Ischemic colitis in postmenopausal women taking hormone replacement therapy.
OBJECTIVE
Estrogen and progestins have established effects on the gastrointestinal tract and ischemic colitis was related in the past with certain regimens including both hormones. On this basis, we aimed to evaluate a group of postmenopausal women who presented with ischemic colitis after taking hormone replacement therapy (HRT) for the last several months.


METHODS
Postmenopausal women taking conjugated estrogens, conjugated estrogens plus medroxyprogesterone acetate, 17beta-estradiol plus norethisterone and estradiol valerate plus norgestrel are included in the present study. All patients, without a medical history of bowel problems, reported an acute crisis of colitis a few months after the beginning of the treatment.


RESULTS
Fasting, parenteral nutrition, intravenous antibiotic treatment with metronidazole and discontinuation of HRT proved successful. Antibiotics were continued after the patients' discharge from the hospital. A second-look colonoscopy, 3 to 4 months after the initial episode, was normal in all cases.


CONCLUSIONS
Ischemic colitis is a rare complication of HRT that should not be ignored when HRT is prescribed.
Department of Gynaecology, Lito Hospital and ATEI Technological University of Athens, Athens, Greece. szervoud@otenet.gr
S
S
Zervoudis
T
T
Grammatopoulos
G
G
Iatrakis
G
G
Katsoras
C
C
Tsionis
I
I
Diakakis
C
C
Calpaktsoglou
S
S
Zafiriou
D000328:Adult; D000368:Aged; D000890:Anti-Infective Agents / Q000627:therapeutic use; D017091:Colitis, Ischemic / Q000139:chemically induced* / Q000188:drug therapy / Q000628:therapy; D015914:Estrogen Replacement Therapy / Q000009:adverse effects*; D004967:Estrogens / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008795:Metronidazole / Q000627:therapeutic use; D008875:Middle Aged; D010288:Parenteral Nutrition; D045167:Progesterone Congeners / Q000009:adverse effects* / Q000627:therapeutic use; D012189:Retrospective Studies
D000890:Anti-Infective Agents; D004967:Estrogens; D045167:Progesterone Congeners; D008795:Metronidazole