoto T, Iida M, Kimura Y, Nanbu T, Fujishima M. Clinical features in young adult patients with ischaemic colitis. J Gastroenterol Hepatol. 1994;9:572–575.

    Article  PubMed  CAS  Google Scholar 

  24. Scowcroft CW, Sanowski RA, Kozarek RA. Colonoscopy in ischemic colitis. Gastrointest Endosc. 1981;27:156–161.

    Article  PubMed  CAS  Google Scholar 

  25. Dawson MA, Schaefer JW. The clinical course of reversible ischemic colitis. Observations on the progression of sigmoidoscopic and histological changes. Gastroenterology. 1971;60:577–580.

    PubMed  CAS  Google Scholar 

  26. Forde KA, Lebwohl O, Wolff M, Voorhees AB. The endoscopy corner: reversible ischemic colitis—correlation of colonoscopic and pathologic changes. Am J Gastroenterol. 1979;72:182–185.

    PubMed  CAS  Google Scholar 

  27. Nagaya T, Tanaka N, Suzuki T, et al. Down-regulation of SREBP-1c is associated with the development of burned-out NASH. J Hepatol. 2010;53:724–731.

    Article  PubMed  CAS  Google Scholar 

  28. Tanaka N, Horiuchi A, Yokoyama T, et al. Clinical characteristics of de novo nonalcoholic fatty liver disease following pancreaticoduodenectomy. J Gastroenterol. 2011;46:758–768.

    Article  PubMed  CAS  Google Scholar 

  29. Hatta T, Fujinaga Y, Kadoya M, et al. Accurate and simple method for quantification of hepatic fat content using magnetic resonance imaging: a prospective study in biopsy-proven nonalcoholic fatty liver disease. J Gastroenterol. 2010;45:1263–1271.

    Article  PubMed  Google Scholar 

  30. Komatsu M, Yazaki M, Tanaka N, et al. Citrin deficiency as a cause of chronic liver disorder mimicking non-alcoholic fatty liver disease. J Hepatol. 2008;49:810–820.

    Article  PubMed  CAS  Google Scholar 

  31. Tanaka N, Sano K, Horiuchi A, Tanaka E, Kiyosawa K, Aoyama T. Highly purified eicosapentaenoic acid treatment improves nonalcoholic steatohepatitis. J Clin Gastroenterol. 2008;42:413–418.

    Article  PubMed  CAS  Google Scholar 

  32. Tsuruta G, Tanaka N, Hongo M, et al. Nonalcoholic fatty liver disease in Japanese junior high school students: its prevalence and relationship to lifestyle habits. J Gastroenterol. 2010;45:666–672.

    Article  PubMed  Google Scholar 

  33. Tsutsui M, Tanaka N, Kawakubo M, et al. Serum fragmented cytokeratin 18 levels reflect the histological activity score of nonalcoholic fatty liver disease more accurately than serum alanine aminotransferase levels. J Clin Gastroenterol. 2010;44:440–447.

    PubMed  CAS  Google Scholar 

  34. Locke GR, Pemberton JH, Phillips SF. American gastroenterological association medical position statement: guidelines on constipation. Gastroenterology. 2000;119:1761–1766.

    Article  PubMed  Google Scholar 

  35. Jaimes EA, DeMaster EG, Tian RX, Raij L. Stable compounds of cigarette smoke induce endothelial superoxide anion production via NADPH oxidase activation. Arterioscler Thromb Vasc Biol. 2004;24:1031–1036.

    Article  PubMed  CAS  Google Scholar 

  36. Raij L, DeMaster EG, Jaimes EA. Cigarette smoke-induced endothelium dysfunction: role of superoxide anion. J Hypertens. 2001;19:891–897.

    Article  PubMed  CAS  Google Scholar 

  37. Glantz SA, Parmley WW. Passive smoking and heart disease. Mechanisms and risk. JAMA. 1995;273:1047–1053.

    Article  PubMed  CAS  Google Scholar 

  38. Barnoya J, Glantz SA. Cardiovascular effects of secondhand smoke: nearly as large as smoking. Circulation. 2005;111:2684–2698.

    Article  PubMed  Google Scholar 

  39. Sánchez-Lozada LG, Soto V, Tapia E, et al. Role of oxidative stress in the renal abnormalities induced by experimental hyperuricemia. Am J Physiol Renal Physiol. 2008;295:F1134–F1141.

    Article  PubMed  Google Scholar 

  40. Kanellis J, Kang DH. Uric acid as a mediator of endothelial dysfunction, inflammation, and vascular disease. Semin Nephrol. 2005;25:39–42.

