title: Risk factors for colon ischemia.
abstract: BACKGROUND
  To identify predictors of colon ischemia, we examined demographic and clinical characteristics of patients, as well as their prior health care utilization.
  
  
  METHODS
  Using insurance data, we identified 700 persons at least 20-yr old with presumed colon ischemia between 1995 and 1999, and 6,440 controls. Case identification was based on diagnosis and procedure codes in insurance claims for which we used a previously reported, validated algorithm. We ascertained preceding medical diagnoses and the use of drugs and health services from the insurance claims files.
  
  
  RESULTS
  Patients with colon ischemia were nearly three times as likely to have IBS than controls. A history of nonspecific colitis, lower gastrointestinal tract hemorrhage, systemic rheumatologic disorders, and ischemic heart disease in the preceding 6 months, and abdominal surgery in the past month were also much more common in colon ischemia cases than controls. Use of a drug to treat diarrhea was strongly associated with risk. The most prevalent risk factor for colon ischemia was the use of drugs with a side effect of constipation, found in one-third of cases and one in nine controls. Cases had seen physicians, particularly gastroenterologists, much more commonly in the preceding 6 months than had controls.
  
  
  CONCLUSIONS
  Clinically evident colon ischemia arises preferentially in persons with prior abdominal complaints, many of whom carry a diagnosis of IBS. Drugs that reduce bowel motility may constitute a widespread and potentially avoidable risk factor. The frequency of preceding doctor visits, without a specific diagnosis, suggests that colon ischemia may have a prolonged subacute presentation.
authors.affiliation: Ingenix Epidemiology, Auburndale, Massachusetts 02466, USA.
authors.forename: Alexander M
authors.initials: AM
authors.lastname: Walker
authors.forename: Rhonda L
authors.initials: RL
authors.lastname: Bohn
authors.forename: Clorinda
authors.initials: C
authors.lastname: Cali
authors.forename: Suzanne F
authors.initials: SF
authors.lastname: Cook
authors.forename: Anuli N
authors.initials: AN
authors.lastname: Ajene
authors.forename: Bruce E
authors.initials: BE
authors.lastname: Sands
mesh_terms: D000328:Adult; D000368:Aged; D000930:Antidiarrheals / Q000009:adverse effects; D003106:Colon / Q000098:blood supply*; D003248:Constipation / Q000139:chemically induced; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000150:complications / Q000188:drug therapy; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000150:complications; D007511:Ischemia / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000150:complications; D012216:Rheumatic Diseases / Q000150:complications; D012307:Risk Factors
chemical_list: D000930:Antidiarrheals