Description

Intestinal ischemia (is-KEE-me-uh), refers to a series of conditions that occur when blood flow to the intestines slows down or stops. The ischemia may be due to a partially or completely blocked blood vessel, usually an artery. Or low blood pressure can lead to reduced blood flow. Intestinal ischemia can affect your small intestine, the large intestine, or both.

Less blood flow means that very little oxygen passes into the cells in the system through which food travels, called the digestive system. Intestinal ischemia is a serious condition that can cause pain. This can make it difficult for the intestines to work properly.

In severe cases, loss of blood flow to the intestines can cause permanent harm to the intestines. And can lead to death.

There are treatments for intestinal ischemia. Get medical help early improves the chances of recovery.

Symptoms

The symptoms of intestinal ischemia can occur quickly. When this happens, the condition is called acute intestinal ischemia. When the symptoms appear slowly, the condition is called chronic intestinal ischemia. The symptoms may vary from person to person. But there are certain symptoms that suggest a diagnosis of intestinal ischemia.

The symptoms of sudden intestinal ischemia, also called acute intestinal ischemia

The symptoms of acute intestinal ischemia most often include:

  • Sudden belly pain.
  • An urgent need to defecate.
  • With strength to defecate often.
  • Abdominal pain or abdominal distension, also called the strain.
  • Blood in the stool.
  • Nausea and vomiting.
  • Mental confusion in older adults.

The symptoms of intestinal ischemia that develops slowly, also called chronic intestinal ischaemia

The symptoms of chronic intestinal ischaemia may include:

  • Spasms in the stomach or a feeling of fullness, most often within 30 minutes after eating, which lasts from 1 to 3 hours.
  • Stomach pain, pain that worsens gradually over weeks or months.
  • Fear of eating because of the pain after eating.
  • The loss of weight without trying.
  • The diarrhea.
  • Nausea and vomiting.
  • The abdominal distension.

When to see a doctor

Seek medical attention right away if you have sudden, severe abdominal pain. The pain that you feel so bad they can't sit still or find a position that feels good is a medical emergency.

If you have any other symptoms that worry you, make an appointment with your health care professional.

Causes

Intestinal ischemia occurs when the blood flow through the major blood vessels that carry blood to and from the intestines slows down or stops. The condition has many possible causes. The causes may include:

  • A blood clot that blocks an artery.
  • A narrowing of the arteries due to the accumulation of fat deposits, such as cholesterol. This condition is called atherosclerosis.
  • Low blood pressure which leads to less blood flow.
  • The obstruction of a vein, which occurs less frequently.

Intestinal ischemia is often divided into groups. Ischemia of the Colon, also called ischemic colitis affects the large intestine. Other types of ischemia affects the small intestine. These are acute mesenteric ischemia, chronic mesenteric ischemia, and ischemia due to mesenteric venous thrombosis.

Ischemia of the Colon, also called ischemic colitis

This type of intestinal ischemia is the most common. This occurs when the flow of blood to the part of the colon is slowed down or blocked. The cause of less blood flow to the colon is not always clear. But the conditions that may increase the risk of colon ischemia include:

  • Very low blood pressure called hypotension. This may be related to heart failure, major surgery, trauma, shock, or loss of body fluids, called dehydration.
  • A blood clot, or severe blockage in an artery that sends blood to the colon. This is called atherosclerosis.
  • A twisting of the bowel, called volvulus, or the capture of the intestinal contents within a hernia.
  • An enlargement of the intestine from scar tissue or a tumor blocks the bowel.
  • Other medical conditions that affect the blood. These include lupus, sickle cell anemia, and swelling, and irritation, the call of inflammation of the blood vessels. This inflammation is known as vasculitis.
  • Drugs that constrict the blood vessels. These include some that treat heart disease and migraine.
  • Hormonal medications, such as birth control pills.
  • Cocaine or methamphetamine.
  • Intense exercise, such as running long distances.

