Angiodysplasia is a condition where malformed or twisted intestines cause blood vessels to widen and become fragile, leading to tears or lesions in the intestinal wall. It is most common in adults over 50 and is often discovered during routine colonoscopy screenings. Treatment options include cauterization, coagulation, or surgical resection of the intestine.
Angiodysplasia is a medical condition in which the intestines are malformed or twisted, causing blood vessels to widen and become fragile, and eventually causing tears or lesions in the intestinal wall. It is also sometimes known as colonic vascular ectasia, colonic arteriovenous malformation, or colonic angioma. Sometimes it’s caused by other intestinal disorders, but more often it’s simply a factor in aging; intestinal walls weaken with age and repeated use, and most people with the condition are over the age of 50. In specific terms, erosion often occurs in the cecum or ascending colon, but can also occur in the small intestine. Multiple lesions usually occur at the same time but are very small and can be difficult to diagnose. Most of the time the condition is also painless, so people don’t necessarily realize they’re afflicted until body scans show or other symptoms begin to emerge. Some medications and outpatient procedures can help reverse the condition, but surgery is often recommended in extensive or advanced cases.
Main causes
The disease is thought to be related to age-related degeneration of blood vessels, as it most typically occurs in adults over the age of 50. Another probable cause is blockage of veins in the colon due to strain on the intestinal wall as it gets bigger. It is rarely associated with other intestinal disorders, such as diverticulosis or colon cancer. There is little evidence of a genetic link, and events in children and young adults are very rare.
Common symptoms
Many people who suffer from this condition are unaware that they have it as pain, the main indicator of ailments, almost never accompanies the problem. Gastrointestinal bleeding is a very common symptom, but when the holes in the intestine are very small, this can be difficult to detect and nearly impossible to feel. Dark, tarry stools are a common result, and anemia (low blood iron count) can also occur as a result. Anemia can be a serious condition, but there are a number of possible causes.
How is it diagnosed
When it comes to statistics, this condition is actually quite rare. Studies typically suggest that angiodysplasia occurs in less than one percent of the population, meaning it’s usually not something health care professionals suspect at first, and it’s also usually not something they test for. In most cases the condition is found more or less accidentally during a routine colonoscopy screening. These screenings are often recommended for mature adults to catch things like colon cancer in its early, treatable stages.
Angiodysplasia occurs equally in men and women. No racial or ethnic group is known to have a higher incidence of the condition, although patients with scleroderma, which is a rheumatic autoimmune disease that primarily affects connective tissues, tend to see slightly higher incidences; sufferers of other autoimmune diseases also usually have a higher risk of developing this condition.
Treatment options
When a healthcare provider suspects angiodysplasia, they typically order an endoscopic procedure to get a better view of what’s happening in the colon. There are several types of this type of procedure, but the most common are esophagogastroduodenoscopy (EGD) or colonoscopy. During both, your doctor may be able to treat the lesions through cauterization or by doing laser coagulation treatment with argon plasma. Both of these are methods of actually repairing injuries and sealing the holes that are causing problems.
Even these methods aren’t always required, though. It is estimated that for about 90% of patients, the condition resolves on its own without intervention. In many cases it will recur, however, particularly if a person has chronic distension of the blood vessels in the colon. In these cases, sealing the lesions is often the best solution.
Cauterization and coagulation usually work best if there are only a few identifiable holes. When there are many lesions, sealing each one can be costly and sometimes dangerous; the more there are, the more likely a surgeon is to miss a few as well, which can render the whole enterprise ineffective. Therefore, if the condition is advanced, surgical resection of the intestine may be required. The process used most often is called a right hemicolectomy, and it actually involves removing part of the intestine.
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