​Chronic Mesenteric (Intestinal) Ischemia

Chronic mesenteric ischemia, also referred to as intestinal ischemia occurs when plaque builds up in the major arteries that supply blood to the small intestine or small bowel. When left untreated, the blockage can decrease blood flow so much that the tissues in the intestines die.

At UPMC, experts from the Division of Vascular Surgery handle the treatment of chronic mesenteric ischemia.

Contact the UPMC Heart & Vascular Institute

Request an appointment online, call 1-855-UPMC-HVI (876-2484), or email us.

What Is Chronic Mesenteric Ischemia?

Chronic mesenteric ischemia is a condition in which plaque builds up in the major arteries — including the celiac and superior mesenteric arteries — that supply blood to the small intestine or small bowel.

These blood clots in the small intestine and bowels can lead to:

  • Weight loss
  • Pain with eating
  • Fear of food

Left untreated over time, blockages can decrease blood flow so much that the tissues in your intestines die.

Chronic mesenteric ischemia causes

Atherosclerosis (hardening of the arteries) causes chronic mesenteric ischemia.

Healthy arteries are flexible and smooth and allow blood to flow freely through them.

In atherosclerosis, fatty deposits and calcium can build up along the inner artery walls and form plaque. Over time, the buildup of plaque causes the arteries to narrow. This limits the amount of oxygen-rich blood that flows to the intestines.

Chronic mesenteric ischemia risk factors

Factors that increase your risk of chronic mesenteric ischemia include:

  • Age, older than age 60
  • Smoking
  • High cholesterol levels
  • Diabetes

Why choose UPMC for chronic mesenteric ischemia care?

UPMC’s Vascular Surgery Division has access to the latest minimally invasive treatments for chronic mesenteric ischemia. We take a team based approach and tailor our treatment plan to your unique circumstances.

A leader in the treatment of chronic mesenteric ischemia, UPMC is actively engaged in research in an effort to improve outcomes for our complex vascular patients.

To make an appointment with a vascular surgeon at the UPMC Heart and Vascular Institute, complete an appointment request form or call 1-855-UPMC-HVI (876-2484).

Learn more about chronic mesenteric ischemia risk factors

UPMC Patient Education Materials:

Chronic Mesenteric Ischemia Symptoms and Diagnosis

Symptoms of chronic mesenteric ischemia include:

  • Severe abdominal pain, 15 to 60 minutes after eating and lasting up to 90 minutes
  • Weight loss
  • Nausea
  • Vomiting
  • Pain that is recurrent and consistently related to food intake
  • Fear of food due to chronic pain
  • Flatulence
  • Constipation

Diagnosing chronic mesenteric ischemia

Your doctor at the UPMC Heart and Vascular Institute may perform several tests to rule out other conditions. In addition, your doctor will perform a physical exam and ask you questions about your medical history.

Tests used to diagnose chronic mesenteric ischemia include:

  • Mesenteric duplex ultrasound — allows your doctor to see how blood flows through the mesenteric arteries and if there is any blockage.
  • Computed tomographic (CT) angiography — can show problems with arteries, such as narrowing or blockage in blood vessels in the abdomen, and help guide treatment options.
  • Angiogram — using a catheter (a thin, flexible tube) through a tiny nick in an artery in your groin or wrist, your doctor can inject a dye in order to visualize exactly where the blockage is located.

To make an appointment with a vascular surgeon at the UPMC Heart and Vascular Institute, complete an appointment request form or call 1-855-UPMC-HVI (876-2484).

Learn More About Chronic Mesenteric Ischemia Testing

UPMC Patient Education Materials

Chronic Mesenteric Ischemia Treatment

The goal of chronic mesenteric ischemia treatment is to restore blood flow to your intestines before damage occurs.

Making changes to your diet with the help of a dietitian may be the only treatment you need.

If diet changes do not help — and symptoms cause weight loss, long-term abdominal pain, and even food fear — your doctor at the UPMC Heart and Vascular Institute may recommend minimally invasive or open surgical treatments to increase blood flow to your intestines.

Angioplasty and stenting

  • Your doctor will insert a balloon-tipped catheter inside the blocked artery at the point of the blockage.
  • Once the catheter is in place, your doctor will inflate and deflate the balloon. As the balloon inflates, it flatten the plaque against the wall of the artery, leaving it open.
  • To make sure the artery stays open, your doctor may place a stent. A stent is a metal-mesh tube that acts as a scaffold by pressing against the artery walls, keeping the artery open.

Bypass surgery

  • An option when angioplasty is ineffective or when more than one blood vessel is blocked.
  • Increases blood flow from the aorta to the blood vessels, supplying the bowel beyond the areas of narrowing.
  • Your vascular surgeon uses a blood vessel from another location to create a detour around the blockage by attaching one end to the blocked artery above the blockage and the other end below the blockage.
  • Blood can flow through the newly placed vessel, bypassing the blockage.
  • Symptoms typically improve immediately and you will receive close follow-up care through regular ultrasounds.

Lifestyle changes

  • Decreasing the risk of atherosclerosis — the condition that causes chronic mesenteric ischemia.
  • Quitting smoking.
  • Controlling blood sugars in people with diabetes.
  • Lowering cholesterol levels.
  • Lowering high blood pressure.
  • Taking anti-platelet medications, such as aspirin and clopidogrel (Plavix).

Make an Appointment

Vascular surgeons at the UPMC Heart and Vascular Institute offer treatment for chronic mesenteric ischemia.

To make an appointment with a vascular surgeon, complete an appointment request form or call 1-855-UPMC-HVI

Learn More About Chronic Mesenteric Ischemia Treatments

UPMC Patient Education Materials

Chronic Mesenteric Ischemia Education Materials

The UPMC Heart and Vascular Institute offers education information and videos about chronic mesenteric ischemia and other heart and vascular diseases and treatments.

Many people find these resources helpful in answering their questions about their condition and preparing them for their procedure or diagnostic test.

The links below will open in a new browser window.

UPMC Patient Education Materials

To make an appointment with a vascular surgeon at the UPMC Heart and Vascular Institute, complete an appointment request form or call 1-855-UPMC-HVI (876-2484).