Intestinal Ischemic Syndrome, also referred to as Mesenteric Ischemic Syndrome or Visceral Ischemic Syndrome, is a condition wherein blood supply to the gastrointestinal system is obstructed due to blockages in the blood vessels leading up to the gut, namely the celiac artery, superior mesenteric artery and the inferior mesenteric artery. This ailment predominantly occurs in the elderly above the age of 60 years but can also arise in young adults and middle-aged individuals with pre-existing chronic illnesses of diabetes, hypertension.
Causes Of Intestinal Ischemia/Mesenteric Ischemia:
The chief cause of intestinal ischemic syndrome is atherosclerosis i.e. fat deposits accumulating in the walls of blood vessels, which invariably makes them narrower and impedes blood flow through the tubular passages.
Types Of Mesenteric Ischemia:
Intestinal or mesenteric ischemia is categorised into two distinct types based on the nature of their onset and duration of symptoms as acute mesenteric ischemia and chronic mesenteric ischemia.
Acute Mesenteric Ischemia: This type of intestinal ischemia occurs suddenly, primarily due to blockage or narrowing of arteries that transport oxygen-rich blood to the intestines.
Chronic Mesenteric Ischemia: Here, the onset of intestinal ischemia is more gradual, with symptoms initially being minor and intensifying over time and happens as a result of blood vessels leading up to the intestines becoming narrow and impeding flow of blood enriched with oxygen and nutrients. Suffering from long-term illnesses like type 2 diabetes mellitus, hypertension or constant high blood cholesterol increases the risk of chronic mesenteric ischemia.
Both the types - acute and chronic mesenteric ischemia - are induced by atherosclerosis i.e. the build-up of fatty deposits – plaque on the walls of the arteries.
The typical signs of acute mesenteric ischemia are:
- Intense pain in the abdomen focused on one particular area
- Feeling of nausea, with vomiting
- The urgency to undergo bowel movements
- Discharge of blood with stools
If left unattended, acute mesenteric ischemia can prompt sepsis, major damage to the intestines and in some cases, even death. Thus, distress in the heart, chest pain and other warning signals of cardiovascular disease must be reported to the medical expert at once, to ensure quick diagnosis and timely treatment.
The characteristic indications of chronic mesenteric ischemia consist of:
Sudden, unexplained weight loss
Fear and hesitation to eat meals regularly due to the excruciating abdominal pain that arises afterwards
Constipation and/or diarrhoea
Cardiovascular disorders such as peripheral artery disease, coronary artery disease and stroke
Once the patient reports prominent abdominal discomfort after eating meals accompanied by weight loss, the doctor gauges that mesenteric ischemic syndrome/intestinal ischemic syndrome could be a possible reason. The physician then carries out a set of diagnostic tests to help confirm the blocking of intestinal blood vessels.
Imaging studies of CT scans, MRI scans and X-rays of the abdomen are done, to visualise any narrowing of arteries traversing up to the small intestine. Furthermore, a contrast dye is incorporated into these scans, termed CT angiography, magnetic resonance imaging angiography, which assists in clearly viewing and spotting the site of the narrowed blood vessels.
Treatment for acute mesenteric ischemia involves invasive surgical procedures, wherein the blood clot within the arteries is removed, or the blood vessel structures are widened, to aid in the unobstructed flow of blood and oxygen to the intestines.
Chronic mesenteric ischemia is also remedied by means of surgery to expand the narrowed arteries, clear blood clots, along with prescription blood-thinning medications to prevent further clotting in the blood vessels passing across the intestines.