Angiodysplasia is an abnormality with the blood vessels in the gastrointestinal (GI) tract. The GI tract includes the mouth, esophagus, small and large intestines, stomach, and anus. This condition causes swollen or enlarged blood vessels, as well as the formation of bleeding lesions in the colon and stomach.
The type of angiodysplasia is based on the location of the blood vessel enlargement. Your doctor may classify your case as either colon angiodysplasia (enlargement of blood vessels in the colon), or stomach angiodysplasia (enlargement of blood vessels in the stomach). In addition, this condition can be broken down into the following categories based on location:
- colonic and gastric angiodysplasia
- angiodysplasia of stomach and the intestine
- cecal angiodysplasia
- duodenal and small bowel angiodysplasia
Angiodysplasia can occur without pain and go undetected, or you may have subtle symptoms. Anemia is one symptom of this condition because it causes lesions and bleeding in the GI tract.
Anemia is when your red blood cell count is lower than normal. This can cause a reduction in oxygen flow throughout your body and trigger a range of symptoms. You may experience any of the following with angiodysplasia:
- shortness of breath
- pale skin
- fast heartbeat
Angiodysplasia can also cause bleeding from the rectum. Blood loss can vary from mild to severe, and blood may appear bright red or black and tarry.
Rectal bleeding can also be a sign of colon cancer and other disorders of the GI tract.
The cause of angiodysplasia is unknown. But normal spasms occurring in the GI tract may be responsible for the enlargement of blood vessels. This enlargement leads to the development of small pathways between a vein and an artery, which can leak with blood. In addition, age-related weakening of blood vessels may also cause angiodysplasia. This might explain why the condition is more common in older people.
Other risk factors for angiodysplasia include a history of heart disease, such as aortic stenosis, as well as taking an anticoagulation or blood thinner medication.
If you present with symptoms of angiodysplasia, your doctor may order a series of tests to check for abnormalities and bleeding in your gastrointestinal tract. These may include:
- Upper endoscopy. In this test, your doctor examines the lining of your esophagus and stomach by inserting a tube with an attached camera down your throat and into your stomach.
- Stool test. Your doctor may ask you for a stool sample to test for traces of blood.
- Complete blood count (CBC). This blood test evaluates your number of red blood cells. The results can confirm or rule out anemia.
- Colonoscopy. This procedure involves inserting a tube with an attached camera into your anus to examine your intestines. Your doctor can view the lining of your large intestines and check for bleeding and other abnormalities.
- Angiogram. This X-ray creates images of your blood vessels and helps identify the location of the bleeding. Your doctor may recommend an angiogram if a colonoscopy doesn’t reveal any lesions, yet your doctor suspects active bleeding.
Sometimes, bleeding caused by angiodysplasia stops on its own without medical intervention. But you may require treatment to control bleeding and reverse anemia.
Treatment depends on the severity of the condition and whether you have anemia. If you don’t have anemia, your doctor may hold off treating the condition until you begin having symptoms. Treatment may include:
- Angiography. In this procedure, your doctor uses a thin plastic tube to deliver medicine to a bleeding blood vessel. This medication closes up the blood vessel and stops bleeding.
- Cauterizing. Once your doctor identifies the site of the bleeding, they can use cauterization to close off a part of the vein and stop the bleeding. This procedure may be performed using an endoscope, a flexible tube that passes through your mouth into the stomach and upper part of the small intestines.
- Surgery. If you have severe bleeding from the colon, surgery may be the only option to stop the bleeding. In this case, your doctor may remove the right side of your colon.
You doctor can also prescribe or recommend over-the-counter iron supplements in cases of anemia. Iron can stimulate red blood cell production.
There doesn’t appear to be any way to prevent angiodysplasia.
It’s important that you don’t ignore signs of angiodysplasia. Contact your doctor if you experience unusual fatigue, weakness, dizziness, or rectal bleeding. If left untreated, angiodysplasia can cause severe blood loss. And in cases of extreme anemia, you may need a blood transfusion.
The outlook for angiodysplasia is good when treatment successfully controls the bleeding. Once bleeding stops, anemia may resolve itself, at which point you may regain energy. Keep in mind that even with treatment, you could experience bleeding again in the future.