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Mesenteric ischemia

Mesenteric ischemia is caused by an interruption in blood flow to all or part of the small intestine or the right colon. You're losing weight, but not because you want to. Lately you've avoided eating regular meals. That's because a short time after eating a meal, you end up with belly pain that lasts for an hour or two. And as the pain has become worse, the thought of eating is not at all appealing.

It's possible you have a condition called chronic mesenteric ischemia - reduced flow of oxygen-rich blood to your gut.

The cause could be accumulation of fatty deposits in some of your arteries (atherosclerosis), which narrows those arteries and restricts the amount of blood moving through them. When atherosclerosis affects the arteries supplying blood to your intestinal tract, it causes pain and makes it more difficult for your intestines to do their job.

Undetected, chronic mesenteric ischemia could lead to a life-threatening blockage of the blood supply to your gut. Fortunately, once chronic mesenteric ischemia is recognized, it can often be successfully treated.

Treatment

Treatment of intestinal ischemia involves restoring a sufficient blood supply to your digestive tract. Options vary depending on the cause and severity of your condition.

• Colon ischemia. Antibiotics are often used to treat or prevent infections. Your doctors also will treat any underlying medical condition, such as congestive heart failure or an irregular heartbeat. You'll need to stop any medications that constrict your blood vessels, such as migraine drugs, hormone medications and some heart drugs. If your colon has been damaged, you may need surgery to remove the severely damaged (infarcted) tissue. Or, you may need surgery to bypass a blockage in one of your intestinal arteries. The procedure is similar to what's done when blocked coronary arteries of the heart are bypassed to redirect blood flow around a blockage.

• Acute mesenteric artery ischemia. Treatment may include medications to prevent clots from forming, dissolve clots or dilate blood vessels. If an arteriogram is done, the radiologist may be able to remove a blood clot, or open up the narrowed artery with angioplasty. Angioplasty involves using a balloon inflated at the end of a catheter to compress the fatty deposits and stretch the artery, making a wider path for the blood to flow. A spring-like metallic coil (stent) may also be placed in your artery to help keep it open. However, surgery is often necessary to remove a blood clot, bypass an artery blockage, or to repair or remove a damaged section of intestine.

• Chronic mesenteric artery ischemia. Treatment involves restoring blood flow to your intestine. Your surgeon can bypass the blocked arteries or widen narrowed arteries with angioplasty therapy or stenting.

• Ischemia due to mesenteric venous thrombosis. If your intestines show no signs of damage, you'll likely need to take anticoagulant medication for about three to six months. Anticoagulants help prevent clots from forming. If portions of your bowel show signs of damage, however, you will need surgery to remove the damaged section. After surgery, you may need to take an anticoagulant for a short time.

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