|Other encyclopedia topics:||A-Ag Ah-Ap Aq-Az B-Bk Bl-Bz C-Cg Ch-Co Cp-Cz D-Di Dj-Dz E-Ep Eq-Ez F G H-Hf Hg-Hz I-In Io-Iz J K L-Ln Lo-Lz M-Mf Mg-Mz N O P-Pl Pm-Pz Q R S-Sh Si-Sp Sq-Sz T-Tn To-Tz U V W X Y Z 0-9|
|Contents of this page:|
Alternative Names Return to topVascular ectasia of the colon; Colonic arteriovenous malformation; Colonic angiomas
Definition Return to top
Angiodysplasia of the colon is enlarged and fragile blood vessels in the colon that result in occasional loss of blood from the gastrointestinal (GI) tract.
Causes Return to top
Angiodysplasia of the colon is mostly related to the aging and degeneration of the blood vessels. It usually occurs in older adults.
There are several theories about the cause. The most likely cause is that normal spasms of the colon lead to enlargement of blood vessels in the area. This swelling becomes so severe that a small direct passageway develops between a very small artery and vein. This is called an arteriovenous fistula. It is in this area of the colon wall that the patient is at risk for bleeding.
Angiodysplasia of the colon is very rarely related to other diseases of the blood vessels, including Osler-Weber-Rendu syndrome. It is not related to cancer, and is different than diverticulosis, another very common cause of intestinal bleeding in older adults.
Symptoms Return to top
The symptoms vary. Often, in elderly patients, the symptoms are weakness, fatigue, and shortness of breath due to anemia. There may not be any signs of bleeding directly from the colon. Others may have occasional mild or severe bleeding episodes with bright red blood coming from the rectum.
Some patients may have dark or black, tarry stools. There is no pain associated with angiodysplasia.
Exams and Tests Return to top
Tests that may be done to diagnose this condition include:
Treatment Return to top
When a person is bleeding from the colon, it is important to determine the source of the bleeding and how fast they are losing blood. The patient's condition must be evaluated continuously and may need to be admitted to a hospital's intensive care unit (ICU). Fluids may be given through a vein, and blood products may be required.
Treatment begins once the source of bleeding is found. Most patients stop bleeding on their own without any treatment.
If treatment is needed, it may involve:
In some instances, surgery is the only option. Removal of the entire right side of the colon (right hemicolectomy) is the treatment of choice for someone with this condition who continues to bleed at a dangerously quick rate, despite several treatments by angiography and colonoscopy.
Outlook (Prognosis) Return to top
Patients who have bleeding related to this condition despite having had colonoscopy, angiography, or surgery are likely to have more bleeding in the future.
The goal of therapy is to reduce, if not totally eliminate, the number of bleeds, hospitalizations, and blood transfusions. Surgery may be a cure in some cases. The outlook remains good if the bleeding is controlled.
Possible Complications Return to top
When to Contact a Medical Professional Return to top
Call your health provider if rectal bleeding or black stools occur.
Prevention Return to top
There is no known prevention.
References Return to top
Hauser S. Vascular diseases of the gastrointestinal tract. In: Goldman L, Ausiello D. Cecil Textbook of Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 146.Update Date: 1/28/2009 Updated by: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; George F Longstreth, MD, Department of Gastroenterology, Kaiser Permanente Medical Care Program San Diego, California. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.