Intestinal twisting, medically known as volvulus, occurs when a loop of the intestine twists around itself and the mesentery that supports it. The mesentery is the tissue that attaches the intestines to the abdominal wall and contains blood vessels. This twisting can create a blockage, preventing digested food from moving through the bowel. It can also cut off the blood supply to the affected part of the intestine, potentially leading to tissue damage or death. Volvulus is a serious medical condition requiring prompt medical attention.
Recognizing the Warning Signs
Symptoms of intestinal twisting often appear suddenly and can worsen quickly. Severe abdominal pain is a primary indicator, frequently described as cramping, persistent, or sharp. This pain can be intense.
Nausea and vomiting are common, particularly the expulsion of green or yellow fluid, known as bilious vomiting. This color indicates the presence of bile, which should not normally be in vomit, and suggests an obstruction in the digestive tract. The abdomen may appear swollen or distended, and it can be tender to the touch.
Individuals might experience constipation or an inability to pass gas, signaling a bowel blockage. Bloody stools or rectal bleeding can also occur, indicating potential damage to the intestinal lining due to compromised blood flow. In infants, additional signs include inconsolable crying, drawing up the legs, lethargy, or rapid heart rate and breathing. These symptoms can progress rapidly, emphasizing the need for quick evaluation.
Differentiating Symptoms from Common Abdominal Discomfort
The symptoms of intestinal twisting differ significantly from routine abdominal discomforts like indigestion or gas, primarily in their severity, suddenness, and persistence. Common stomach issues present with milder, transient pain that might resolve with over-the-counter remedies or rest. Pain from indigestion or gas often fluctuates and does not consistently intensify.
Symptoms of intestinal twisting have an acute onset, meaning they appear suddenly and intensely, rather than gradually building over time. The pain associated with volvulus is unrelenting and severe, making it difficult to move or find a comfortable position. This intense pain, especially when combined with bilious vomiting or abdominal distension, points to a more serious underlying problem than a simple stomach upset.
When to Seek Immediate Medical Attention
Seeking immediate medical attention is essential if intestinal twisting is suspected. Severe, unrelenting abdominal pain, especially if it makes movement difficult, warrants an emergency room visit. This condition should not be monitored at home or treated with self-care.
Bilious vomiting, particularly in infants or children, signals a medical emergency. Bloody stools, abdominal distension, or an inability to pass gas or have a bowel movement alongside severe pain also necessitate immediate emergency care. Waiting for symptoms to worsen can lead to severe complications, including tissue death or intestinal perforation.
What to Expect at the Doctor’s Office
Upon arrival at the medical facility, doctors typically begin with a physical examination and take a detailed medical history. This examination involves checking for abdominal tenderness, distension, and listening to bowel sounds. Health care providers will inquire about the onset, nature, and progression of symptoms.
Further diagnostic steps often include imaging tests to visualize the intestines. Abdominal X-rays can reveal signs of obstruction or air in unusual places. A computed tomography (CT) scan provides more detailed images, helping to locate the twist and assess any bowel damage. Other tests like an upper or lower gastrointestinal (GI) series, which use contrast material, or an ultrasound, might also be performed to evaluate intestinal positioning and blood flow. Blood tests can help identify signs of infection or electrolyte imbalances.