What's new about inflammatory bowel diseases in Ischemic colitis induced by the newly reformulated multicomponent weight-loss supplement Hydroxycut(®)

Abstract

Ischemic colitis accounts for 6%-18% of causes of acute lower gastrointestinal bleeding. It is more often multifactorial and more common in elderly. Drugs are considered important causative agents of this disease with different mechanisms. In this paper, we describe a 37-year-old otherwise healthy female presented with sudden onset diffuse abdominal pain and bloody stool. Radiologic, colonoscopic and histopathologic findings were all consistent with ischemic colitis. Her only suspected factor was hydroxycut which she had been taking for a period of 1 mo prior to her presentation. Her condition improved uneventfully after cessation of hydroxycut, bowel rest, intravenous hydration, and antibiotics. This is a first case of ischemic colitis with clear relationship with hydroxycut use (Naranjo score of 7). Our case demonstrates the importance of questioning patients regarding the usage of dietary supplements; especially since many patients consider them safe and do not disclose their use voluntarily to their physicians. Hydroxycut has to be considered as a potential trigger for otherwise unexplained ischemic colitis.

Keywords: Colonoscopy; Gastrointestinal bleeding; Herbal; Hydroxycut; Ischemic colitis; Weight-loss supplement.

Figure 1

Computed tomography scan and histopathology. A, B: Computed tomography scan shows thickening of the colonic wall involving the descending colon (arrows); C, D: Histopathology shows: the overlying surface mucosa is eroded, the lamina propria is partially hyalinized with fibropurulent exudate and acute inflammation, consistent with ischemic colitis.

Figure 2

Colonoscopy shows. A: Normal mucosa of the right colon (hepatic flexure); B, C: Erythematous, edematous, erosive, and ulcerated mucosa of the splenic flexure of the colon, consistent with ischemic colitis; D: Normal mucosa of the sigmoid colon.