Migraine to Mesenteric Mishap: A Case Report of Ischemic Colitis Due to Sumatriptan

TL;DR

A 73-year-old woman developed severe colon inflammation likely caused by sumatriptan, a migraine medication, leading to major surgery.

Contribution

This case report highlights sumatriptan as a potential cause of ischemic colitis in a patient with a history of migraines.

Findings

The patient's severe ischemic colitis was likely triggered by high-dose sumatriptan use.

The patient required subtotal colectomy and ileostomy due to the severity of the condition.

This case emphasizes the importance of medication review in diagnosing ischemic colitis.

Abstract

Ischemic colitis (IC) results from reduced blood flow to the colon, which can lead to tissue infarction and may be precipitated by medications that induce vasoconstriction. This case involves a 73-year-old female with a history of migraines and chronic back pain who presented with abdominal pain and was diagnosed with severe IC, ultimately requiring subtotal colectomy and ileostomy. The patient had been using nonsteroidal anti-inflammatory drugs for many years, then initiated high doses of the 5-hydroxytryptamine receptor agonist sumatriptan prior to her first episode of IC, suggesting that sumatriptan was the primary etiology. This case represents the patient’s third episode of IC, highlighting the importance of thorough medication review in identifying potential etiologies.

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