Changes

===Clinical signs===

===Clinical signs===

Ingestion of sand without impaction may lead to clinical signs associated with a physical colitis due the abrasive nature of sand. These may include diarrhoea and signs of endotoxaemia such as congested mucous membranes and prolonged capillary refill time. If sufficient sand has been ingested to cause an impaction, the clinical signs are generally dependent on the anatomical site affected. Horses affected by a pelvic flexure impaction often present with signs of mild abdominal pain and generally respond well to conservative treatment. Impaction of the transverse colon is often associated with more severe abdominal pain due to the build up of gas in the the colon proximal to the obstruction.  

Ingestion of sand without impaction may lead to clinical signs associated with a physical colitis due the abrasive nature of sand. These may include diarrhoea and signs of endotoxaemia, such as congested mucous membranes and a prolonged capillary refill time. If sufficient sand has been ingested to cause an impaction, the clinical signs are generally dependent on the anatomical site affected. Horses affected by a pelvic flexure impaction often present with signs of mild abdominal pain and generally respond well to conservative treatment. Impaction of the transverse colon is often associated with more severe abdominal pain due to the build up of gas in the the colon proximal to the obstruction.  

===Diagnosis===

===Diagnosis===