Mesenteric artery ischemia is a condition that restricts blood flow to your intestines. There are three main arteries that supply blood to your small and large intestines. These are known as the mesenteric arteries. Narrowing or blocking the arteries reduces the amount of blood that travels to your digestive tract.
When your intestines don’t receive enough oxygen-rich blood, it can lead to serious health problems, including cell death and permanent damage. It can even be life-threatening.
People of any age can develop mesenteric artery ischemia (MAI), but it’s most common in adults over 60 years of age.
MAI may occur with cardiovascular disease. The mesenteric arteries that deliver blood to your intestines branch off from the aorta, the heart’s main artery. The buildup of fatty deposits, called atherosclerosis, can lead to heart disease. This kind of heart disease usually occurs in combination with changes in the aorta and the vessels that branch off of the aorta.
High cholesterol contributes to the ischemia because it causes plaque to line your arteries. This plaque buildup causes narrowing of the vessels and reduces the blood flow to your intestines. You’re more likely to develop atherosclerosis if you smoke, have diabetes, have high blood pressure, or have high cholesterol.
Blood clots can block the mesenteric arteries and reduce blood flow to the digestive tract. A blood clot is a group of blood cells that stick together. Blood clots can also increase your risk of stroke if they travel to the brain. Birth control pills and other medications containing estrogen can increase your risk of developing blood clots.
Cocaine and methamphetamine use can also lead to ischemia in some people. These drugs cause your blood vessels to narrow.
Blood vessel surgery is another possible cause of ischemia. Surgery can create scar tissue that narrows the arteries.
Mesenteric artery ischemia has two types: acute and chronic. The acute form of the disease appears suddenly. Acute ischemia has severe symptoms. The chronic type of MAI has a more gradual onset. For most people, blood clots cause acute ischemia. Atherosclerosis is usually the cause of chronic ischemia.
- abdominal pain and tenderness
- bloating or a sense of fullness
You may also have a sudden urge to have frequent bowel movements during an acute case of MAI. Blood in the stool is a common symptom.
Stomach pain after eating is also a symptom of chronic ischemia. You may develop a fear of eating due to the expectation of pain. This can cause unintended weight loss.
Your doctor will take your medical history and perform a physical exam to diagnose MAI. Imaging tools can confirm a narrowing of one or more mesenteric arteries. These include:
- CT scans: X-rays that produce cross-sectional images of body structures and organs
- ultrasound: a sonogram that uses high-frequency sound waves to create images of body organs
- MRI: magnet and radio waves that look at body organs
- MRA: magnetic resonance angiography (MRA) is an MRI exam of the blood vessels
- arteriogram: a procedure that uses X-rays and a special dye to look at the inside of blood vessels
Acute blockages in the intestines must receive treatment immediately to prevent tissue death. Usually, in the case of an acute ischemia attack, surgery removes blot clots, scar tissue, and parts of the intestines that have already died. Your doctor may prescribe blood-thinning medications to prevent future blood clots.
Angioplasty is another treatment option for narrowed arteries. A mesh tube called a stent is inserted into the narrowed artery to hold it open. In cases of total blockage, sometimes the blocked artery is bypassed altogether.
Surgery can treat chronic mesenteric artery ischemia, if needed. Surgery isn’t always necessary if intestinal ischemia progresses slowly. Lifestyle adjustments may help reverse atherosclerosis naturally. Lifestyle changes can include following a low-fat and low-sodium diet to reduce your cholesterol and blood pressure levels. Daily exercise can also lower cholesterol, regulate blood pressure, and increase heart health.
These medications also play a role in treating mesenteric artery ischemia:
- antibiotics (if an infection caused a blockage in the intestinal arteries)
- blood thinners to prevent future blood clots, such as heparin or warfarin
- vasodilator drugs to widen your blood vessels, such as hydralazine
Most people with chronic mesenteric artery ischemia recover well with treatment and lifestyle changes. Acute intestinal ischemia has a higher chance of morbidity, as treatment can occur too late after intestinal tissue is already dead. Prompt treatment is imperative for a healthy outlook.