Acute mesenteric ischemia

Mesenteric ischemia occurs when narrowed or blocked arteries restrict blood flow to the small intestine. This may cause permanent damage to the small intestine.

Acute mesenteric ischemia is the result of a sudden loss of blood flow to the small intestine. It may be due to:

  • A blood clot, also called a stroke, that comes from losing in the heartand travels through the blood to clog an artery. Most often, the blocks of the superior mesenteric artery that sends oxygen-rich blood to the intestines. This is the most common cause of acute mesenteric artery ischemia. Congestive heart failure, a heart attack, or irregular heartbeats, called arrhythmias, can bring this about.
  • A crash that happens in one of the main arteries of the intestine. This is often the result of atherosclerosis. This type of sudden ischemia usually occurs in people with chronic diseases of the intestinal ischemia.
  • Decreased blood flow to the low blood pressure.Low blood pressure may be due to shock, heart failure, certain medications, or in the course of renal failure, it is called chronic renal failure. Decreased blood flow is more common in people who have other serious illnesses and the fat deposits on the wall of the artery, called atherosclerosis. This type of acute mesenteric ischemia is often called nonocclusive ischemia. This means that it is not due to a blockage in the artery.

A blood clot, also called a stroke, that comes from losing in the heart and travels through the blood to clog an artery. Most often, the blocks of the superior mesenteric artery that sends oxygen-rich blood to the intestines.

This is the most common cause of acute mesenteric artery ischemia. Congestive heart failure, a heart attack, or irregular heartbeats, called arrhythmias, can bring this about.

Decreased blood flow to the low blood pressure. Low blood pressure may be due to shock, heart failure, certain medications, or in the course of renal failure, it is called chronic renal failure. Decreased blood flow is more common in people who have other serious illnesses and the fat deposits on the wall of the artery, called atherosclerosis.

This type of acute mesenteric ischemia is often called nonocclusive ischemia. This means that it is not due to a blockage in the artery.

Chronic mesenteric ischemia

Chronic mesenteric ischemia is due to the accumulation of fatty deposits on the wall of the artery, called atherosclerosis. The process of the disease most often is slow. It is also called angina intestinal due to that it is due to less blood flow to the intestines after eating.

You may not need treatment until at least two of the three main arteries that carry blood to the intestines become very narrow or blocked all the way.

A possible dangerous complication of chronic mesenteric ischemia is to have a blood clot in an artery narrowed. This can cause a sudden blockage, which can cause acute mesenteric ischemia.

Ischemia due to mesenteric venous thrombosis

This type of ischemia occurs when the blood can't leave the small intestine. This may be due to a blood clot in a vein that drains blood from the intestines. The veins carry the blood back to the heart after the oxygen is removed. When the vein is blocked, the blood accumulates in the intestines, causing swelling and bleeding.

This may be the result of:

  • Acute or chronic irritation and swelling, called inflammation of the pancreas. This condition is called pancreatitis.
  • The infection inside the womb.
  • Cancers of the digestive system.
  • Diseases of the intestine, such as ulcerative colitis, Crohn's disease or diverticulitis.
  • Conditions that cause the blood to clot more easily.
  • Medications such as estrogen, which can increase clotting risk.
  • Injuries in the belly area.

Risk factors

Factors that may increase the risk of intestinal ischemia include:

