Mesenteric Ischemia

Mesenteric ischemia is a rare condition that causes inadequate blood flow to the small intestines.  It only has about 200,000 cases per year in the United States.  This inadequate blood flow is caused by narrowed or blocked arteries.  If not treated it can cause permanent damage to the small intestines. 

There are two types of Mesenteric ischemia, acute and chronic.  Acute Mesenteric ischemia is most common in patients that have a history of heart conditions or heart disease.  If you suffer from acute Mesenteric ischemia it requires immediate action to cure, usually leading to surgery to remove the blood clot.  Acute in this case of a disease, means emergency.  A clot has formed causing there to be an emergent need to get the clot broken up.  Chronic Mesenteric ischemia develops over time, where the hardening of the arteries is gradual.


First symptom that is usually noticed from Mesenteric ischemia is stomach pain after eating.  There are different symptoms for the two different types.  The main one that can happen in either type though is the stomach pain after eating.  For acute Mesenteric ischemia your symptoms can include sudden severe stomach pain, nausea, urgent need to have a bowel movement, fever, gas, constipation, and rectal bleeding.  With chronic Mesenteric ischemia you could suffer from abdominal pain thirty minutes after eating, pain that worsens over an hour, pain that only lasts one to three hours, weight loss, and eating less to avoid pain.
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Treatment is key to lead to no complications.  Complications can arise though if left untreated.  Untreated Mesenteric ischemia could lead to sepsis which then could cause multi organ failure.  Irreversible bowel damage, where the bowel could potentially die.  Some of these could even lead to death if continued to be left untreated.  When chronic Mesenteric ischemia is the case you can also suffer from fear of eating due to the pain, and unintentional weight loss, though these don’t usually turn fatal they can wreak havoc on your body and your wellbeing.


Your primary care physician after doing a physical exam and taking a family and medical history if they suspect that you may have Mesenteric ischemia they may refer you on to a Vascular surgeon.  The vascular surgeon will then do a physical exam, listen to your symptoms and then may order some tests to be done.   A doppler ultrasound will show how the blood is flowing in your arteries.  This can show if there is any kind of blockage or slow flowing blood indicating blockage.  CT angiogram shows pictures of the arteries or abdominal organs.  Angiogram, MR angiogram and blood tests may all need to be done as well.

Risk Factors

There are some people who are more at risk of developing Mesenteric ischemia.  People of older age, who suffer from low or high blood pressure, who have heart disease already, high cholesterol all suffer from higher risks.  As well as if you smoke, have blood that easily clots, use cocaine, or have had a recent heart attack.  People who have inflammatory conditions, rheumatologic conditions, injury, kidney failure, or decompression sickness are also at a higher risk of developing Mesenteric ischemia.


The goal of treatment is to re-open the artery to allow adequate blood flow to the intestines.  Treatment varies per patient.  It also varies if you suffer from acute or chronic Mesenteric ischemia.  For acute Mesenteric ischemia treatment is usually some form of an emergency procedure.  You may be given narcotics for the pain.  If the blood clot is caught early enough you may be able to do thrombolytic therapy which is a clot dissolving medication.  Otherwise you may have to go in for surgery to remove the clot and if diagnosis wasn’t caught soon enough surgery to remove any dead bowel.  A surgery that can be done is a Transaortic endarterectomy which is when a surgeon makes an incision in the abdomen and removes the plaque or clot from the artery.  After surgery you may need medications to restore fluids, dissolve clots, and open the blood vessels.  

Since chronic Mesenteric ischemia can be slow progressing over time emergency treatments don’t usually occur in these cases.  You may need a balloon angioplasty which is when a balloon is placed to help open up the arteries to help widen them for easier blood flow, or a stent may be placed to help redirect blood flow.  This is usually non invasive and can be done at the same time as an angiogram.  Another treatment could be bypass surgery, to create a new route to the intestines.


Lifestyle changes can decrease your risk as well as keep you healthy if you suffer from chronic Mesenteric ischemia.  If you suffer from a family history of heart disease you will want to follow a heart healthy diet.  Avoid smoking or stop smoking.  Exercise regularly as well as stay hydrated.  Chronic conditions such as diabetes, high blood pressure, kidney failure, and heart disease should be well managed and treated.

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Though Mesenteric ischemia is rare, if you have a heart condition or heart disease you are at higher risk of suffering from this.  People who have blood that easily clots should be checked and monitored as well, for that can lead to acute Mesenteric ischemia.  If you suffer from pain in your abdomen shortly after eating you may want to contact your physician.  

Mesenteric ischemia is a rare condition that causes inadequate blood flow to the small intestines.


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