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| {{SK}} Colonic angiodysplasia; colonic arteriovenous malformation; vascular ectasia of the colon; angioectasia | | {{SK}} Colonic angiodysplasia; colonic arteriovenous malformation; vascular ectasia of the colon; angioectasia |
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| ==Therapy==
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| If the anemia is severe, [[blood transfusion]] is required before any other intervention is considered. [[Endoscopy|Endoscopic]] treatment is an initial possibility, where cautery or [[argon plasma coagulation]] (APC) laser treatment is applied through the endoscope. [[Resection]] of the affected part of the bowel may be needed. However, the lesions may be widespread, making such treatment impractical. [[Embolisation]] through [[angiography]] is occasionally contemplated with severely bleeding lesions that cannot be visualised on colonoscopy.
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| If the bleeding is from multiple or inaccessible sites, systemic therapy with [[medication]] may be necessary. First-line options include the antifibrinolytics [[tranexamic acid]] or [[aminocaproic acid]]. Estrogens can be used to stop bleeding from angiodysplasia. Estrogens cause mild hypercoaguability of the blood. Estrogen side effects can be dangerous and unpleasant in both sexes. Changes in voice and [[gynecomastia|breast swelling]] is bothersome in men, but older women often report improvement of [[libido]] and [[menopause|perimenopausal]] symptoms. (The worries about [[hormone replacement therapy]]/HRT, however, apply here as well.)
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| In difficult cases, there have been positive reports about [[octreotide]]<ref>{{cite journal |author=Junquera F, Saperas E, Videla S, Feu F, Vilaseca J, Armengol JR, Bordas JM, Piqué JM, Malagelada JR |title=Long-term efficacy of octreotide in the prevention of recurrent bleeding from gastrointestinal angiodysplasia |journal=Am. J. Gastroenterol. |volume=102 |issue=2 |pages=254-60 |year=2007 |pmid=17311647 |doi=10.1111/j.1572-0241.2007.01053.x}}</ref> and thalidomide,<ref>{{cite journal |author=Shurafa M, Kamboj G |title=Thalidomide for the treatment of bleeding angiodysplasias |journal=Am. J. Gastroenterol. |volume=98 |issue=1 |pages=221-2 |year=2003 |pmid=12526972 |doi=10.1111/j.1572-0241.2003.07201.x}}</ref>
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| In severe cases or cases not responsive to either endoscopic or medical treatment, [[surgery]] may be necessary to arrest the bleeding.
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| ==References== | | ==References== |
