What Causes Intestinal Ischemia?

Intestinal ischemia is a group of conditions that happen when intestinal blood flow decreases because of a blocked blood vessel. The small and large intestines can both be affected by intestinal ischemia. It is a serious condition that results in pain and makes it hard for the intestines to function normally. Severe cases can result in damage to the intestinal tissues and can result in death. Intestinal ischemia can also cause the development of a hole in the intestines or perforation causing peritonitis or sepsis. Sometimes the body is able to heal itself from intestinal ischemia. However, during the healing process, the body develops scar tissues that block or narrow the intestines. Treatment for intestinal ischemia focuses on restoring the supply of blood to the digestive tract. Depending on the underlying cause, certain medications and surgery may be needed to restore normal intestinal function.

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Hypotension

Hypotension is a condition characterized by abnormally low blood pressure level under 90/60. Most cases of low blood pressure that do not produce symptoms are harmless. However, some cases can indicate a more serious underlying condition and can result in health problems associated with a lack of adequate blood supply. Heart failure, severe trauma, going into shock, the use of certain medications, chronic kidney failure, or major surgery can all cause dangerously low blood pressure. This means oxygenated blood flow will not make it to all of the tissues around the body the way it should. If the blood flow to the small intestine becomes abruptly slowed due to low blood pressure, acute mesenteric ischemia occurs. When low blood pressure levels result in the impeded flow of blood to the large intestine or colon, ischemic colitis or colon ischemia occurs. Symptoms that occur in a patient who has hypotension precipitated acute intestinal ischemia include sudden abdominal pain, an urgent need for a bowel movement, abdominal distension, mental confusion, and frequent bowel movements.

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Bowel Twisting

Abnormal bowel twisting or volvulus occurs when a region of the small intestine or the colon twists. The intestine can twist around the tissues that hold it in place, or it can rotate around itself. This twisting will keep liquid and food from being able to pass through the affected area. When food is unable to move through a part of the lower digestive tract, it is considered an intestinal or bowel obstruction. The most common variation of this condition is called sigmoid volvulus, which occurs when the sigmoid or the last part of the colon becomes twisted. Another common location this condition occurs in is the cecum or the beginning of the large intestine, which is called cecal volvulus. When the twisting results in an obstruction of blood flow and stops the passing of normal intestinal contents, intestinal ischemia will happen. If volvulus triggered ischemia occurs, surgical intervention is needed to prevent another volvulus. Should a volvulus triggered ischemia go untreated, affected parts of the intestines can die from a lack of oxygen.

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