Angiodysplasia of the GI tract (The Basics)

Written by the doctors and editors at UpToDate

What is angiodysplasia of the GI tract?

“Angiodysplasia” is the term doctors use for blood vessels that become abnormal. (AVM’s or arteriovenous malformation are an abnormal tangle of blood vessels) The “GI tract,” short for the gastrointestinal tract, includes all the organs in the body that digest food. In angiodysplasia of the GI tract, blood vessels along the GI tract become abnormal. This condition can lead to problems. When blood vessels are abnormal, they can bleed very easily and people can have bleeding in their GI tract. The term doctors use for bleeding in the GI tract is a “GI bleed.” Angiodysplasia of the GI tract happens most often in older adults.

What are the symptoms of angiodysplasia of the GI tract?

Symptoms depend on whether the abnormal blood vessels bleed or not. If the abnormal blood vessels do not bleed, people do not have any symptoms. They find out they have the condition after their doctor does tests for another reason. If the abnormal blood vessels bleed, people might or might not realize they have a GI bleed. When a GI bleed causes symptoms, it can cause bloody or tar-colored bowel movements. But some people with a GI bleed have no symptoms and don’t see any blood. People might not see any blood when the bleeding happens very slowly over time. A GI bleed sometimes leads to a condition called “anemia,” which is when the body has too few red blood cells. Anemia can make people feel tired or weak.

Is there a test for angiodysplasia of the GI tract?

Yes. Doctors can do different tests to check for angiodysplasia of the GI tract. The test you have depends on which part of the GI tract your doctor wants to check. The different tests can include:

• An upper endoscopy – This procedure lets the doctor look at the lining of your esophagus (the tube from the mouth to the stomach), stomach, and duodenum (the first part of the small intestine). During this test, the doctor puts a thin tube with a camera and light on the end into your mouth and down your esophagus (figure 2).
• A colonoscopy – This procedure lets the doctor look at the inside of the large intestine (colon). During this test, the doctor puts a thin tube with a camera and light on the end into your anus and up your rectum and colon (figure 3).
• A capsule endoscopy – This test uses a small camera about the size of a pill. You swallow the camera, and it sends pictures of your small intestine to a recording device that you wear on a belt for 8 hours. After the test, the camera leaves your body in a bowel movement.
• A CT scan – A CT scan is an imaging test that creates pictures of the inside of the body.

How is angiodysplasia of the GI tract treated?

Treatment depends on whether the abnormal blood vessels are bleeding, and if you have anemia. In most cases, people only need treatment if the abnormal blood vessels are bleeding or they have anemia. People who do not have bleeding or anemia usually don’t need any treatment. When treatment is needed, it usually involves a procedure to stop the bleeding. Your doctor can do this procedure during your colonoscopy or upper endoscopy.  If this procedure doesn’t stop the bleeding, your doctor will talk with you about other possible treatments to stop the bleeding. These might include:

• A procedure called “angiography” to block the bleeding blood vessel
• A procedure called “enteroscopy” – This is like an upper endoscopy, but the doctor puts the tube further into the small intestine.
• Surgery – Most people do not need surgery, but people with a lot of bleeding might need surgery to remove part of their intestine.
• Other medicines – Certain medicines might help stop the bleeding, but these medicines don’t always work and they can have harmful side effects.

People with anemia or bleeding might also need treatment with:

• Extra iron, which usually comes in pills
• Blood transfusions – During a blood transfusion, you will get blood that has been donated by someone else. The donated blood goes into your vein.

 

Written by the doctors and editors at UpToDate