What are intestinal ischemic syndromes?

Intestinal ischemic syndromes -- also called visceral or mesenteric ischemic syndromes -- occur when blood flow to the bowel or gastrointestinal system (intestines) is decreased because of a blood vessel blockage.

The three major abdominal blood vessels that may become blocked include the celiac artery, superior mesenteric artery or inferior mesenteric artery. Usually two or three of these arteries must be narrowed or blocked to cause intestinal ischemic syndromes.

What causes these syndromes?

In most cases, intestinal ischemic syndromes are caused by atherosclerosis (buildup of fatty matter and plaque on the blood vessel walls), leading to narrowing or blockage of the vessel. The conditions also can be caused by blood clots or aneurysms (an abnormal enlargement or bulging) in the vessels.

Are these conditions more common at a certain age?

Intestinal ischemic syndromes are more common after age 60 but can occur at any age.

Types of Intestinal Ischemic Syndromes

Intestinal ischemic syndromes can occur suddenly (acute) or over time (chronic).

Acute Mesenteric Ischemia

The arteries supplying oxygen-rich blood and nutrients to your intestines can become narrowed from atherosclerosis in the same way that coronary (heart) arteries become narrowed in heart disease. Mesenteric ischemia can develop if the narrowing or blockage become severe.

Another cause of acute mesenteric ischemia is a blood clot. If a blood clot forms or travels to the narrowed artery, the blood supply to the intestine is suddenly interrupted. The tissues below the blocked vessel will be starved for oxygen-rich blood and die. This event is a life-threatening condition.

Prompt diagnosis and treatment are necessary to save the patient’s intestine and life.

Chronic Mesenteric Ischemia

Chronic mesenteric ischemia is characterized by narrowing of the blood vessels that supply the intestines with nutrients and oxygen-rich blood. This narrowing also is caused by atherosclerosis (buildup of fatty matter and plaque on the blood vessel walls). Chronic mesenteric ischemia is more common in women than men, and occurs after age 60.

Risk Factors

Just like any form of blood vessel disease, factors that increase the risk of developing chronic mesenteric ischemia include:

  • Smoking
  • Diabetes
  • Hypertension (high blood pressure)
  • High lipid values (cholesterol, LDL, triglycerides)

Acute Mesenteric Ischemia

Early signs and symptoms of acute mesenteric ischemia include:

  • Severe abdominal pain, concentrated in one area of the abdomen
  • Nausea and/or vomiting
  • Bloody stools
  • History of chronic atrial fibrillation or cardiovascular disease

Chronic Mesenteric Ischemia

The organs of the gastrointestinal system are responsible for the digestion of food. Therefore, decreased blood supply to these organs cause symptoms related to eating or after-meal digestion, including:

  • Abdominal pain after meals
  • Weight loss
  • Fear of eating or change in eating habits due to post-meal pain
  • Nausea and/or vomiting
  • Constipation or diarrhea
  • History of cardiovascular disease (such as peripheral arterial disease, stroke, coronary artery disease or heart attack)

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