Gastric antral vascular ectasia

Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at November 17, 2016
StartDiseasesGastric antral vascular ectasia

Gastric antral vascular ectasia is a very uncommon health issue that results in many intestinal problems. It is also referred to as watermelon stomach because it causes distinctive red streaks on the stomach that look like a watermelon's marks. Though this condition is still not completely understood, there are many potential treatment methods available. 


Definition & Facts

Gastric antral vascular ectasia is the medical name for dilated blood vessels in the stomach that result in gastrointestinal bleeding. This condition most commonly occurs among women over the age of 50, but it is still extremely rare. Generally, patients with gastric antral vascular ectasia tend to be elderly. Gastric antral vascular ectasia frequently occurs alongside other health conditions, particularly autoimmune diseases or renal disease.

Symptoms & Complaints

The symptoms of gastric antral vascular ectasia can go unnoticed for quite a while since gastrointestinal bleeding does not immediately result in health issues. However, the constant blood loss can cause many problems over time.

Patients with gastric antral vascular ectasia often end up developing anemia due to the drastic increase in red blood cells. This causes a person to feel tired and weak even when they get enough sleep. When they exercise, they quickly become short of breath.

It can also cause an increase in mental confusion that patients describe as feeling foggy. Standing up quickly while anemic can result in dizziness or fainting. Patients suffering from anemia due to gastric antral vascular ectasia also frequently complain of headaches or heart palpitations.

Occasionally blood can appear in stools, looking either black and tarry or bright red. Patients may deal with abnormal bowel movements such as constipation or diarrhea. Though it is not visible without an examination, the interior of the stomach will get long, horizontal, mottled red streaks. Gastric antral vascular ectasia can be painless or it can cause vague sensations of abdominal pain. If the bleeding is severe, it can cause patients to start vomiting blood.


Gastric antral vascular ectasia causes gastrointestinal bleeding because small blood vessels in the lower part of the stomach become dilated. These dilated blood vessels can bleed profusely, causing all of the symptoms of the condition. However, the exact underlying cause of gastric antral vascular ectasia is unknown. Because it is so rare and was only discovered a few decades ago, medical researchers are still working to learn more about the condition.

There are several theories about the condition's cause that may at least partially explain it. Gastric antral vascular ectasia generally occurs after a patient develops conditions such as autoimmune diseases, multiple sclerosis, kidney failure, liver failure, or certain collagen vascular diseases.

It seems likely that an overall increase in inflammation throughout the body may be inflaming the lining of the stomach. The condition also tends to appear after a patient develops high blood pressure (hypertension), so this may have something to do with the problem.

Diagnosis & Tests

It can take quite a while for a doctor to suspect the condition. Because it commonly occurs alongside other severe diseases, the mild symptoms of gastric antral vascular ectasia may be ignored at first. The condition is not well-known, so some doctors may not even realize they should test a patient for gastric antral vascular ectasia. However, a physical examination or a basic blood test will reveal the tell tale signs of anemia, encouraging a doctor to look for the condition causing the anemia.

Other causes of gastrointestinal bleeding, like ulcers or portal hypertension, must be ruled out. An endoscopy is used to get a closer look at the gastrointestinal tract, and this will show the distinctive watermelon stripes of the condition. This procedure is minimally invasive, but it will require the patient to avoid eating or drinking for a few hours beforehand.

During an endoscopy test, the doctor will insert a small camera down the throat and into the stomach. This camera then reveals the interior of the stomach lining. If the stomach lining has the long red streaks that look like watermelon marks, then the diagnosis for gastric antral vascular ectasia will be confirmed.

Treatment & Therapy

As soon as gastric antral vascular ectasia is diagnosed, a patient may need iron supplementation or even blood transfusions to start treating their anemia. Endoscopic methods will be utilized to stop bleeding. These procedures consist of either cauterizing the bleeding vessels or stopping them with argon plasma coagulation. Endoscopic treatments pass a camera and the cauterizing instrument through the throat, so no surgery is needed. However, it does not always work, because other non-treated blood vessels can start acting up.

Medications like estrogen therapy and corticosteroids have shown some promise, but they are not frequently used. As a last resort, surgery to remove the lower portion of the stomach can remove the area that was bleeding. This is somewhat invasive, so it is not recommended for older or weaker patients.

Patients with gastric antral vascular ectasia will need to make lifestyle changes to avoid further upsetting their stomach after treatment. Doctors recommend that patients start eating smaller, more frequent meals instead of stuffing their stomach. Anything that can irritate the stomach lining, like spicy foods, alcohol, or excessively greasy foods, should be avoided. A high fiber diet can help to further aid digestion.

Prevention & Prophylaxis

Because the cause of gastric antral vascular ectasia is not known, there is no definite way to avoid developing the condition. In general, it may be beneficial to lead a healthy lifestyle with a healthy diet and regular exercise. This may help to reduce inflammation and high blood pressure that could cause gastric antral vascular ectasia to develop.

Since it is more common among patients with autoimmune disorders, people with a higher risk of gastric antral vascular ectasia should be aware of the signs of anemia. Seeking prompt treatment is necessary to reduce severe symptoms and complications.