What is Gastric Antral Vascular Ectasia?

Gastric Antral Vascula Ectasia

(GAVE) is a rare condition caused by gastrointestinal bleeding. It is also sometimes the reason for iron deficiency anemia. The condition is nicknamed watermelon stomach. The disease generally manifests itself in the antrum. The antrum is the last part of the stomach. A study suggests that the discussed condition causes up to 4% of gastrointestinal bleeding other than what is caused by the varices of the stomach and esophagus.
Blood vessels of the stomach get dilated and under duress may rupture and cause intestinal bleeding. The dilated blood vessels appear as red long streaks all along the stomach lining. Women are more likely to have the condition than men. 71% of all the cases registered of GAVE have been found in women. It is more common in older women above the age of 80.


What are the causes of Gastric Vascular Ectasia of the stomach?

The condition is caused when the blood vessels dilate due to certain ailments which are as follows:

  • Portal hypertension brought about by cirrhosis of liver.
  • Graves’s disease.
  • Any physical abdominal trauma or injury.
  • Heart disease.
  • Chronic constipation.
  • Irritable bowel syndrome.
  • Chronic renal failure.
  • Diffuse Systemic Scleroderma brought about by the abnormal hardening of the skin and connective tissue.
  • Collagen vascular disorder which affects the collagen protein.

Symptoms of Watermelon stomach

  • Anemia and a drop in the hemoglobin number.
  • Melena (Black Tarry stools)
  • Hematochezia (Maroon stools)
  • Abdominal pain and discomfort.
  • Fatigue and weakness.
  • Lack of concentration.

Diagnosis of Watermelon stomach

Endoscopy with an invasive nasogastric tube is often enough to detect the red streaks associated with the condition. A biopsy also follows an endoscopy most of the times, to rule out a malignancy. However, if it has appeared as an associated symptom to some other disease especially that of the liver, then it is important to conduct other tests to detect the exact cause.

Treatment of Gastric Antral Vascular Ectasia

  • Medications:

    Treatment with medications is the first step. Corticosteroids, anti fibrinolytic drugs as tranexamic acid are effective but often is associated with side effects.

  • Coagulation therapy:

    Blood Clotting medications are introduced into the dilated blood vessels through the endoscope. This is known as the Argon Photocoagulation therapy. It is generally well received and makes surgery unnecessary.

  • Cryotherapy:

    The bleeding vessels are exposed to extremely cold temperatures which helps the blood to clot. Liquid nitrogen is introduced through the endoscope which freezes the oozing blood from the vessels.

  • Estrogen and Progesterone Therapy:

    The condition is treated with artificially given estrogen and progesterone hormones.


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