Ischemic bowel disease

Ischemic bowel disease could be a condition in which there’s not enough blood flow to the intestines. This happens when veins or arteries within the intestines are blocked. It can happen in the bowel or the little intestine (figure). It can cause belly pain, nausea, diarrhoea, and other symptoms.

The symptoms include:

  • Belly pain – this could be mild or severe. It can:
    • Start suddenly, or happen over several days or years.
    • Start about 1 hour after eating, and last about 2 hours. Eating a big meal can make this pain even worse.
  • Nausea, vomiting, or both
  • Blood in bowel movements – this can be bloody diarrhoea
  • Weight loss, when not trying to lose weight
  • Eating problems, such as:
    • Food fear – Not wanting to eat because pain starts after eating
    • Feeling full too quickly when eating

Yes. The Gastroenterologist will ask about the symptoms and do an exam. He or she will also order one or more tests.

These can include:
• X-ray, CT scan, or ultrasound of the belly – These imaging tests create pictures of the inside of the body. They can help show the cause of symptoms.
• Blood tests – These can show signs of not enough nutrition. Or they might show that a different condition is causing symptoms.
• Tests called “endoscopy,” “upper endoscopy,” “sigmoidoscopy,” or “colonoscopy” – For these tests, the Gastroenterologist puts a skinny tube down your throat and into your stomach, or up your rectum and into your colon. The tube encompasses a camera attached, therefore the Gastroenterologist can look inside your body. The tube also has tools attached to it, which the Gastroenterologist can use to require samples of tissue. These samples can be moved to the lab to be checked for problems.
• A test called an “angiogram” – For this test, the Gastroenterologist injects a dye into the vessels that carry blood to the bowel. This dye may be seen with an imaging test like a CT, MR, or fluoroscopy (a moving X-ray). The test can show if arteries round the bowel are blocked. If they’re, this might be keeping a part of the bowel from getting enough blood.
• Laparoscopy – this is often a procedure that the Gastroenterologist does within surgery. The Gastroenterologist makes a little cut near the belly button. Then he or she puts a little device called a “laparoscope” inside. The Gastroenterologist looks through the laparoscope to determine if he or she will be able to find the explanation for the symptoms.

Treatment for ischemic bowel disease depends on:
• What is blocking the blood vessels
• What kind of vessel is blocked, an artery (which brings blood to the bowel) or a vein (which drains blood from the bowel)
• Whether the symptoms started suddenly or came on over a protracted time
Most people with ischemic bowel disease need treatment within the hospital. within the hospital, the Gastroenterologist can:
• Give you fluids and nutrition through a little tube that goes into a vein, called an “IV”
• Put a thin tube called a “nasogastric tube” in your nose, down your esophagus, and into your stomach. If there is extra fluid and air in your stomach or intestines, the tube can suck it up. This can make you feel better and help keep you from vomiting.

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Dr. Harsh J Shah