Mesenteric artery ischemia is a condition that restricts blood flow to your intestines.
Three main arteries, called the mesenteric arteries, supply blood to your small and large intestines. Narrowing or blockage in these 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 such as excessive weight loss and malnutrition. Intestinal cell death can cause permanent damage and can even be life threatening.
People of any age can develop mesenteric artery ischemia.
The condition 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 as well as ischemia.
High cholesterol contributes to 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. Factors that increase your likelihood for plaque buildup include:
Blood clots can also block the mesenteric arteries and reduce blood flow to the digestive tract. A blood clot is a group of blood cells that stick together. The most common cause of blood clots that cause acute mesenteric ischemia is heart disease, especially atrial fibrillation. A blood clot can form in the heart and travel to the intestines.
Chronic mesenteric ischemia is caused by a narrowing of more than one of the intestinal arteries. Chronic mesenteric ischemia can become acute when a blood clot forms within the plaque buildup inside the mesenteric arteries and completely blocks it.
Previous blood vessel surgery is another possible cause of ischemia. Surgery can create scar tissue that narrows the arteries. People who have had surgery on their blood vessels will be monitored to detect these occasional re-narrowings before they become dangerous.
Mesenteric artery ischemia has two types: acute and chronic.
The acute form of the disease appears suddenly and has severe symptoms. For most people, blood clots cause acute ischemia.
The chronic type of mesenteric artery ischemia has a more gradual onset. Atherosclerosis is usually the cause of chronic ischemia.
Acute symptoms include:
- severe abdominal pain
- diarrhea (which may be bloody)
Chronic symptoms may include:
- consistent pain after eating meals
- unintended weight loss
You may also have a sudden urge to have frequent bowel movements during an acute case of mesenteric artery ischemia. Blood in the stool is a common symptom.
Stomach pain after eating is also a symptom of chronic ischemia. If you anticipate pain after every meal, you may start eating less, causing unintentional weight loss.
Your doctor will take your medical history and perform a physical exam to diagnose mesenteric artery ischemia. Imaging tools can confirm a narrowing of one or more mesenteric arteries. These tools include:
- CT scans. These scans produce cross-sectional images of body structures and organs.
- Ultrasound. This sonogram uses high-frequency sound waves to create images of body organs.
- MRA. Magnetic resonance angiography (MRA) is an MRI exam of the blood vessels.
- Arteriogram. This invasive procedure uses X-rays and a special dye to look at the inside of blood vessels.
Acute arterial blockages in the intestines require immediate
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 to treat chronic mesenteric artery ischemia can include:
- eating a low-fat and low-sodium diet to reduce blood pressure and cholesterol levels
- exercising daily to lower cholesterol, regulate blood pressure, and increase heart health
- quitting smoking, if you smoke
- 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, such as hydralazine or nitroglycerin, to prevent spasm of your blood vessels
Acute intestinal ischemia is more life threatening, as treatment can occur too late after intestinal tissue is already dead. Prompt treatment is crucial for a good outlook.
If you have sudden onset symptoms of acute mesenteric ischemia, you should call local emergency services or go to the nearest emergency room.