PRELIMINARY STUDY ON BACTERIAL INFLUENCE IN ISCHEMIC COLITIS

Background:  It is necessary to exclude infectious colitis by fecal culture for diagnosis of ischemic colitis. But even if pathogenic bacteria are excluded, it is expected that the population of normal bacterial flora of the lesion is probably changing. We have performed bacterial culture using colonoscopic sampling in order to detect more important bacteria, when we diagnose ischemic colitis on colonoscopy.Methods:  The subject group comprised 81 patients diagnosed with ischemic colitis between January 1998 and July 2004. During initial colonoscopy, we sprayed 20 mL saline on the most severe site of the inflammatory lesion and collected the fluid by suction for culture (colonoscopic spraying wash culture). When only one species of bacteria was isolated, we registered the bacteria as the predominant organism. When two or more species of bacteria were isolated, we registered the bacteria that were isolated most superior in number.Results:  Escherichia coli (48 patients), Klebsiella (22 patients), Enterococcus (22 patients), Enterobacter (12 patients) and others were registered. Generally, younger patients (under 50 years) had prominently E. coli, and elderly patients (above 70 years) had Klebsiella. Patients with baseline disease such as hypertension, diabetes mellitus, and hyperlipidemia generally had Enterococcus. Patients without baseline disease generally had E. coli. Sex and the length of period after onset were not significantly different. Colonoscopic features of the cases isolated only one species of bacteria by colonoscopic spraying wash culture that were different to each other.Conclusion:  It is expected that age and baseline diseases contribute to the onset of ischemic colitis and to the disruption of normal flora. Meanwhile, it is supposed that the disruption of normal flora is related to the induction of various configurations of ischemic colitis.