What Is an Angiodysplasia?
Angiodysplasia is a malformation of the intestine that causes the blood vessels to enlarge and become fragile. It most often occurs in the cecum or ascending colon, but can occur in the small intestine as well. The lesions often are multiple and difficult to diagnose due to their diminutive size. It is a common cause of gastrointestinal bleeding and anemia. Other medical terms for angiodysplasia include vascular ectasia of the colon, colonic arteriovenous malformation, and colonic angiomas.
The disease is thought to be related to degeneration of the blood vessels due to age, as it most typically occurs in adults over the age of 50. Another likely cause is obstruction of the veins in the colon due to tension on the intestinal wall as it becomes larger. It rarely is associated with other intestinal disorders, such as diverticulosis or colon cancer.
Angiodysplasia typically occurs in less than one percent of the population and usually is found during a routine colonoscopy screening. It occurs equally in men and women. No racial or ethnic group is known to have a higher incidence of the condition. Patients with scleroderma, or other autoimmune diseases, usually have a higher risk of developing angiodysplasia.
The condition typically is not likely to cause pain. Symptoms of angiodysplasia often include dark, tarry stools, which is indicative of gastrointestinal bleeding. If blood loss is great, anemia could develop, leaving a patient with weakness and fatigue. For approximately 90 percent of patients, the condition resolves on its own without intervention, but often recurs due to chronic distension of the colon blood vessels.
When a physician suspects angiodysplasia, an endoscopic procedure typically is ordered, either an esophagogastroduodenoscopy (EGD) or colonoscopy. During an endoscopy, the physician may be able to treat the lesions through cauterization or by performing an argon plasma coagulation laser treatment. If the condition is advanced, surgical resectioning of the intestine may be required. The process used most often to resection is called a right hemicolectomy.
If surgical intervention is not possible or bleeding is recurrent, medication such as estrogen can be used to coagulate the blood and stop bleeding. Scientists are evaluating the use of thalidomide as a possible treatment for angiodysplasia. Iron supplements could be given when bleeding has caused anemia.
Written by Denise Reynolds
