Skip to main contentLast updated: 12-Nov-2026
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Dr Harsh Shah
MS, MCh (Surgical Gastroenterology), DrNB (Surgical Gastroenterology)
Registered with Gujarat Medical Council, Reg. No. G-38738
Gastro & Cancer Surgeon
Dr. Jivraj Mehta Hospital, Vasna, Ahmedabad · 18 years of experience
In short
Angiodysplasia is a patch of thin, swollen vessels in the gut lining. A Dieulafoy lesion is one oversized artery under a tiny gap. Both bleed and are easy to miss.
Angiodysplasia bleeds slowly and often. A Dieulafoy lesion bleeds suddenly and heavily. Scopes, a capsule camera or a scan find them, and most are closed through a scope.
This post covers two small vessel causes. For the full plan of tests and treatment, see our lower GI bleeding treatment page.
Both are tiny blood vessel faults, not growths. They sit in the gut wall and break without warning.
In angiodysplasia, thin-walled vessels in the lining swell with age and wear. They are often several, and they sit in the right colon or the small bowel. In a Dieulafoy lesion, one artery runs too close to the surface and pokes through a pinhole in the lining. It is mostly found in the upper stomach, and less often in the duodenum, small bowel or colon.
| Point | Angiodysplasia | Dieulafoy lesion |
|---|---|---|
| What it is | Several swollen, thin vessels in the lining | One large artery under a small gap in the lining |
| Usual place | Right colon and small bowel | Upper stomach, sometimes duodenum or colon |
| How it bleeds | Slow, repeated, hidden, with anaemia | Sudden and heavy, then may stop |
| Usual age | Over 60 | Any adult, more often men |
| Common helper | Heart valve disease, kidney failure, blood thinners | Pain-killer tablets, alcohol, heart and kidney disease |
It is mostly a problem of older age, made worse by a tight aortic valve, kidney failure and blood thinners.
A narrowed aortic valve can thin out a clotting protein in the blood. Together with fragile vessels, this makes bleeding more likely. Doctors call this link Heyde syndrome. Kidney failure also makes platelets work poorly. Blood thinners and aspirin do not create the vessels, but they turn a small leak into a large bleed.
These vessels are flat, small and move with the blood pressure. They can look normal when you are sedated.
When the pressure drops during sedation or after a bleed, the vessels collapse and fade. A Dieulafoy lesion is even harder. The gap in the lining is the size of a pinhead, and it hides under food or blood. A second look by an expert often finds what the first missed. So does a scope done soon after a bleed.
The plan follows the site of the blood: upper scope, colonoscopy, then the small bowel, then a scan during active bleeding.
Most are closed through the scope. Medicines, a vessel-blocking procedure or surgery are kept for lesions that keep returning.
Never stop a heart or blood-thinner tablet on your own. Your cardiologist and surgeon decide that together. If a bleed is heavy, go to a hospital with a scope team at once.
Surgery is the last step. It is considered for a heavy bleed that scopes cannot stop, or a lesion that returns again and again.
If a scan or scope shows one clear site, removing it can stop the repeats. That may mean a small piece of stomach, or the right colon. Surgery is planned after the site is marked, because a blind operation rarely works. The usual route is laparoscopic or open, chosen for your health and the site of the lesion.
It is a patch of thin, swollen blood vessels in the lining of the gut. It sits mostly in the right colon and small bowel, and it causes slow, repeated bleeding and anaemia in older people.
It is one oversized artery lying just under the lining, poking through a tiny gap. It is mostly in the upper stomach. It can bleed suddenly and heavily, then stop on its own.
No. Both can look normal on the day, because the vessels flatten during sedation or hide under blood. A repeat scope, a capsule camera or a scan during a bleed may still find them.
No. It is a benign vessel problem and does not turn into cancer. Piles, growths and ulcers can bleed in the same way, so they are ruled out first.
A narrowed aortic valve can thin a clotting protein in the blood, so fragile gut vessels bleed more. This is called Heyde syndrome. Treating the valve can reduce the bleeding.
A scope with clips or a band usually closes the artery. If that fails, a radiologist can block it from inside the vessel. Or a surgeon removes the small area of stomach wall.
It can, especially with angiodysplasia, since there are often several patches. Your team then repeats the scope, tries medicines, or plans a procedure. Fixing anaemia and review of tablets help too.
Go to a hospital at once for heavy bleeding, black stool with faintness, or vomiting blood. See a surgeon for repeat bleeding, anaemia that returns, or bleeding no scope has explained.
For the whole picture, start at the lower GI bleeding page. For questions before you travel, call +91-63555-64601.
Dr Harsh Shah — Dr. Jivraj Mehta Hospital, Vasna, Ahmedabad
Dr. Jivraj Mehta Hospital, Dr Jivraj Mehta Marg, Vasna, Ahmedabad 380007.
Consultations, review of reports and scans, operations and follow-up. OPD Monday to Saturday, 9 am to 5 pm.
Appointments: +91-63555-64601 · +91-63590-11009 · Hospital 079-2663 6363
Directions to the hospital · WhatsApp +91-63555-64601
Told that your scopes were normal, yet the blood and the anaemia keep returning? Dr Harsh Shah, a surgeon, reads your colonoscopy, endoscopy and capsule reports with you. He checks your heart valve, kidney and tablet history, and plans the next test. Bring all your reports and tablet strips. You can also call, or message us on WhatsApp. Call For Appointment Book on WhatsApp Tapping Book on WhatsApp will likely open the WhatsApp app on your phone.
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