Review Article

The Pharmacological Causes of Colon Ischaemia

Ziga Vodusek; Paul Feuerstadt; Lawrence J. Brandt


Aliment Pharmacol Ther. 2019;49(1):51-63. 

In This Article


Colonic ischaemia is the most common ischaemic disease of the digestive tract, classically presenting with abdominal pain in the distribution of the affected segment of bowel, with or without bloody diarrhoea.[1–3] There are multiple potential causes for colonic ischaemia including vascular, cardiac, infectious, iatrogenic, physiologic and pharmacologic,[4] but, to date, there have been no studies presenting data on the proportion of patients who have colonic ischaemia resulting from pharmacological agents compared with other causes. In 2016, Bielefeldt et al. used the Federal Adverse Event Reporting System to systematically associate classes of drugs with resultant colonic ischaemia.[5] In this manuscript, we focus on classes of colonic ischaemia-associated medications (Table 1) with a comprehensive review and update of the existing literature including proposed pathophysiologic mechanisms for the respective medications. Our goal was to increase general awareness of drug-induced colonic ischaemia.