Angiodysplasia

Overview

Angiodysplasia is a condition where small, abnormally formed blood vessels develop in the lining of the digestive tract, most often in the large intestine (colon). These blood vessels can become fragile and may bleed, sometimes without causing any symptoms.

It is not rare, especially in people over 60, but many people with it never know they have it because it often causes no symptoms.

Most often affects older adults, particularly those over 60. It can also occur in younger people with certain inherited conditions, but this is much less common.

Symptoms

Common symptoms

• No symptoms at all
• Black or tarry stools
• Blood in or on the stool
• Bright red blood from the rectum
• Tiredness, paleness, or weakness from anemia

Symptoms in children

• Angiodysplasia is uncommon in children. When it occurs, it is usually linked to an inherited condition, and symptoms may include dark or bloody stools, or anemia.

Symptoms in older adults

• Dark or bloody stools
• Feeling unusually tired or weak
• Shortness of breath with activity
• Dizziness or light-headedness

Causes

Main causes

• Aging and wear on blood vessel walls
• Abnormal connections between arteries and veins
• Pressure inside the bowel that affects blood vessels

Risk factors

• Age over 60
• Chronic kidney disease
• Heart valve disease
• Inherited blood vessel conditions
• Use of blood-thinning medicines

When to see a doctor

See a doctor urgently if:

• If you see blood in your stool
• If you feel tired, dizzy, or short of breath

Book a routine appointment if:

• If you have ongoing changes in bowel habits
• If you are concerned about low iron or anemia

Diagnosis

Doctors diagnose angiodysplasia by looking inside the digestive tract using a flexible tube with a camera, or by imaging tests that show blood vessels.

Tests that may be done

• Colonoscopy
• Upper endoscopy if needed
• Capsule endoscopy (swallowing a small camera pill)
• Angiography (a special X-ray of blood vessels)
• Stool tests to check for hidden blood
• Blood tests to check for anemia

What to expect at your appointment

You may be asked to follow special preparation instructions before a scope test, such as a clear liquid diet. The procedures are usually done with sedation or local anaesthetic and are generally well tolerated.

Treatment

Treatment depends on whether the abnormal blood vessels are bleeding. If you have no symptoms, you may not need treatment, only monitoring. If bleeding happens, doctors can often treat it during a scope procedure or with other non-surgical methods.

Self-care at home

• Keep a record of any symptoms and share it with your doctor
• Take iron supplements only if your doctor recommends them
• Make sure all your medicines and supplements are reviewed by your doctor

Medical treatments

For active bleeding, doctors may use heat, laser, or clips applied through an endoscope to seal the abnormal vessels. Medications that reduce blood flow to the area may also be used in some cases. In rare situations, iron infusions or blood transfusions are needed to replace lost blood. You may also be advised to avoid or adjust certain medicines that increase bleeding risk—always discuss this with your doctor.

When is surgery considered?

Surgery is rarely needed. It may be considered only if bleeding is severe, keeps coming back, and other treatments have not worked.

Living with this condition

For most people, angiodysplasia is not a daily concern. If you have had bleeding, you may need regular blood tests to check for anemia and follow up with your gastroenterology team.

Lifestyle tips

• Stay hydrated and eat a balanced diet to keep stools soft
• Avoid nonsteroidal anti-inflammatory pain relievers unless your doctor says they are safe for you
• Report any new or returning bleeding symptoms promptly

Diet and exercise

No special diet is proven to treat angiodysplasia, but a fibre-rich diet with plenty of fluids can help maintain healthy bowel function. Gentle regular exercise can help with overall wellbeing, unless you are actively bleeding.

Mental health and emotional wellbeing

Living with a condition that can cause bleeding can make some people anxious. It is normal to worry, and talking to your doctor or a counsellor can help.

Prevention

There is no reliable way to prevent angiodysplasia because it seems to develop with age and is partly linked to blood vessel structure. You can reduce risks by managing other health conditions and having regular check-ups.

Vaccines

There is no vaccine that prevents angiodysplasia.

Screening programmes

There is no routine screening test for angiodysplasia. Bowel cancer screening tests are still important, because they can sometimes pick up hidden blood.

Complications

If left untreated

• Repeated or heavy bleeding
• Iron-deficiency anemia
• Low blood pressure or shock from significant blood loss
• Need for blood transfusions or iron replacement

Long-term outlook

With care from a healthcare team, most people with angiodysplasia do very well. For many, the condition stays silent or only needs occasional monitoring. Treatments are available if bleeding occurs, and serious complications are uncommon.

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