Ischemic colitis during pregnancy and contraceptive medication

Ischemic bowel disease is generally considered a disease of the elderly and usually consists of reversible colopathy. Nonocclusive causes of ischemic colitis include low-flow states due to cardiac dysfunction and hypovolemia and use of certain medications including progestational medication. We repo rt 2 cases of ischemic colitis in young women. The first one occurred in a young patient who developed three consecutive episodes of ischemic colitis during her pregnancy, whereas the second woman presented with ischemic coli tis in relation with the estrogen use. Each episode had a favorable outcome . Having ruled out an infectious cause, or a low blood flow state and in th e absence of known thrombogenic disease, we hypothesized the etiology of th ese ischemic episodes to a high level of circulating estrogens due to pregn ancy in the first case and oral contraceptive medication in the second. Phy sicians treating hemorrhagic colitis in young women should consider the use of contraceptive medication containing estrogens or pregnancy as possible causes. Copyright (C) 2001 S. Karger AG, Basel.