    Article  PubMed  CAS  Google Scholar 

  41. Johnson RJ, Kang DH, Feig D, et al. Is there a pathogenetic role for uric acid in hypertension and cardiovascular and renal disease? Hypertension. 2003;41:1183–1190.

    Article  PubMed  CAS  Google Scholar 

  42. Fang J, Alderman MH. Serum uric acid and cardiovascular mortality the NHANES I epidemiologic follow-up study, 1971–1992. National Health and Nutrition Examination Survey. JAMA. 2000;283:2404–2410.

    Article  PubMed  CAS  Google Scholar 

  43. Culleton BF, Larson MG, Kannel WB, Levy D. Serum uric acid and risk for cardiovascular disease and death: the Framingham heart study. Ann Intern Med. 1999;131:7–13.

    PubMed  CAS  Google Scholar 

  44. Sugiishi M, Takatsu F. Cigarette smoking is a major risk factor for coronary spasm. Circulation. 1993;87:76–79.

    PubMed  CAS  Google Scholar 

  45. Murohara T, Kugiyama K, Ohgushi M, Sugiyama S, Yasue H. Cigarette smoke extract contracts isolated porcine coronary arteries by superoxide anion-mediated degradation of EDRF. Am J Physiol. 1994;266:H874–H880.

    PubMed  CAS  Google Scholar 

  46. Sugiyama S, Kugiyama K, Ohgushi M, et al. Supersensitivity of atherosclerotic artery to constrictor effect of cigarette smoke extract. Cardiovasc Res. 1998;38:508–515.

    Article  PubMed  CAS  Google Scholar 

  47. Sánchez-Lozada LG, Tapia E, Santamaría J, et al. Mild hyperuricemia induces vasoconstriction and maintains glomerular hypertension in normal and remnant kidney rats. Kidney Int. 2005;67:237–247.

    Article  PubMed  Google Scholar 

  48. Zharikov SI, Swenson ER, Lanaspa M, Block ER, Patel JM, Johnson RJ. Could uric acid be a modifiable risk factor in subjects with pulmonary hypertension? Med Hypotheses. 2010;74:1069–1074.

    Article  PubMed  CAS  Google Scholar 

  49. Villegas R, Xiang YB, Cai Q, et al. Prevalence and determinants of hyperuricemia in middle-aged, urban Chinese men. Metab Syndr Relat Disord. 2010;8:263–270.

    Article  PubMed  Google Scholar 

  50. Nishida Y, Iyadomi M, Higaki Y, Tanaka H, Hara M, Tanaka K. Influence of physical activity intensity and aerobic fitness on the anthropometric index and serum uric acid concentration in people with obesity. Intern Med. 2011;50:2121–2128.

    Article  PubMed  Google Scholar 

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Acknowledgments

We thank Trevor Ralph for his English editorial assistance.

Conflict of interest

The authors have declared that no conflict of interest exists.

Author information

Authors and Affiliations

  1. Department of Internal Medicine, Division of Gastroenterology, Shinshu University School of Medicine, Matsumoto, Japan

    Takefumi Kimura, Naoki Tanaka, Tadanobu Nagaya, Michiharu Komatsu, Takeji Umemura, Akihiro Matsumoto & Eiji Tanaka

  2. Department of Gastroenterology, Suwa Red Cross Hospital, Suwa, Japan

    Akihiro Shinji

  3. Digestive Disease Center, Showa Inan General Hospital, Komagane, Japan

    Akira Horiuchi

  4. Department of Metabolic Regulation, Shinshu University Graduate School of Medicine, 3-1-1 Asahi, Matsumoto, 390-8621, Japan

    Naoki Tanaka

  5. Department of Gastroenterology, Shinshu Ueda Medical Center, Ueda, Japan

    Takashi Shigeno

  6. Department of Gastroenterology, Marunouchi Hospital, Matsumoto, Japan

    Naoshi Nakamura

  7. Endoscopic Examination Center, Shinshu University Hospital, Matsumoto, Japan

    Norikazu Arakura

Authors
  1. Takefumi Kimura
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  2. Akihiro Shinji
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  8. Michiharu Komatsu
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  11. Akihiro Matsumoto
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  12. Eiji Tanaka
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Corresponding author

Correspondence to Naoki Tanaka.

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Kimura, T., Shinji, A., Horiuchi, A. et al. Clinical Characteristics of Young-Onset Ischemic Colitis. Dig Dis Sci 57, 1652–1659 (2012). https://doi.org/10.1007/s10620-012-2088-5

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  • DOI: https://doi.org/10.1007/s10620-012-2088-5

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