Zervoudis S, Grammatopoulos T, Iatrakis G, Katsoras G, Tsionis C, Diakakis I, Calpaktsoglou C, Zafiriou S
Department of Gynaecology, Lito Hospital and ATEI Technological University of Athens, Athens, Greece.
Gynecol Endocrinol. 2008 May;24(5):257-60. doi: 10.1080/09513590802002163.
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.
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.
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.
Ischemic colitis is a rare complication of HRT that should not be ignored when HRT is prescribed.
雌激素和孕激素对胃肠道有明确影响，过去缺血性结肠炎与包括这两种激素的某些用药方案有关。在此基础上，我们旨在评估一组在过去几个月接受激素替代疗法（HRT）后出现缺血性结肠炎的绝经后女性。
本研究纳入了服用结合雌激素、结合雌激素加醋酸甲羟孕酮、17β-雌二醇加炔诺酮以及戊酸雌二醇加炔诺孕酮的绝经后女性。所有患者均无肠道问题病史，均在治疗开始数月后出现急性结肠炎发作。
禁食、肠外营养、甲硝唑静脉抗生素治疗以及停用HRT均获成功。患者出院后继续使用抗生素。初次发作3至4个月后进行的二次结肠镜检查在所有病例中均正常。
缺血性结肠炎是HRT的一种罕见并发症，在开具HRT处方时不应被忽视。
