Angiodysplasia is characterized by swollen and fragile blood vessels in the colon which intermittently cause loss of blood from the gastrointestinal tract. Angodysplasia is a small vascular malformation in the colon. The lesions are multiple, and are usually seen in the ascending colon or cecum; while they may develop at other places in the colon as well.
Angiodysplasia is linked to aging and degeneration of the blood vessels. Generally, it develops in older individuals. By and large it is seen on the right side of the colon.
The most probable etiological factor is that the normal spasms of the colon cause an enlargement of blood vessels. This enlargement becomes excessive and very severe and thereby produces a small direct passage between a very small vein and artery – an arterio-venous fistula. It is here that there is a huge risk for bleeding.
Symptoms Of Angiodysplasia Of Colon
The clinical picture of angiodysplasia of the colon is as follows:
- The symptoms tend to vary. Customarily, in elderly people, the symptoms are apparent as exhaustion and weariness, and shortness of breath because of anemia.
- There may not be any indications of bleeding from the colon at all.
- Some people present with intermittent episodes of mild or severe bleeding from the rectum.
- Some people present with black, tarry stool and the blood loss is usually subtle, with symptoms of anemia predominating.
- No pain is associated with angiodysplasia of the colon.
Diagnosis And Treatment Of Angiodysplasia Of Colon
Making the right diagnosis is a little difficult; given that the symptoms are vague and indistinct. Your doctor will order a few tests ad investigations to ascertain the precise cause. Tests done to diagnose this condition include:
- Angiography
- Colonoscopy
- Complete blood count to assess anemia.
- Stool evaluation for occult (hidden) blood.
- It is very vital to establish what is causing the bleeding from the colon and how fast blood is lost.
- It may be necessary to admit you to a hospital.
- Fluids and blood need to be given intravenously.
- Once the source of bleeding has been found, your doctor will prescribe other treatments. In most people, the bleeding stops without any treatment at all.
- Angiography is carried out to help occlude the blood vessel that is bleeding or to convey medications to make the blood vessel to tighten up and stop the bleeding.
- Cauterizing the site of the bleed using heat or laser employing a colonoscope is another therapeutic technique used by doctors.
- In certain cases, surgical intervention is the only alternative. Excising the entire right side of the colon – i.e. a right hemicolectomy is the treatment of choice when the bleeding refuses to halt and continues at a dangerously rapid rate, in spite of the various treatments by angiography and colonoscopy.
- Medications such as – thalidomide and estrogens are also used to decrease the bleeding and the number of angiodysplasias.
- Patients who have bleeding regardless of having had colonoscopy, angiography, or surgical intervention will in all likelihood have more episodes of bleeding in the future.
- The prognosis for colon angiodysplasia is fairly good if the bleeding is well controlled.