Ischemic bowel disease in the elderly

The ischemic bowel diseases (IBD) are a heterogeneous group of disorders usually seen in elderly individuals. They represent ischemic damage to different portions of the bowel and, therefore, produce a variety of clinical syndromes and outcomes. Colonic ischemia is the commonest of these disorders and has a favorable prognosis in most cases. In contrast, acute mesenteric ischemia, most commonly caused by a superior mesenteric artery embolus, is a disease with a very poor prognosis. Acute mesenteric ischemia caused by nonocclusive mesenteric ischemia usually is a catastrophic complication of other severe medical illnesses, most notably atherosclerosis. Proper diagnosis and management of patients with IBD require vigilance on the part of the physician and a willingness to embark on an aggressive plan of diagnosis and management in the appropriate setting.