Long-term Mucosal Scarring in Non-IBD Colitis Mimicking IBD

Colitis is an inflammatory condition of the colon commonly associated with inflammatory bowel disease (IBD). However, non-IBD colitis can also present similarly, often resulting from medications or ischemia leading to chronic symptoms as well as diagnostic challenges. The literature on non-IBD colitis typically addresses acute presentations, with limited reports on long-term outcomes including mucosal scarring, which is more commonly seen in IBD. This case report discusses a 78-year-old female with a history of ischemic colitis who presented with persistent constipation for two years. A follow-up colonoscopy revealed diffuse mucosal scarring in the proximal and middescending colon, consistent with her prior ischemic event. Biopsies showed benign pathology without active colitis. The patient improved with dietary and hydration modifications in addition to continued fiber supplementation. This case highlights the potential for long-term mucosal changes such as scarring following non-IBD colitis, emphasizing the need to differentiate these patients from those with IBD. In cases where ischemic colitis leads to chronic symptoms, therapy involving lifestyle approach with dietary and hydration management can improve symptoms in contrast to patients with IBD requiring immunosuppressive therapy.