How do intestines die

This is called atherosclerosis, or hardening of the arteries. As plaque builds, it starts to block blood flow through your artery.

This type of ischemia may come and go for a while, and then become constant. Acute mesenteric ischemia is a constant and severe decrease in blood flow.

A blood clot that forms in the heart and then breaks free and blocks the mesenteric arteries often causes this condition. Who is at risk for mesenteric ischemia? Risk factors for mesenteric ischemia include: Older age Low blood pressure High blood pressure Heart disease, including coronary artery disease, heart failure, heart valve disease, atrial fibrillation High cholesterol and triglycerides in the blood Cigarette smoke Blood that easily clots Inflammatory conditions such as pancreatitis and diverticulitis Rheumatologic conditions called vasculitis Injury Kidney failure Decompression sickness, a deep water diving injury Recent heart attack Recent catheter studies of the blood vessels Use of cocaine What are the symptoms of mesenteric ischemia?

Tests that may be done to diagnose the disease include: Angiography. For this test, a long, thin tube called a catheter is inserted into an artery in the groin. Dye that shows up on X-rays is injected and images are taken. Once the blockage is found, treatment may be done through the catheter. CT angiography. This test is similar to angiography but uses 3-Dimages guided by a computer. MR angiography. This test is similar to other types of angiography, but the 3-Dimages are created using a computer and radio waves.

Doppler ultrasound. This test uses sound waves to create images of blood vessels to see whether blood is flowing through them. Blood tests. Tests that measure the number of white blood cells and the level of acidity in the blood may help in the diagnosis. How is mesenteric ischemia treated?

Options include: Angioplasty. A doctor does this procedure during an angiogram. A small balloon at the end of the catheter inflates to open up your artery and restore blood flow. Your doctor may leave in place a tiny support structure, called a stent.

This helps keep your artery open. What isn't absorbed by the intestines continues along the digestive tract and is expelled as stool during a bowel movement. Diarrhea can be present due to abnormalities in the small intestine or the large intestine.

Intestinal ischemia is-KEE-me-uh describes a variety of conditions that occur when blood flow to your intestines decreases due to a blocked blood vessel, usually an artery. Intestinal ischemia can affect your small intestine, your large intestine colon or both. Intestinal ischemia is a serious condition that can cause pain and make it difficult for your intestines to work properly. In severe cases, loss of blood flow to the intestines can damage intestinal tissue and possibly lead to death.

Treatments are available for intestinal ischemia. To improve the chances of recovery, it's crucial to recognize the early symptoms and get medical help right away. Signs and symptoms of intestinal ischemia can develop suddenly acute or gradually chronic.

Signs and symptoms may be different from one person to the next, but there are some generally recognized patterns that suggest intestinal ischemia. Seek immediate medical care if you have sudden, severe abdominal pain. Pain that makes you so uncomfortable that you can't sit still or find a comfortable position is a medical emergency. Intestinal ischemia occurs when the blood flow through the major arteries that supply blood to your intestines slows or stops.

The condition has many potential causes, including a blockage in an artery caused by a blood clot, or a narrowing of an artery due to buildup of deposits, such as cholesterol. Blockages also can occur in veins, but they're less common. People with chronic intestinal ischemia often experience intermittent, dull, nondescript abdominal pain after they eat a meal.

The pain occurs after eating because the intestines require more blood flow during digestion, and the partially blocked arteries cannot supply that extra blood. People with this milder form of intestinal ischemia often do not seek medical help right away, and instead may subconsciously cut back on meals to avoid discomfort. They often have substantial weight loss before they finally ask their doctor for help.

Unfortunately, many never get a medical evaluation until they finally develop acute intestinal ischemia. Intestinal ischemia usually occurs when one of two major arteries becomes obstructed: the superior mesenteric artery SMA , which supplies most of the small intestine; or the inferior mesenteric artery IMA the major supplier of the large intestine. Sometimes a blockage in the venous drainage from the intestines can also lead to intestinal ischemia. There are several general vascular conditions that can cause acute intestinal ischemia.

These include:. Almost any form of cardiac disease, vascular disease, or disorders of blood clotting can increase a person's risk of developing intestinal ischemia. In particular, the risk of intestinal ischemia increases with:. The key to diagnosing acute intestinal ischemia is for the doctor to think of the diagnosis, and then do the appropriate testing to confirm it or rule it out.

It is important to make the diagnosis quickly, so that treatment can be instituted before catastrophic damage is done to the intestine. The key symptom of intestinal ischemia is abdominal pain. However, there are scores of medical conditions that produce abdominal pain, so in order for the doctor to focus on the possibility of intestinal ischemia, he or she must always be ready to consider this diagnosis. People with intestinal ischemia often have very few findings on physical exam and, in fact, young doctors are taught to think of this condition any time a patient complains of severe pain that is out of proportion to the physical findings.

The doctor's level of concern should increase in a patient with unexplained sudden abdominal pain who also has risk factors for intestinal ischemia, and in patients who describe a history of abdominal pain after meals. Once intestinal ischemia is deemed to be a reasonable possibility, specialized imaging studies of the abdomen should be performed immediately.

CT angiography a CT scan combined with the injection of a dye into a vein or conventional arteriography a catheterization technique in which dye is injected into an artery and x-rays are done is often required to confirm the diagnosis. If suspicion of acute intestinal ischemia is high enough, or if there are signs of peritonitis or cardiovascular instability, immediate exploratory surgery may be necessary before a definitive diagnosis can be made.

In treating acute intestinal ischemia, it is important to stabilize the patient as rapidly as possible, while working to restore blood flow to their intestines.

Typically, fluids are administered to restore and maintain blood circulation, pain control is achieved with opioids , antibiotics are given to try to prevent any leakage of intestinal bacteria into the abdominal cavity from producing peritonitis, and anticoagulant medication is given to prevent further blood clotting.

It is unfortunately common for some degree of intestinal infarction to occur with acute intestinal ischemia. If signs of deterioration or of peritonitis should appear, surgery should be performed right away to remove the dying portion of intestine and to surgically restore blood flow through the occluded SMA or IMA.

If emergency surgery is not required, options for restoring blood flow include anticoagulant drugs, bypass surgery, angioplasty and stenting , or administering "clot-busting" drugs. The optimal choice can be difficult, and often requires a team approach involving a gastroenterologist, cardiologist, and surgeon. In a person who has been diagnosed with chronic intestinal angina, that is, partial occlusion of the SMA or IMA caused by an atherosclerotic plaque, treatment can be accomplished either with bypass graft surgery, or with angioplasty and stenting.

This treatment will make it easier to eat meals without symptoms and should help to prevent acute intestinal ischemia from occurring. Acute intestinal ischemia is a severe medical condition that can be challenging to diagnose rapidly and difficult to treat.

Once a person with acute intestinal ischemia has been treated and stabilized, the long-term outcome depends largely on the nature of the underlying cardiovascular problem or other medical conditions that led to the intestinal ischemia in the first place.

In any case, recovering from acute intestinal ischemia can be a challenge. These individuals tend to be older, and usually have substantial underlying cardiovascular disease.

They may also have a temporary or in some cases a permanent colostomy or ileostomy, if a partial intestinal resection has been required. In all cases, they will need thorough management of any underlying cardiovascular conditions that have contributed to their intestinal ischemia.

They will also need a full evaluation of contributing risk factors—including hypertension, cholesterol, obesity, smoking, and diabetes—and will need to aggressively manage these.