Intestinal ischemia occurs when blood does not reach the intestine properly. This reduction in flow affects the small intestine, large intestine, or both. Without enough blood, intestinal tissues lose oxygen and nutrients. In severe situations, the organ suffers serious damage and can even become necrotic.
This problem appears suddenly or develops gradually. In many cases, this disease appears in people with other vascular diseases. However, it also affects younger people in specific situations. Therefore, doctors consider intestinal ischemia an emergency requiring prompt attention.
What is intestinal ischemia and why is it a concern?
Intestinal ischemia represents a change in the circulation that nourishes the intestine. The arteries that carry blood can become blocked or narrowed. In some cases, the veins that drain blood also become blocked. Thus, the organ ceases to receive the volume necessary for its functioning.
Experts divide the problem into a few types. The acute form begins suddenly and usually progresses rapidly. The chronic form evolves slowly. In the latter case, the body tries to adapt to the reduced flow. However, the intestine suffers from a lack of oxygen.
When the disease sets in, the intestinal wall becomes inflamed and swells. Shortly after, bacteria in the intestine can cross this barrier. This increases the risk of infection of the abdomen and blood. In situations without treatment, the person risks death.
Main causes of intestinal ischemia
The causes of intestinal ischemia vary depending on the type of obstruction. In many patients, a blood clot blocks a mesenteric artery. This clot usually forms in the heart and travels through the bloodstream. People with arrhythmias, such as atrial fibrillation, are at greater risk.
Another common cause is fatty plaques in the abdominal arteries. These plaques, called atheromas, narrow the vessels over time. At some point, part of the plaque breaks off and forms a thrombus. Thus, blood stops circulating in this segment of the intestine.
In addition, certain factors increase the risk of intestinal ischemia:
- Advanced ageespecially after 60 years;
- Smokingwhich attacks the walls of vessels;
- High blood pressure And high cholesterol;
- Diabetes poorly controlled;
- Heart failure and arrhythmias;
- Coagulation diseases which promote thrombi;
- Illicit drug uselike cocaine.
In some situations, ischemia appears even without visible blockage. In these cases, blood pressure drops considerably, as during violent shocks. As a result, blood flows away from less vital organs to protect the brain and heart. Thus, the intestine receives little flow and suffers.
What are the symptoms of intestinal ischemia?
Symptoms vary greatly between acute and chronic forms. In acute intestinal ischemia, abdominal pain appears suddenly. This pain is usually intense and constant. Typically, the person experiences greater discomfort than the physical examination indicates.
Other signs frequently appear at this stage:
- Nausea and vomiting persistent;
- Diarrhea or bloody stools;
- Fever at more advanced stages;
- Abdominal bloating progressive;
- Pressure drop and intense discomfort.
In the chronic form, the pathology appears more discreet. The pain always appears after meals, especially the largest ones. The discomfort is concentrated in the central region of the abdomen. Typically, the patient begins to eat less out of fear of pain. Over time, weight loss and weakness occur.
Any sudden, severe pain in the abdomen requires urgent evaluation. This care is even more valid for people suffering from heart or vascular problems. Early identification increases the chances of preserving the intestine.
How do doctors diagnose intestinal ischemia?
Diagnosis begins with a detailed clinical assessment. The professional asks questions about previous illnesses, medications and lifestyle habits. Then examine the abdomen, measure vital signs and observe general condition. Thus, this creates a first hypothesis about the image.
Next, the doctor orders laboratory and imaging tests. Certain blood markers indicate intestinal inflammation and distress. However, these tests alone do not confirm the diagnosis. The use of imaging methods therefore becomes essential.
THE abdominal tomography angiography appears today as a central examination. It shows the mesenteric arteries and areas with less circulation. In some cases, the specialist prescribes catheter angiography. This examination allows you to visualize the vessels from the inside. In addition, this allows certain treatments to be carried out during the procedure itself.
Treatments available for intestinal ischemia
Treatment of intestinal ischemia varies depending on the cause and timing of development. In acute situations, teams quickly put support measures in place. So, the patient receives intravenous serum, painkillers and antibiotics. In addition, professionals monitor blood pressure and heart rate.
When there is a clot in a mesenteric artery, several options present themselves. In some cases, the doctor injects medications that dissolve the thrombus through a catheter. In others, he performs balloon angioplasty and places a stent. If the obstruction does not allow these methods, the team performs open surgery.
During surgery, the surgeon removes necrotic sections of the intestine. It then recomposes the transit when it finds healthy tissues. In very serious conditions, the patient undergoes more than one operation. This way the team can assess the recovery of the organ.
In chronic ischemia, emphasis is placed on revascularization and risk control. Therefore, doctors use:
- Anticoagulant medications;
- Strict control of blood pressure and diabetes;
- Stopping smoking and medications that narrow blood vessels;
- Endovascular procedures to open narrowed arteries.
In addition, regular follow-up with an angiologist, vascular surgeon or gastroenterologist is essential. In this way, the patient maintains stable intestinal flow and reduces the risk of further ischemia.
In summary, intestinal ischemia requires prompt attention, clear information, and continuous monitoring. With early diagnosis and appropriate treatment, many conditions progress favorably and preserve intestinal function.
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