  • The accumulation of fatty deposits in the arteries, called atherosclerosis. If you've had other conditions caused by atherosclerosis, you have a higher risk of intestinal ischemia. These conditions include less blood flow to the heart is called coronary artery disease; less blood flow to the legs, called peripheral vascular disease; or less blood flow to the arteries going to the brain, called carotid artery disease.
  • Age. People older than 50 years are more prone to intestinal ischemia.
  • The habit of smoking. The use of cigarettes and other forms of smoked tobacco increases the risk of intestinal ischemia.
  • Heart and blood vessel conditions. The risk of intestinal ischemia is higher if you have congestive heart failure or an irregular heartbeat, such as atrial fibrillation. Diseases of the blood vessels in the result of the irritation, the call of inflammation of the veins and the arteries may also increase the risk. This inflammation is known as vasculitis.
  • Drugs. Certain medications may increase the risk of intestinal ischemia. Examples include birth control pills and medications that cause the blood vessels to expand or contract, as some allergy medications, and medications for migraine.
  • Blood clotting problems. The diseases and conditions that increase the risk of blood clots may also increase the risk of intestinal ischemia. Examples include sickle cell disease and a genetic condition known as factor V Leiden mutation.
  • Other health conditions. Have high blood pressure, diabetes, or high cholesterol can increase the risk of intestinal ischemia.
  • The use of illicit drugs. Cocaine and methamphetamine have been linked to intestinal ischemia.

Complications

The complications of intestinal ischemia can include:

  • The death of intestinal tissue. A sudden and complete blockage of blood flow to the intestines, it can kill intestinal tissue. This is called gangrene.
  • A hole through the wall of the intestines, which are called a perforation. A hole can cause what is in the gut of the brain in the belly. This can cause a serious infection called peritonitis.
  • Scarring or narrowing of the intestine. Sometimes the intestines recover from ischemia. But as part of the healing process, the body forms scar tissue that narrows or blocks the intestines. This happens most often in the colon. Rarely, it occurs in the small intestine.

Other health conditions, such as chronic obstructive pulmonary disease, also called COPD , can cause intestinal ischemia worse. Emphysema, a type of COPD , and other smoking-related lung disease increase this risk.

Sometimes, intestinal ischemia can be fatal.

Diagnosis

If your healthcare provider suspects of intestinal ischemia after a physical exam, you can have several diagnostic tests based on the symptoms. Tests may include:

  • Blood tests. Although the blood tests alone cannot diagnose intestinal ischemia, blood test results could suggest the condition. An example of this type of result is a high leukocyte count.
  • Imaging tests.Imaging tests allow your health care professional to see their internal organs and rule out other causes of your symptoms. Imaging tests may include a chest x-ray, ultrasound, aCTscan or anMRI. To look at the flow of the blood in your veins and arteries, your health care professional may use an angiogram using a certain type ofCTscan orMRI.
  • The use of an endoscope to look inside the digestive tract. This involves the placement of a flexible tube with a camera at its tip into the rectum to view your digestive tract. The scope you can see in the last 2 feet of his colon, a test called a sigmoidoscopy. When the test is seen in all of his colon, is called colonoscopy.
  • The use of a dye that controls the flow of blood through the arteries.During this test, called an angiogram, a long, thin tube called a catheter is inserted into an artery in the groin or arm. A contrast dye is injected through the catheter flowing intestinal arteries. The dye moves through the artery allows narrowed areas or blockages show up on x-rays. Angiography also allows a health professional to treat a blockage in an artery. The health care provider may remove a blood clot, to put in a medicine or in the use of special tools, to widen an artery.
  • Surgery. In some cases, surgery may be needed to find and remove the damaged tissue. The opening of the belly allows the diagnosis and treatment during a procedure.

Imaging tests. Imaging tests allow your health care professional to see their internal organs and rule out other causes of your symptoms. Imaging tests may include an x-ray, an ultrasound, a ct scan or an mri .

To look at the flow of the blood in your veins and arteries, your health care professional may use an angiogram of using a certain type of computed tomography or magnetic resonance imaging .

The use of a dye that controls the flow of blood through the arteries. During this test, called an angiogram, a long, thin tube called a catheter is inserted into an artery in the groin or arm. A contrast dye is injected through the catheter flowing intestinal arteries.

The dye moves through the artery allows narrowed areas or blockages show up on x-rays. Angiography also allows a health professional to treat a blockage in an artery. The health care provider may remove a blood clot, to put in a medicine or in the use of special tools, to widen an artery.

Treatment

Treatment of intestinal ischemia consists in the restoration of the blood supply to the digestive tract. The options vary depending on the cause of the condition and how bad it is.

