Expanding Your Knowledge of Mesenteric Ischemia

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The multiple forms of intestinal disease

When looking at the many different vascular-related conditions that can affect the body, mesenteric ischemia is far from the most well-known disease of the bunch. While many conditions relate directly to an important organ or part of the body that we immediately recognize (pulmonary embolism in the lung, deep vein thrombosis in the leg, etc.), we tend to not think about conditions that can affect lesser-known parts of the body.

With that said, the effects of mesenteric ischemia can range from mild and treatable, to serious and harmful, depending on the particular subset of the condition. However, due to mesenteric ischemia going so under the radar by many people, few tend to know what the condition entails in general, let alone its various subsets. However, in order to understand these subsets, one must first understand the effects of mesentery ischemia.

Defining the Disease

Mesenteric Ischemia is defined by a blockage in the mesentery, which is a fold of membranes tissue attached to the intestinal tract, arising from the back wall of the peritoneal cavity. Basically, these are how the intestines get a supply of blood circulation. The condition itself occurs when a decreased blood flow to the mesenteric organs occurs, including the stomach, liver, colon, etc.

However, not many people realize that there are a few different variations of mesenteric ischemia that can occur in the body - all with different complications and levels of severity. These subsets include acute mesenteric ischemia, chronic mesenteric ischemia, and mesenteric venous thrombosis.

Acute Mesenteric Ischemia

Bringing sudden, permanent damage to the intestines, acute mesenteric ischemia occurs through a blockage of blood flow to the arteries, and requires immediate medical when it happens. Acute mesenteric ischemia can be caused by a multitude of conditions, including, but not limited to: A blood clot dislodging from the heart as a result of a prior condition, such as congestive heart failure, arrhythmias, or a heart attack; atherosclerosis; conditions causing low blood pressure, such as heart/kidney failure or shock; high blood pressure; illegal drug use; or blood clotting disorders, such as sickle cell anemia, or anti-phospholipid syndrome. Finally, treatment of acute mesenteric ischemia, done in emergency situations, is done through a mixture of narotic pain medication and thrombolytic therapy involving a clot dissolving drug, followed by intestinal surgical removal of the clot.

Chronic Mesenteric Ischemia

Chronic Mesenteric Ischemia, unlike Acute Mesenteric Ischemia, causes damage to the intestines through a casual narrowing of the arteries over an extended period of time, with a progressive demonstration of symptoms. These symptoms are typically experienced 15-60 minutes after eating, including changes in bowel movement frequency, as well as nausea, vomiting, and bloating. Many of the pre-existing conditions that cause acute mesenteric ischemia, however, can also cause chronic mesenteric ischemia, though atherosclerosis is more prominent in chronic's development. Finally, because chronic mesenteric ischemia is developed through an ongoing process, the treatment for the condition is different. Pain medication is initially given to help subside symptoms - however, if this doesn't solve the problem, either balloon angioplasty or a bypass surgery is undergone to help clear any blockage caused by the condition.

Mesenteric Venous Thrombosis

In another, unrelated type of mesenteric ischemia, mesenteric venous thrombosis occurs when blood can't leave the intestines, where a clot develops in the vein, draining deoxygenated blood from the intestines. When this occurs, blood can back up in the intestines, and swelling and bleeding can occur. Unlike the prior two conditions, mesenteric venous thrombosis can stem from different conditions, including acute or chronic pancreas inflammation; abdominal infection; bowel disease, including Chron's disease, diverticulitis, or ulcertive colitis; inherited clotting disorders; or trauma to the abdomen. Finally, mesenteric venous thrombosis is treatable, with treatment coming from a blood thinner regimen lasting 3-6 months, as well as surgery if the bowels appear to be damaged.