Angiodysplasia of the colon. It is the presence of inflamed and fragile blood vessels in the colon that occasionally causes bleeding from the gastrointestinal (GI) tract.
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- 1 Causes, incidence and risk factors
- 2 Symptoms
- 3 Signs and tests
- 4 Treatment
- 5 Forecast
- 6 Complications
- 7 Situations requiring medical assistance
- 8 Prevention
- 9 Alternative names
- 10 Sources
Causes, incidence and risk factors
Angiodysplasia of the colon is largely related to aging and degeneration of the blood vessels. It usually occurs in older adults and is almost always seen on the right side of the colon. There are various theories about the cause, but the most likely is that normal spasms of the colon lead to dilation of the blood vessels in the area. This swelling becomes so severe that a small, direct communication occurs between a very small artery and a vein, called an arteriovenous fistula . It is in this area of the colon wall where the patient is at risk of bleeding. Angiodysplasia of the colon is seldom related to other vascular diseases, including Osler-Weber-Rendu syndrome. It is not related to cancer and is different from diverticulosis , a very common cause of intestinal bleeding in older adults.
The symptoms vary. Often in the elderly, the symptoms are weakness, fatigue, and respiratory distress due to anemia. There is likely to be no sign of bleeding directly from the colon. Others may have occasional episodes of heavy or light bleeding with bright red blood from the rectum. There is no pain associated with angiodysplasia.
Signs and tests
Tests that can be done to diagnose this condition include:
- Angiography (useful only if there is active bleeding within the colon).
- Complete blood count (CBC) to check for anemia.
- Stool test for hidden or inadvertent gastrointestinal bleeding (a positive test result suggests bleeding from the colon).
It is important to determine what is causing the bleeding in the colon and how fast it is losing blood. You may need to be hospitalized. Fluids may be given intravenously and blood products may be required. Other treatments may be needed once the source of the bleeding is found. Most patients stop bleeding spontaneously without any treatment. If treatment is required, it may involve: Angiography to help block the blood vessel that is bleeding, or administering medicine to help cause the blood vessels to close to stop bleeding. Burning (cauterizing) the bleeding site with heat or laser using a colonoscope. In some cases, the only option is surgery. Excision of the entire right side of the colon (right hemicolectomy) is the treatment option for someone with this condition who continues to bleed at a dangerously fast rate, despite various treatments using angiography or colonoscopy. Medications (thalidomide and estrogens) can be used to reduce bleeding and the number of angiodysplasias in certain patients.
Patients who have bleeding related to this condition despite having undergone colonoscopy, angiography, or surgery are likely to experience more bleeding in the future. The prognosis is still good if bleeding is controlled.
- Death from excessive blood loss
- Side effects of treatment
- Severe loss of blood from the gastrointestinal tract
Situations requiring medical assistance
Call your health care provider if rectal bleeding occurs.
There is no known form of prevention.
Colonic arteriovenous malformations; Vascular ectasia of the colon