Colonic Angiodysplasia - Causes, Symptoms, Diagnosis, and Treatment

Introduction

Angiodysplasia is the abnormal enlargement of the blood vessels in the gastrointestinal tract, which leads to severe bleeding and anemia in the body. The condition mainly occurs in adults above 60 years of age, having bowel and gastrointestinal bleeding symptoms caused by angiodysplasia. This abnormality can be generated in any part of the digestive tract and is usually not associated with systemic, skin, or hereditary disease. The exact cause of angiodysplasia is unknown, but many cases have reported severe bleeding in the lower and upper gastrointestinal tract. The prevalence rate of colon angiodysplasia is one to two percent and is the second most common cause of rectal or anal bleeding.

What Are the Symptoms of Colonic Angiodysplasia?

Angiodysplasia may occur asymptomatic or can be present with mild symptoms. The condition causes iron deficiency anemia symptoms are sometimes present because it can cause bleeding and lesions in the gastrointestinal tract.

Colonic angiodysplasia shows the following signs:

• Pale skin.

• Dizziness.

• Tiredness.

• Rapid heartbeat.

• Shortness of breath (caused by anemia).

• Lightheadedness.

• Weakness.

• Fatigue.

What Is the Cause of Colonic Angiodysplasia?

Colonic angiodysplasia is caused due to the following reason.

• Colonic angiodysplasia is the enlargement of the blood vessels caused by the typical colon spasm. The condition is usually present on the right side of the colon. Colonic angiodysplasia is mainly caused in adults due to the breakdown and aging of the blood vessels.

• Due to the severity of the swelling and enlargement of blood vessels, a tiny passage develops in the small veins and arteries. This swelling causes an arteriovenous malfunction that leads to bleeding in the colon.

• Colonic angiodysplasia is rarely associated with any other disease or condition of the blood vessels and is not related to colon cancer.

How Is Colonic Angiodysplasia Diagnosed?

Angiodysplasia of the colon can be diagnosed in the following ways:

• Blood Test: This is done to diagnose anemia and red blood cell count.

• Stool Test: The test is done to check the blood traces in the stool to diagnose bleeding from the colon.

• Angiography: This helps identify the bleeding blood vessels in the colon and allows the doctor to discover the lesion for suspected bleeding if the colon does not show any symptoms.

• Colonoscopy: This technique is used by the doctor to examine a person's intestines with the help of a camera inserted through the anus. It helps to detect bleeding and other abnormalities in the gastrointestinal tract and anus.

What Are the Treatment Options for Colonic Angiodysplasia?

The treatments for colonic angiodysplasia mainly depend upon the symptoms of anemia and the severity of the condition. Colonic angiodysplasia sometimes does not need any treatment, but severe bleeding and symptoms of anemia need proper medical interventions. The treatment options are as follows:

• Angiography: This procedure stops the bleeding of the blood vessels with the help of a narrow plastic tube that delivers the medicine to the bleeding area. This blocks or tightens the blood vessels thus, stops the bleeding.

• Cauterizing: This helps to stop the bleeding by cauterizing or burning the bleeding spot in the blood vessel with a laser or heat. The procedure is done with an endoscope, a thin tube inserted into the stomach and upper part of the small intestines via the mouth.

• Surgery: In severe cases of colonic angiodysplasia, the doctor uses a surgical method to remove the right part of the colon to stop bleeding. The surgical procedure is used if multiple lesions of angiodysplasia are present or severe bleeding occurs in the GI tract, which can be life-threatening.

• Angiogenesis Inhibitors: It include Thalidomide and Bevacizumab, used to treat angiodysplasia or gastrointestinal blood vessel malformation.

• Hormone Therapy: Estrogen is used in this treatment method with or without progesterone to treat severe gastrointestinal bleeding.

• Octreotide: It is a subcutaneous injection given to a person in case of refractory angiodysplasia related to gastrointestinal bleeding.

What Are the Factors Responsible for the Treatment of Colonic Angiodysplasia?

The factors on which the doctor makes the treatment decisions include:

• Actively bleeding angiodysplasia lesions are treated with continuous monitoring of the blood count, blood transfusion, and managing the oxygen-carrying capacity of the tissues.

• Incidental angiodysplasia does not have any treatment available unless the bleeding is present.

• A hemodynamically unstable person having severe bleeding is given intravenous fluids and blood transfusion, and blood count is monitored. A colonoscopy or endoscopy is also needed.

• Nonbleeding angiodysplasia with gastrointestinal bleeding is also treated with expert advice to stop and prevent the condition from worsening.

What Are the Risks Caused by Treatment for Colonic Angiodysplasia?

Mild side effects like stomach and intestinal perforations and bleeding are caused by endoscopy.

However, medications used in the treatment, such as anesthesia, painkillers, and sedatives, can produce the following risk factors due to reactions:

• Low blood pressure.

• Slow heart rate.

• Excessive sweating.

• Breathing difficulties.

• Laryngeal spasm.

What Are the Complications Associated With Colonic Angiodysplasia?

The complications associated are as follows:

• Iron deficiency anemia

• Death due to excessive bleeding or blood loss.

• Blood loss from the gastrointestinal tract.

• Hemodynamic instability.

What Are the Risk Factors Caused by Angiodysplasia of the Gastrointestinal Tract?

The risk factors caused by angiodysplasia are as follows:

• Aortic stenosis.

• Chronic kidney disorders.

• Von Willebrand disease.

What Is the Differential Diagnosis for Colonic Angiodysplasia?

• Hemorrhoidal bleeding.

• Colitis due to radiation, ischemia, or infection.

• Peptic ulcer diseases.

• Gastrointestinal malignancies such as rectal or colon cancer.

• Diverticulosis (bulging pouches in the digestive tract).

What Are the Other Types of Angiodysplasia?

Angiodysplasia can be of various types depending upon the location of the blood vessel enlargement or swelling.

These include:

• Cecal angiodysplasia.

• Angiodysplasia in the stomach and intestines.

• Small bowel and duodenum angiodysplasia.

Conclusion

Colonic angiodysplasia is a torturous condition caused by malformation of the blood vessels in the duct. The condition causes profuse bleeding, which can lead to anemia and blood loss from the body. Angiodysplasia is challenging to diagnose without lab investigations and can be evaluated with the help of angiography or colonoscopy. The treatment options for colon angiodysplasia show a good prognosis if the bleeding is arrested because it can automatically resolve the anemia. However, excessive bleeding due to multiple angiodysplasia lesions in the duct can affect the prognosis and reduce the body's hemoglobin levels. Consult the nearby doctor for timely medical intervention if these symptoms occur. A person might need a blood transfusion to tackle this condition.