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Intestinal Ischemia
Also known as Mesenteric Ischemia
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Intestinal or mesenteric ischemia is a condition where blood flow where to the intestines is blocked, either partially or completely. It can affect anywhere from the small intestine to the large intestine. This is a very bad condition that can be lethal. This is a condition that can be very painful and can interfere with the work of the intestines. The intestinal tissue can be damaged and can rupture.
Effective treatments do work for mesenteric ischemia. The idea is to diagnose the disease early in the course and open up the arteries before they become damaging to the walls of the intestine or cause perforation.
The signs and symptoms of mesenteric ischemia can be sudden or can occur gradually as time passes. The signs and symptoms of intestinal ischemia include acute abdominal pain which can be severe, the feeling of wanting to have a bowel movement, diarrhea, which can be explosive, abdominal distension or tenderness, blood in the stools, nausea, vomiting or fever.
Symptoms of chronic mesenteric ischemia include abdominal cramps or fullness of the abdomen that lasts 1-3 hours and which begins thirty minutes postprandial (after eating). The abdominal pain gets worse over several weeks or several months. You tend to fear eating because of the pain that follows. You can have unintended weight loss, nausea, vomiting and diarrhea.
The cause of intestinal or mesenteric ischemia is when the blood flow to the intestines is interrupted due to blockage of major blood vessels. It can be caused by narrowing of the affected arteries from cholesterol or to a blood clot that goes to the blood vessels. The digestive tract is starved of oxygen, weakening and killing off the cells that comprise these organs.
A person can have ischemic colitis, affecting the large bowel. This is the most common form of intestinal ischemia. It occurs usually in adults greater than 60 years of age. Symptoms include rectal bleeding and pain on the left-hand side of the lower abdomen. It can be caused by atherosclerosis, low blood pressure or a blood clot that forms in the supplying artery. A bowel obstruction can be a cause of intestinal ischemia of this type and surgeries to nearby areas can contribute to signs and symptoms. Some medications like estrogen or migraine medications and drugs like cocaine or methamphetamine can contribute to getting ischemic colitis. Even those who practice long distance running can be at risk for ischemic colitis.
Acute mesenteric ischemia affects the small bowel and has a sudden onset. Like ischemic colitis, it can be caused by a blood clot that originates in the heart or can be caused by a heart attack or irregular heart beat. Atherosclerosis can cause acute mesenteric ischemia as can low blood pressure.
Chronic mesenteric ischemia is also called intestinal angina and is a stable form of blood impairment to the small intestine. The danger is that it can progress to acute mesenteric ischemia. The symptoms can be mild or severe but tend to be short-lived.
You can get mesenteric ischemia if the blood cannot leave the intestinal system due to a blockage of the veins. This can be caused by acute or chronic inflammation of the pancreatitis, abdominal infections, cancers of the digestive system, or bowel diseases, including Crohn's disease, ulcerative colitis and diverticulitis. If you have an inherited disorder that makes you hypercoagulable, you can clot more easily and develop this disease. Abdominal trauma can lead to the disease as can menopausal therapy with hormones.
Complications of abdominal ischemic diseases include death of the tissue of the intestine, which can be fatal, scar tissue or narrowing of the colon, which can lead to blockage of the intestines. You can end up with surgery and a colostomy or other ostomy.
Tests for intestinal ischemia include imaging tests, such as CT scans, X-rays and an MRI exam. Using a scope, the doctor can look inside the colon or small intestines to see if there are areas of intestinal cell death. An intestinal angiogram can be done to see what the blood flow of the abdomen looks like. In severe cases, exploratory surgery may be done which may lead to surgery to remove the damaged intestines. Antibiotics are used to destroy the colonic bacteria which may leak into the system from damaged tissue. Depending on the cause of the ischemia, it can actually fix itself once the offending cause is removed. Even so, dead tissue may need to be removed.
Clots can be removed from the mesenteric arteries so that the blockage is opened again. Medications can be given to remove the blood clots within the arteries. In chronic mesenteric ischemia, the surgeon can bypass a damaged artery, similar to a heart bypass surgery.