Angiodysplasia natural history, complications and prognosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Nikita Singh, M.D.[2]

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Natural History

• Small bowel angiodysplasia (SBA) contributes to 50% of obscure GI bleeding.
• SBA tend to re-bleed more than angiodysplasia of colon and stomach.
• In a retrospective study, re-bleeding occurred after about 11 months of diagnosis in 80% patients and 3.5% died as a direct result of bleeding.
• Multiple lesions and valvular heart diseases have been found to be increase the risk of re-bleeding.
• Apart from recurrence of bleeding, some other concerns in the natural history of angiodysplasia are transfusion requirements, hospital readmissions and requirement endoscopic, pharmacological or surgical therapy.
• In asymptomatic people the course of angiodysplasia is benign and the bleeding risk is low. Consequently, treatment is not required for incidentally found lesions.
• Complications

• Anemia
• Death from excessive blood loss
• Side effects from treatment
• Severe loss of blood from the GI tract

Prognosis

Patients who have bleeding related to this condition despite having had colonoscopy, angiography, or surgery are likely to have more bleeding in the future. The outlook remains good if the bleeding is controlled.