Amphetamine-Induced Ischemic Colitis: A Case Report

We report a rare case of ischemic colitis secondary to amphetamine use in a 72-year-old woman, highlighting an uncommon etiology in an elderly patient. The patient, with a medical history of hypertension, deep vein thrombosis, scoliosis, and polysubstance abuse, presented to the emergency department with abdominal pain, diarrhea, and melena that had persisted for the past 24 hours. On initial examination, she was found to be tachycardic, tachypneic, and hypertensive. Diagnostic evaluation included laboratory tests, computed tomography (CT) imaging revealing severe colitis affecting the distal transverse, descending, and sigmoid colon, and a urine drug screen that was positive for amphetamines. Gastroenterology was consulted, and the diagnosis of ischemic colitis secondary to amphetamine use was confirmed. The patient was treated with supportive care and demonstrated significant clinical improvement over the next three days, with resolution of symptoms at follow-up one week later. This case emphasizes the need for healthcare providers to consider amphetamine use as a potential cause of ischemic colitis, regardless of age, and underscores the need for heightened clinical vigilance amid rising amphetamine use. Recognition of this association may broaden diagnostic considerations and guide timely, supportive management to improve outcomes in similar patients.