Colon ischemia

Your health care professional may suggest antibiotics to treat or prevent infections. Other medical conditions, such as congestive heart failure or an irregular heartbeat, should also be treated.

It is likely that you need to stop taking medicine that narrows the blood vessels. These include hormonal drugs, and some medications to treat migraine headaches and heart disease. More often, colon ischemia cure for his own account.

Serious damage to the colon, you may need surgery to remove the dead tissue. You may also need surgery to prevent a blockage in one of his arteries intestinal. If you have an angiography to diagnose the condition, it may be possible to widen a narrowed artery during the procedure.

Angioplasty uses a balloon inflated on the end of a catheter to the press in the fatty deposits. The ball also extends to the artery, making a wide path for the flow of the blood.

Your health care provider may put a springlike metal tube, called a stent in the artery to help keep it open. Your health care professional may also remove a blood clot or dissolve the medicine.

Acute mesenteric artery ischemia

You might need a surgery to remove a blood clot, to prevent a blockage of the artery, or to repair or remove a damaged part of the intestine. Treatment may also include antibiotics and drugs to prevent the formation of blood clots, dissolve blood clots, or widen the blood vessels.

If you have an angiography to diagnose the condition, it may be possible to widen a narrowed artery or remove a blood clot during the procedure. Your health care professional may also put in a metal tube, called a stent to help keep the narrowing of the artery open.

Chronic mesenteric artery ischemia

The goal of treatment is to restore the flow of blood to the intestine. Your surgeon can avoid the blockage of the arteries, or to expand the narrowing of the arteries with angioplasty or placement of a stent in the artery.

Ischemia due to mesenteric venous thrombosis

If the intestine shows no damage, you do not need repair. But it is likely that you need to take a medicine that prevents the clotting of the blood, called anticoagulant medicine, for around 3 to 6 months.

You might need a procedure to remove a blood clot. If parts of your intestine to show signs of damage, you may need surgery to remove the damaged part. If the tests show that you have a blood-clotting disorder, you may need to take medicines called anticoagulants for the rest of your life.

Preparing for your appointment

Seek medical attention right away if you have severe abdominal pain that makes it so uncomfortable that you can't sit still.

Maybe your pain in the belly is not so bad, and knowing when is going to start, so soon after eating. Then, make an appointment with your health care professional. You may be sent to a doctor who specializes in digestive problems, called a gastroenterologist, or a vascular surgeon.

Here's some information to help you prepare for your appointment.

What you can do

When you make the appointment, ask if there is something that you need to do before your appointment, as the not to eat before certain tests. Also, ask a friend or family member to go with you, if possible, to help you remember the information that is obtained.

Make a list of:

  • Their symptoms. Include any that doesn't seem linked to the reason for which you scheduled the appointment, and when they began.
  • His medical history. Include other medical conditions, such as a blood clot, or the procedures that we have had.
  • All the drugs, vitamins, herbs and other supplements that you take. Include the dose. If you take birth control pills, make a note of the name.
  • Questions to ask your health care professional.

Intestinal ischemia, some questions are:

  • What is the most likely cause of my condition?
  • Do you think my condition is going to disappear or be long-term?
  • What tests do I need?
  • What treatment do you suggest?
  • If I need surgery, what will my recovery be like? How much time do I have to be in the hospital?
  • What diet and lifestyle changes I have to do?
  • What follow-up care and treatments do I need?
  • Are there brochures or other printed material I can have? What websites do you suggest?

Be sure to ask all the questions that you have.

What to expect from your doctor

Your health care professional may ask:

  • The symptoms stayed the same or worsened?
  • Do your symptoms come and go?
  • How bad are the symptoms?
  • How soon after eating, do your symptoms begin?
  • Your symptoms are better if you eat small meals rather than big?
  • Does anything make your symptoms better or worse?
  • Do you or do you smoke? How much?
  • You have lost weight without trying?
Symptoms and treatment of Intestinal ischemia