Digestive system requires a permanent supply of oxygen-rich blood to function well as other organs. Intestinal ischemia is a condition of reduced blood flow to the small intestine or colon.Intestinal ischemia can lead to pain and cause disruption to the intestines to function normally. Loss of blood flow to the intestine in severe cases can lead to intestinal tissue damage or death. Intestinal ischemia can be fatal as a heart attack.
However, intestinal ischemia can be treated effectively. The most important factor in order to effectively treat intestinal ischemia is to recognize early symptoms and get immediate medical help.
Cause
The aorta is the large arterial vessels that supply the body with oxygen-rich blood is pumped by the heart. Part of the aorta that extends below the diaphragm into the abdomen called the abdominal aorta.
Three arteries branching from the abdominal aorta, which supplies almost all the blood to the gastrointestinal tract. These arteries, among others:
1. Superior mesenteric artery
2. The inferior mesenteric artery
3. Celiac artery
Intestinal ischemia can occur if blood flow through arteries or veins adjacent to be reduced, the change can be acute or chronic. Any or all of the arteries that supply the gastrointestinal tract can be affected by the accumulation of particles of cholesterol, calcium, scarring, and other cellular debris (atherosclerosis).
This happens just as with other arteries in the body that narrows and limits the amount of blood moving through the vessels. Progressive atherosclerotic buildup can decrease blood flow to the small intestine, large intestine, or both. Chronic intestinal ischemia is usually the result of a buildup of atherosclerosis.
Acute intestinal ischemia, mostly due to the formation of blood clots in the heart which then goes to one of the intestinal arteries. Blood clots can develop in the veins and away from the gut, thereby reducing the flow of deoxygenated blood.
Intestinal ischaemia sometimes occurs because a portion of the intestine becomes clogged due to hernia (strangulated hernia) or because of adhesions from previous abdominal surgery. In other cases it can occur because of low blood pressure or heart failure.
Whatever the cause, the main cause is reduced blood flow with sufficient oxygen in the digestive tract cells. In these circumstances, the cells can weaken and then die.
Inflammation can develop due to a growing number of damaged cells. This causes an inability to absorb food and nutrients, causing diarrhea accompanied by blood.Infection and tissue death can result in significant damage. Intestinal ischemia can be fatal if not treated promptly.
Symptom
Intestinal ischemia can occur and bring the symptoms with a sudden (acute intestinal ischemia), which is usually caused by blood clots that block blood flow to or from the intestine.
In addition to acute intestinal ischemia, ischemia may develop slowly over time due to various causes, commonly referred to as chronic intestinal ischemia.
a. Acute intestinal ischemia
Signs and symptoms of acute intestinal ischemia usually include:
1. Frequent bowel movements
2. Fever
3. Dysentery
4. Sudden abdominal pain that can range from mild to severe
5. Abdominal pain or distention
6. Nausea or vomiting
b. Chronic intestinal ischemia
Chronic intestinal ischemia, where blood flow to the intestine decreases with time, usually characterized by:
1. Afraid to eat because after that will feel the pain
2. Stomach cramps or feel fullness, start within 30 minutes after eating and lasts 1-3 hours
3. Nausea or vomiting
4. Bloating
5. Abdominal pain that gets worse over several weeks or months
6. Diarrhea
7. Losing weight is not desirable
Chronic intestinal ischemia can develop into an acute episode. People may suffer from severe abdominal pain that occurs over several weeks or months of lost and pain attacks occur after eating.
In the case of a sudden, get medical help immediately obtained. If the patient still felt the constant stomach pain due to delay of treatment, can make treatment more difficult.
Consulting a doctor is needed immediately if experiencing one or more of these signs or symptoms of the following:
1. Chronic abdominal pain after eating, especially when someone is also trying to lose weight
2. Dysentery
Treatment
Treatment of intestinal ischemia focus on restoring adequate blood supply to the gastrointestinal tract is involved. Treatment options vary depending on the reason behind the severity of the condition, such as among others:
1. Treatment for intestinal ischemia
a. Antibiotics
Antibiotics are commonly used to treat or prevent infections that may occur. Any underlying medical condition should be treated as well, such as irregular heartbeat and congestive heart failure.
One is needed to stop the drug that constricts blood vessels, such as hormone drugs, certain heart medications, and migraine medications.
b. Surgery
Surgery may be necessary to remove the tissue (infracted) died when some parts of the intestine has been damaged. Alternatively, surgery may be needed in order to bypass a blockage in one artery intestine.
This operation is similar to what is done when there is blockage of the coronary arteries of heart that is passed to direct blood flow around blockages. Your doctor may consider a full colonoscopy after symptoms become better because colon cancer is one of the reasons behind the occurrence of colon ischemia.
2. Treatment for acute mesenteric artery ischemia
Usually the operation is necessary to remove blood clots, clogged arteries through which, or to repair or remove part of intestine that has been damaged.
Additional treatment may include medications to prevent the formation of frozen blood, blood vessels dilate, or dissolve the clot.
In the case of angiography is performed to diagnose the problem, radiologists may be able to simultaneously remove blood clots, or open a narrowed artery with angioplasty.
A balloon used in angioplasty at the end of the catheter to compress the fatty deposits and stretch the artery, thus making a wider path for blood flow. A metallic coil (stent) can be positioned in extra to help keep the artery open.
3. Treatment for chronic mesenteric artery ischemia
Treatment aims to restore blood flow to the intestines. The surgeon can expand the narrowed arteries or bypass clogged arteries with angioplasty or stenting therapy.
4. Ischemia due to venous thrombosis mesesenterik
In the case of a person's intestine showed no signs of damage, probably will need to take anticoagulant medication for about 3-6 months. Anticoagulants help prevent the formation of frozen blood.
As part of the intestine showed signs of damage, patients will still need surgery to retrieve the broken part. After surgery, one may need to take anticoagulants for a short time.
Sources: Epharmapedia
