Angiodysplasia: Causes, Symptoms, Treatment, Diagnosis
What is Angiodysplasia?
Angiodysplasia is the condition that is characterized by abnormality of small blood vessels in the intestinal tract which lead to severe bleeding. The severity of the condition is actually determined by the size of the lesion. Little bleeding from one lesion often remain unnoticed. However, several big lesions may lead to heavy bleeding accompanied with anemia and black tarry stool. This disorder makes the affected organ enlarged and as a result excessive bleeding and loss of blood occurs through the blood vessels.
Depending upon its origin, Angiodysplasia may be categorized as:
- Gastric and colonic Angiodysplasia
- Cecal Angiodysplasia
- Small bowel and duodenal Angiodysplasia
- Angiodysplasia of intestine and stomach.
Since Angiodysplasia includes vascular malformation, it is also medically termed as vascular ectasia of the colon. Serious condition of Angiodysplasia may also cause Heyde's Syndrome in patients, which is a condition that occurs in combination with heavy blood loss.
Causes of Angiodysplasia
Though the actual cause of Angiodysplasia is vague, once can ascribe it to the impact and process of ageing which is the common cause of this disorder. As we age, the blood vessels start getting degraded and subsequently it ruptures and lead to heavy blood loss.
A condition referred as colon spasms may also cause Angiodysplasia in patients. This condition leads to enlargement of blood vessels in affected area and the enlargement of vessels usually creates a slender passage between vein and artery which is called a arteriovenous fistula. Through passage the patient starts bleeding. Mucosal hypoperfusion which actually occurs due to cardiac issues is also cited as a cause of Angiodysplasia.
Pulmonary or cardiac disorders where hypo-oxygenation of microcirculation is involved and other vascular disorder may also cause Angiodysplasia in patients. Other underlying disorders that affect the blood vessels like Osler Weber Rendu Syndrome may also cause Angiodysplasia. Some of the other disorders that cause Angiodysplasia are:
- Renal failure
- Hedre's Syndrome
- Hereditary hemorrhagic telangiectasia.
Symptoms of Angiodysplasia
Majority of people suffering from Angiodysplasia may experience subtle symptoms of Angiodysplasia. This medical condition usually victimizes the elderly people. However, it is also seen amongst the young generation today. Most of the people suffering from Angiodysplasia usually have anemia and symptoms of anemia along with severe blood loss. Some of the Angiodysplasia patients may also experience symptoms of shortness of breath, fatigue, weakness and pale skin.
In some cases, Angiodysplasia patients may also experience symptoms of bleeding from the rectum which can prove to be severe to mild and bright in color. Patients with Angiodysplasia never experience any kind of pain in the abdominal region. In some cases, this medical condition occurs along with other diseases of vessel wall. A medical condition referred as Heyde's Syndrome which is basically caused due to internal bleeding may also occur along with Angiodysplasia.
Possible Complications Associated with Angiodysplasia
Patients with Angiodysplasia may have long term effect from this disorder and if it is kept untreated then it can prove to be fatal later. Some of the possible complications of Angiodysplasia include:
- Death due to excessive blood loss
- Serious loss of blood from gastrointestinal tract
- Side effect from the drugs and treatment procedures.
Diagnosis of Angiodysplasia
There are procedures available to diagnose the condition and severity of Angiodysplasia. Diagnosis of Angiodysplasia can easily be done with the help of following procedures.
- If your doctor notices active bleeding occurring from the colon then they may ask you to undergo angiography of blood vessels of mesentery which can be beneficial to detect the cause of bleeding.
- Blood tests are also done by pathologists to identify the count and percentage of hemoglobin and relative anemia
- CT Angiography is the ultimate examination that can easily help the doctor to diagnose the condition because this tool displays the precise site and the severity of tuft of blood vessel.
- Patients with Angiodysplasia of colon may be asked to undergo a colonoscopy which is a sensitive test to detect the Angiodysplasia of colon. But, patients with active bleeding may be asked to undergo angiography along with colonoscopy test for more precise results.
- Stool test is also done for the occult blood.
Treatment for Angiodysplasia
The treatment for Angiodysplasia usually depends on the severity of the condition and bleeding from return and nature of the symptoms. However, Angiodysplasia patients who are hemodynamically unstable are usually treated by administering intravenous pulse cyclophosphamide treatment procedures combined with packed RBCs. In some cases, Angiodysplasia patients are also treated with endoscopic procedures where the doctor uses laser techniques like:
- Monopolar eletrocautery
- Heater probe
- Neodymium: yttrium-aluminum-garnet lasers
- Band ligation
- Olympus EVIS LUCERA
- Argon plasma coagulation lasers.
If in case the lesions are not clearly visible in the colonscopy test, then the doctor may ask the patient to undergo Angiodysplasia angiography test to more precise results. Based on the report of the test, the doctor will administer treatment procedures.
There are also other medications like desmopressin, thalidomide, aminocaproic acid and estrogens which are prescribed to the patients to treat the condition. In some rare cases, patients may also be asked to undergo a hormone replacement therapy using estrogen. However, there are side effects associated with this type of treatment procedure which can be complicated to counter at times.
In more severe cases of Angiodysplasia, the patients are asked to undergo surgical procedure. The surgical procedure may include partial gastrectomy or complete gastrectomy and the right hemicolectomy. However, the surgical options are the last option which is only recommended when no other treatment procedures work efficiently to treat Angiodysplasia. Patients must avoid using the non-steroidal anti-inflammatory medication during such condition because such drugs may make the condition aggressive. So, considering all these factors it is necessary for the patients with Angiodysplasia to undergo proper timely treatment before the condition turns out to be fatal.