Patient education: Ischemic bowel disease (The Basics)

What is ischemic bowel disease? — Ischemic bowel disease is a condition in which there is not enough blood flow to the intestines. This happens when veins or arteries in the intestines are blocked. It can happen in the large intestine or the small intestine (figure 1). It can cause belly pain, nausea, diarrhea, and other symptoms.

What are the symptoms of ischemic bowel disease? — The symptoms include:

●Belly pain – This can 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 diarrhea.

●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

Will I need tests? — Yes. The doctor or nurse will ask about your symptoms and do an exam. They will also order 1 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 poor nutrition. Or they might show that a different condition is causing symptoms.

●Tests called "endoscopy," "upper endoscopy," "sigmoidoscopy," or "colonoscopy" (figure 2) – For these tests, the doctor puts a thin tube down your throat and into your stomach, or up your rectum and into your colon. The tube has a camera attached so the doctor can look inside your body. The tube also has tools attached to it, which the doctor can use to take samples of tissue. These samples go to the lab to be checked for problems.

●A test called an "angiogram" – For this test, the doctor injects a dye into the vessels that carry blood to the bowel. This dye can be seen on an imaging test such as a CT, MRI, or fluoroscopy (a moving X-ray). The test can show if arteries around the bowel are blocked. If they are, this could be keeping part of the bowel from getting enough blood.

●Laparoscopy – This is a procedure that the doctor performs in the operating room. The doctor makes a small cut near the belly button. Then they put a small device called a "laparoscope" inside. The doctor looks through the laparoscope to see if they can find the cause of symptoms.

How is ischemic bowel disease treated? — Treatment for ischemic bowel disease depends on:

●What is blocking the blood vessels

●What type 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 long time

Most people with ischemic bowel disease need treatment in the hospital. In the hospital, the doctor can:

●Give you fluids and nutrition through a small 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 will make you feel better and help keep you from vomiting.

Other treatments can include:

●Antibiotics to treat infection

●A procedure or surgery to open a blocked artery

●Anticlotting medicines (sometimes called "blood thinners") to treat clots in the vessels

●Surgery to take out part of the bowel if it is not healthy

These treatments can help the bowel work correctly again.

More on this topic

Patient education: Diarrhea in adolescents and adults (The Basics)
Patient education: Abdominal pain (The Basics)

Patient education: Acute diarrhea in adults (Beyond the Basics)
Patient education: Upset stomach (functional dyspepsia) in adults (Beyond the Basics)