Ischemic Bowel | MedStar Health

Restoring blood flow to the intestines

Intestinal ischemic syndrome, also known as intestinal ischemia or ischemic bowel, occurs when your intestines don’t get enough blood flow.

This usually happens because of blockages in the major arteries that bring blood to the intestines. These arteries often become narrowed or blocked because of atherosclerosis, a buildup of plaque inside the arteries. Blood clots also can block the flow of blood through the blood vessels.

Intestinal ischemia can happen suddenly or over time and lead to abdominal pain with eating to life-threatening intestinal ischemia.

Treating intestinal ischemic syndrome may require vascular surgery, depending on the type and severity of your disease. The MedStar Vascular Program is a recognized leader in the treatment of vascular disease, and our doctors are known for their expertise and quality in vascular care.

There are three main forms of intestinal ischemic syndrome:

  • Colon ischemia, also known as ischemic colitis, a blockage of blood flow to the colon (large intestine)

  • Mesenteric ischemia, a lack of blood flow that usually affects the small intestine

  • Mesenteric venous thrombosis, a blockage in a vein that prevents blood from leaving the intestines

What are the symptoms of intestinal ischemic syndrome?

Symptoms can be different based on whether your condition develops suddenly (acute) or gradually over time (chronic). Nausea, vomiting, and abdominal pain are common symptoms of both acute and chronic intestinal ischemic syndrome.

Symptoms of acute intestinal ischemic syndrome include:

  • Bloody stool

  • Confusion (especially in older adults)

  • Frequent or urgent bowel movements

  • Sudden mild or severe belly pain, swelling, or tenderness

Symptoms of chronic intestinal ischemic syndrome include:

  • Belly cramps or pain that gets worse over weeks or months, especially after eating

  • Diarrhea

  • Feeling bloated

  • Losing weight without trying to

Who is at risk for intestinal ischemic syndrome?

Anyone with other conditions caused by atherosclerosis is at risk for developing intestinal ischemic syndrome. Examples of other such conditions include:

Other risk factors for intestinal ischemic syndrome include:

  • Heart problems such as heart failure or atrial fibrillation (Afib)

  • Blood pressure that is too high (hypertension) or too low (hypotension)

  • Conditions that increase your risk for blood clots, such as sickle-cell anemia or antiphospholipid syndrome, an immune disorder


Abdominal duplex ultrasound

Abdominal duplex ultrasound is a combination of a traditional and doppler ultrasound that assesses the blood vessels in your abdomen for blockages or aneurysms.

Angiogram (angiography)

An angiogram is a special X-ray taken as a special dye is injected through a thin, flexible tube called a catheter to detect blockages or aneurysms in blood vessels.

Computerized tomography (CT) scan

The cardiac computed tomography scan, or cardiac CT, uses X-rays to create three-dimensional images of your heart and blood vessels.

Electrocardiogram (ECG)

An electrocardiogram, also known as an ECG, measures the heart’s electrical activity.


Your doctor may prescribe medication to treat intestinal ischemic syndrome. For severe cases, we may recommend one or more of the following treatments:

Intestinal PAD treatment options

Intestinal PAD treatment options include medication, minimally invasive procedures, and surgery.