Mesenteric ischemia is a condition where you experience blockages or poor circulation in the blood vessels that supply your large and small intestines.
When this condition occurs suddenly, it is called acute mesenteric ischemia (AMI). AMI is usually caused by a blood clot. When mesenteric ischemia develops slowly, it is called chronic mesenteric ischemia (CMI). This chronic form is usually caused by atherosclerosis, a hardening of your mesenteric arteries. Sometimes, the condition is called mesenteric artery ischemia because arteries are much more likely to develop these blockages than veins.
If left untreated, mesenteric ischemia can lead to severe problems in your gastrointestinal (GI) tract or other complications, such as heart attack. Acute mesenteric ischemia can be a life-threatening condition. Without enough oxygen to your bowel, you can develop an intestinal infarction, causing necrosis (dead tissue) in your small or large intestine. This can lead to organ failure and, ultimately, death.
Wherever you are in Kentucky, the vascular experts at the Comprehensive Vascular Clinic at the UK Gill Heart & Vascular Institute are ready to treat acute and chronic mesenteric ischemia.
The most common symptom of both acute and chronic mesenteric ischemia is abdominal pain. However, that pain tends to show up differently depending on the type of ischemia.
Symptoms of AMI include:
- Bloating
- Bloody stool
- Diarrhea
- Fever
- Sudden, severe abdominal or stomach pain
- Vomiting or nausea
Symptoms of CMI include:
- Abdominal or stomach pain that starts within an hour of eating and lasts up to four hours
- Constipation or diarrhea
- Feeling full after eating a small amount
- Nausea or vomiting
- Weight loss
If you have CMI, your stomach pain may make you scared to eat, which can lead to weight loss.
Your heart supplies oxygen-rich blood to your abdominal organs through three large arteries that are supplied directly by the aorta: the celiac trunk (or celiac artery), the superior mesenteric artery (SMA) and the inferior mesenteric artery (IMA). You need proper mesenteric blood flow for your digestive system to work properly.
Mesenteric ischemia interferes with the blood flow to your intestines.
- AMI occurs when the blood flow stops suddenly. A blood clot in the artery that leads to blockage of your arteries (mesenteric arterial occlusion) is the most common cause. However, blood clots in the veins (mesenteric venous thrombosis) do occur.
- CMI causes your blood to slowly stop meeting your intestines’ needs. CMI happens as plaque builds up in your arteries. This causes a narrowing of your arteries – a condition known as mesenteric artery stenosis.
Mesenteric ischemia is rare. Around 10%of people over age 65 will develop mesenteric artery stenosis, but only a few of them will later develop CMI. Some patients with CMI will later develop a blood clot that causes AMI, but many AMI patients do not have CMI.
Mesenteric ischemia may not always be preventable but taking steps to improve your heart and circulatory health can limit your risk. You can:
- Eat a heart-healthy diet
- Exercise regularly
- Maintain a healthy weight
- Quit smoking
- Stay on top of health conditions, such as high cholesterol and diabetes, and take any medicine as directed
Your primary care provider can suggest other preventive steps based on your personal risk factors.
Risk factors for AMI include:
- Age
- Cocaine or other vasopressor medication use
- History of chronic mesenteric ischemia
- History of heart disease, including atrial fibrillation, heart attack or congestive heart failure
- Hypotension (low blood pressure)
- Recent heart or abdominal surgery
Risk factors for CMI include:
- Age
- Diabetes
- Heart disease
- Hypertension (high blood pressure)
- Hyperlipidemia (high cholesterol)
- Smoking
Mesenteric ischemia is a serious and life-threatening condition. Patients with untreated asymptomatic CMI – meaning they have the condition but do not have symptoms – have a 40%chance of dying within five years, often due to a heart attack. Patients who have CMI with symptoms but do not get treatment have an almost 100%chance of dying within five years.
AMI is even more dangerous, with nearly 60%of people dying within 30 days of onset of symptoms if they do not get treatment. If you think you may have AMI, you should seek emergency care immediately.
In most cases, your first visit to UK HealthCare Comprehensive Vascular Clinic is a time of education and introductions. You meet members of your care team and learn about detecting, treating and managing your vascular condition.
Diagnosing vascular disease is a unique process that requires detective work. One of the most important steps toward diagnosis is listening to your story. Your team will ask a lot of questions about your symptoms and medical history. The goal is to gather all the information that can help pinpoint the source of your vascular issue.
Along with discussing your medical history, you will undergo a physical examination. Your care team will then be able to determine the proper next step to take on your diagnostic journey.
When appropriate, your team may prescribe one or more diagnostic tests. These tests typically take place on a different day, and your care team helps schedule them at your convenience. In some cases, you will undergo an ultrasound or other testing as part of your initial visit.
When coming to your first vascular appointment, plan to do the following:
- Arrive early. You may need to fill out paperwork when you arrive. Getting to your appointment early ensures you have time to complete paperwork without feeling rushed.
- Bring a current list of medications or supplements you take. You should also list any previous surgeries, symptoms you’ve experienced and other past health issues.
- Dress comfortably. Working toward a diagnosis takes time. Comfortable clothes help you remain relaxed and attentive throughout your visit. They also make it easier for your team to perform your physical exam.
- Eat and drink normally. In most cases, you won’t undergo imaging or other testing at your first visit. Therefore, there are no dietary restrictions. If specialized testing is part of your first visit, a team member will call to explain any dietary restrictions to follow for your visit. We will also mail you a letter with instructions.
- Have your insurance information on hand. UK HealthCare accepts most insurers, and financial assistance is available.
- Request a loved one to join you. Bring a family member or friend with you to take notes and ask questions you may not think of asking.
Where we are
UK HealthCare Comprehensive Vascular Clinic is located at 740 S. Limestone on the fifth floor, wing D, room L-504.
Where to park
Please park in the parking garage across the street, which is located at 140 Huguelet Drive. For easiest access, drive to the back of the garage and use one of the parking spots reserved for patients of the Comprehensive Vascular Clinic. Once inside, you can access further assistance at the information desk. Wheelchairs are available upon request.
Our vascular care experts help residents of Central Kentucky and beyond improve their vascular health every day. To improve the future of treatment and management of vascular conditions, they also participate in clinical trials.
At any given time, our staff engages in trials for new treatments and devices that provide better treatment and management of vascular conditions. By offering access to clinical trials, we provide access to vascular treatment not available at many other facilities.
If you’re a candidate for an ongoing trial, your care team will discuss the possibility with you.
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