Causes Of Intestinal Angioedema: Its Symptoms And Treatment

Angioedema is a kind of swelling which affects the deeper layers in the skin; by and large, angioedema is harmless, even without any treatment. On the other hand, a serious episode of angioedema can be life threatening if the swelling causes the throat to occlude your airway.

Intestinal angioedema is rather rare; it is characterized by swelling of the wall of the intestines. It may afflict the small or large intestine. It often causes a range of clinical features which are somewhat indistinct and consequently diagnosis is sometimes missed or the case is confused with some other GI derangement.

Signs And Symptoms Of Intestinal Angioedema

Common signs and symptoms of intestinal angioedema are:

  • Pain and discomfort in the abdomen.
  • The pain tends to worsen after eating.
  • Nausea and vomiting.
  • Heartburn and acidity.
  • Cramps in the tummy.
  • Bloating and distension of the abdomen.
  • Digestion and absorption of food may get severely affected. This could lead to weight loss as well as malabsorption syndromes leading to nutritional insufficiencies.

What Causes Intestinal Angioedema?

The deeper layers of the skin as well as the submucosal layers get afflicted.

The intestine has a mucosal lining and beneath the mucosal lining is the submucosal layer. When angioedema occurs, the vessels of the submucosa become leaky and permeable; as a result fluid from the blood empty in to the interstitial fluid of the submucosal lining and this causes swelling of the intestinal walls.

A common cause for the development of intestinal agioedema is ACE inhibitors – i.e. angiotensin converting enzyme inhibitors. ACE is an enzyme that controls the contraction of muscles of the blood vessels. Muscle contraction causes hypertension; and hence, an ACE inhibitor hampers the muscle contractions, triggering muscle relaxation. What’s more, ACE inhibitors increase the level of bradykinin which also promotes dilation of the blood vessels. This helps lower high the pressure in the blood vessels. On the other hand, bradykinin is vaso-active which increases vascular permeability causing a leak. Fluid from the blood vessels gains entry in to the interstitial spaces of the submucosa, setting off edema. In case there is too much swelling, the lumen of the small intestine gets occluded.

Those who have acquired as well as hereditary angioedema are also susceptible to intestinal angioedema. Usually, this occurs due to C1-INH (C1-inhibitor) insufficiency. C1-INH enzyme inhibits the activity of a type of immune chemical known as complement. An insufficiency of C1-INH makes complement C1 to act uncontrollably. This sets off an activation of the kinins which also step up vascular permeability which further causes swelling of the submucosa of the intestines.

Treatment For Intestinal Angioedema

Once the diagnosis has been made, your doctor will prescribe the treatment regimen.

  • In drug related angioedema, the drug that is triggering the disorder should be discontinued and you need to take a substitute; and amelioration will be evident in about 24 hours.
  • With booth acquired as well as hereditary angioedema, treatment options usually prescribed are :
  • Serine proteinase inhibitors
  • Anabolic steroids
  • Kallikrein inhibitors
  • It is very vital that intestinal angioedema be diagnosed and managed by a doctor. Anti-histamines and other allergy drugs which are normally prescribed may not be effective for treating this condition; hence professional supervision is a must.