Abdominal angina

Abdominal angina is abdominal pain after eating that occurs in individuals with ongoing poor blood supply to their small intestines known as chronic mesenteric ischemia. Although the term angina alone usually denotes angina pectoris (a type of chest pain due to obstruction of the coronary artery), angina by itself can also mean "any spasmodic, choking, or suffocative pain", with an anatomic adjective defining its focus; so, in this case, spasmodic pain in the abdomen. Stedman's Medical Dictionary Online defines abdominal angina as "intermittent abdominal pain, frequently occurring at a fixed time after eating, caused by inadequacy of the mesenteric circulation resulting from arteriosclerosis or other arterial disease. Synonym: intestinal angina."

Signs and symptoms
Symptoms of abdominal angina include postprandial pain, weight loss, diarrhea, nausea, vomiting, and an aversion or fear of eating caused by the pain associated with eating.

Abdominal angina usually starts 30 minutes after eating and lasts for one to three hours. The patient typically expresses the pain as a dull ache by clenching their fist over the epigastrium (the abdominal Levine sign).

Patients who restrict their own food intake to prevent the pain of abdominal angina typically present with weight loss. Additionally, patients may experience changes in their bowel habits, most commonly diarrhea from malabsorption (which leads to weight loss) or less frequently constipation.

Pathophysiology
The pathophysiology is similar to that seen in angina pectoris and intermittent claudication. The most common cause of abdominal angina is atherosclerotic vascular disease, where the occlusive process commonly involves the ostia and the proximal few centimeters of the mesenteric vessels. It can be associated with:
 * carcinoid
 * aortic coarctation
 * antiphospholipid syndrome

Treatment
Stents have been used in the treatment of abdominal angina.