CHRONIC MESENTERIC ISCHEMIA
Mesenteric ischemia is poor blood flow (circulation) in the vessels that supply blood to the stomach, intestines, and liver (mesenteric organs). Chronic mesenteric ischemia, also called mesenteric angina or intestinal angina, is a long-term (chronic) condition. It happens when an artery or vein that provides blood to the mesenteric organs gradually becomes blocked or narrow, restricting the blood supply to the organs. When the blood supply is severely restricted, the mesenteric organs cannot work properly.
This condition is commonly caused by fatty deposits that build up in an artery (plaque), which can narrow the artery and restrict blood flow. Other causes include:
- Weakened areas in blood vessel walls (aneurysms).
- Conditions that cause twisting or inflammation of blood vessels, such as fibromuscular dysplasia or arteritis.
- A disorder in which blood clots form in the veins (venous thrombosis).
- Scarring and thickening (fibrosis) of blood vessels caused by radiation therapy.
- A tear in the aorta, the body’s main artery (aortic dissection).
- Blood vessel problems after illegal drug use, such as use of cocaine.
- Tumors in the nervous system (neurofibromatosis).
- Certain autoimmune diseases, such as lupus.
The following factors may make you more likely to develop this condition:
- Being female.
- Being over age 50, especially if you have a history of heart problems.
- Congestive heart failure.
- Irregular heartbeat (arrhythmia).
- Having a history of heart attack or stroke.
- High cholesterol.
- High blood pressure (hypertension).
- Being overweight or obese.
- Kidney disease (renal disease) requiring dialysis.
Symptoms of this condition include:
- Abdomen (abdominal) pain or cramps that develop 15–60 minutes after a meal. This pain may last for 1–3 hours. Some people may develop a fear of eating because of this symptom.
- Weight loss.
- Bloody stool.
- Abdominal pain after stress or with exercise.
This condition is diagnosed based on:
- Your medical history.
- A physical exam.
- Tests, such as:
- CT scan.
- Blood tests.
- Urine tests.
- An imaging test that involves injecting a dye into your arteries to show blood flow through blood vessels (angiogram). This can help to show if there are any blockages in the vessels that lead to the intestines.
- Passing a small probe through the mouth and into the stomach to measure the output of carbon dioxide (gastric tonometry). This can help to indicate whether there is decreased blood flow to the stomach and intestines.
This condition may be treated with:
- Dietary changes such as eating smaller, low-fat, meals more frequently.
- Lifestyle changes to treat underlying conditions that contribute to the disease, such as high cholesterol and high blood pressure.
- Medicines to reduce blood clotting and increase blood flow.
- Surgery to remove the blockage, repair arteries or veins, and restore blood flow. This may involve:
- This is surgery to widen the affected artery, reduce the blockage, and sometimes insert a small, mesh tube (stent).
- Bypass surgery. This may be done to go around (bypass) the blockage and reconnect healthy arteries or veins.
- Placing a stent in the affected area. This may be done to help keep blocked arteries open.
Eating and drinking
- Eat a heart-healthy diet. This includes fresh fruits and vegetables, whole grains, and lean proteins like chicken, fish, eggs, and beans.
- Avoid foods that contain a lot of:
- Salt (sodium).
- Saturated fat (such as red meat).
- Trans fat (such as fried foods).
- Stay hydrated. Drink enough fluid to keep your urine clear or pale yellow.
- Stay active and get regular exercise as told by your health care provider. Aim for 150 minutes of moderate activity or 75 minutes of vigorous activity a week. Ask your health care provider what activities and forms of exercise are safe for you.
- Maintain a healthy weight.
- Work with your health care provider to manage your cholesterol.
- Manage any other health problems you have, such as high blood pressure, diabetes, or heart rhythm problems.
- Do not use any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. If you need help quitting, ask your health care provider.
- Take over-the-counter and prescription medicines only as told by your health care provider.
- Keep all follow-up visits as told by your health care provider. This is important.
- Your symptoms do not improve or they return after treatment.
- You have a fever.
- You have severe abdominal pain.
- You have severe chest pain.
- You have shortness of breath.
- You feel weak or dizzy.
- You have palpitations.
- You have numbness or weakness in your face, arm, or leg.
- You are confused.
- You have trouble speaking or people have trouble understanding what you are saying.
- You are constipated.
- You have trouble urinating.
- You have blood in your stool.
- You have severe nausea, vomiting, or persistent diarrhoea.
- Mesenteric ischemia is poor circulation in the vessels that supply blood to the the stomach, intestines, and liver (mesenteric organs).
- This condition happens when an artery or vein that provides blood to the mesenteric organs gradually becomes blocked or narrow, restricting the blood supply to the organs.
- This condition is commonly caused by fatty deposits that build up in an artery (plaque), which can narrow the artery and restrict blood flow.
- You are more likely to develop this condition if you are over age 50 and have a history of heart problems, high blood pressure, diabetes, or high cholesterol.
- This condition is usually treated with medicines, dietary and lifestyle changes, and surgery to remove the blockage, repair arteries or veins, and restore blood flow.