Intestinal ischemia

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Treatments and drugs

By Mayo Clinic staff

Treatment of intestinal ischemia involves restoring sufficient blood flow to your digestive tract. The options vary, depending on the type and severity of your condition.

Colon ischemia
Colon ischemia may heal on its own. But your doctor may recommend antibiotics to treat or prevent infections. Your doctor can also treat any underlying medical condition, such as congestive heart failure or an irregular heartbeat. You'll need to stop any medications that constrict your blood vessels, such as migraine drugs, hormone medications and some heart drugs.

If your colon has been damaged, you may need surgery to remove the dead tissue or to bypass a blockage in an intestinal artery.

Acute mesenteric ischemia
Surgery is usually needed to remove a blood clot, to bypass an artery blockage, or to repair or remove a damaged section of intestine. Treatment also may include medications to prevent clots from forming, to dissolve clots or to expand blood vessels.

If angiography is used to diagnose the problem, it may be possible to treat the condition with angioplasty at the same time. Angioplasty involves using a balloon inflated at the end of a catheter to compress the fatty deposits and stretch the artery, making a wider path for blood flow. A metallic coil (stent) also may be placed in your artery to help keep it open.

Chronic mesenteric ischemia
Surgery is usually needed to restore blood flow and to prevent progression to acute mesenteric ischemia. Your surgeon can bypass the blocked arteries or widen narrowed arteries with angioplasty, or by placing a stent after angioplasty.

Mesenteric venous thrombosis
If your intestines show no signs of damage, you'll likely need to take anticoagulant medication for about three to six months. Anticoagulants help prevent clots from forming. If tests show you have a blood-clotting disorder, you may need to take anticoagulants for the rest of your life. If portions of your bowel show signs of damage, you may need surgery to remove them.

References
  1. Feldman M, et al. Sleisinger and Fordtran's Gastrointestinal and Liver Disease: Pathology, Diagnosis, Management. 9th ed. Philadelphia, Pa.: Saunders; 2010. http://www.mdconsult.com/book/player/linkTo?type=bookHome&isbn=978-1-4160-6189-2&eid=4-u1.0-B978-1-4160-6189-2..X0001-7--TOP&uniq=200844987-3. Accessed June 19, 2012.
  2. Goldman L, et al. Cecil Medicine. 24th ed. Philadelphia, Pa.: Saunders Elsevier; 2012. http://www.mdconsult.com/das/book/body/191371208-2/0/1492/0.html. Accessed June 19, 2012.
  3. Catheter angiography. RadiologyInfo.org. http://www.radiologyinfo.org/en/info.cfm?pg=angiocath. Accessed June 19, 2012.
  4. What is atherosclerosis? National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/health-topics/topics/atherosclerosis/. Accessed June 20, 2012.
DS00459 Aug. 17, 2012

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