Definition and Overview

Also known as mesenteric vascular disease, mesenteric ischemia refers to an injury in the veins or arteries of the small intestine, which restricts blood supply in the organ. When the small intestine is deprived of oxygen-rich blood, the patient can suffer from permanent damage in the digestive system. Mesenteric ischemia, especially the more severe forms, is considered a life-threatening condition.

There are two types of mesenteric ischemia, namely:

  • Acute mesenteric ischemia (AMI) - This can be a result of trauma. AMI is relatively rare, and affects one in every 20,000 people in the developed world. The symptoms of AMI appear more suddenly.

  • Chronic mesenteric ischemia (CMI) - This refers to mesenteric ischemia that gradually develops over time. CMI is comparatively rarer than AMI, and a majority of diagnosed patients are over sixty years old.

Cause of Condition

The condition is caused by an illness or injury, but the following factors can increase an individual’s risk of having mesenteric ischemia:

  • Age - This condition is more common in people over sixty years old.

  • Having cardiovascular disease - Research shows that cardiovascular diseases can increase the risk of mesenteric ischemia, because the mesenteric arteries in the intestines are connected to the aorta. Plaque and fatty deposits in the aorta can affect the mesenteric arteries the same way.

  • High cholesterol levels - The mesenteric arteries can also narrow the mesenteric arteries and reduce the amount of oxygen-rich blood flowing into the small intestines.

  • Smoking

  • Having high blood pressure

  • Drug use - Using drugs such as methamphetamines and cocaine can constrict the blood vessels.

  • Using birth control pills - Research shows that the use of birth control pills can constrict the blood vessels.

Blood clots, especially ones that can flow into the patient’s bloodstream, can cause a reduction in blood flow to the arteries. This is an alarming condition since the clots can travel to the patient’s brain and lead to stroke.

Having surgery performed in the intestines can also affect the blood flow to the organ, since the blood vessels can scar, which can narrow the pathway for oxygen-rich blood.

Key Symptoms

Symptoms for acute mesenteric ischemia include:

  • Severe pain in the stomach
  • Vomiting
  • Nausea
  • Blood in the feces

On the other hand, chronic mesenteric ischemia symptoms are:

  • Significant weight loss
  • Stomach pains, especially after eating
  • Significant change in eating habits, since the patient can be in so much pain right after eating
  • Diarrhea
  • Constipation

Some of the symptoms of mesenteric ischemia can also be linked to the reduction of not only blood flow to the small intestine, but also reduced amount of nutrition the patient is receiving.

Who to See and Types of Treatment Available

The treatment for this condition depends on the cause/s.

If the mesenteric ischemia is caused by a blood clot, the doctor can prescribe anticoagulants to dissolve the clots and prevent it from occurring in the future. On other hand, blocked arteries can also be addressed by an angioplasty, where a stent is inserted into the blood vessels to keep the pathways wide and clear, and to restore the blood flow to the small intestine.

In more serious cases of mesenteric ischemia, the patient can undergo surgical procedures to remove the plaque and fatty deposits and repair the blood vessels.

The doctor can also prescribe a change of diet and lifestyle to the patient. Several smaller low-fat meals a day can be an effective way to manage chronic mesenteric ischemia. Engaging in physical activities and taking steps to manage conditions such as diabetes, high cholesterol levels, and hypertension can also help.

References:

  • Hauser SC. Vascular diseases of the gastrointestinal tract. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 145.
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