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Last Updated on November 26, 2025 by Bilal Hasdemir
A twisted intestine, also known as volvulus, happens when a part of the bowel or colon twists around itself. This twisting can block the intestine. It can affect both the colon and the small intestine. The sigmoid colon is most often affected in adults.
At Liv Hospital, we know how serious this condition is. It can cause severe pain, bloating, and other problems. Our team works hard to give the best care and support to those with this issue.Discover what causes twisted intestine in humans. Get the shocking facts on how a volvulus happens and what the major risk factors are.
A twisted intestine, or volvulus, happens when a part of the intestine twists around its base. This can cut off blood flow. It can cause severe problems, like tissue damage and death.
Volvulus is a serious condition where a part of the intestine twists. This can block the intestine and cut off blood flow. It can happen in different parts of the gut, like the small intestine or the colon.
The twist can go either way and might block the intestine. If not treated quickly, it can cause serious damage and even be life-threatening.
Intestinal volvulus can be classified by where in the intestine it happens. The most common types are:
| Type of Volvulus | Commonly Affected Population | Characteristics |
| Sigmoid Colon Volvulus | Older adults, especially men | Common in regions with high-fiber diets |
| Cecal Volvulus | Younger adults, often associated with anatomical abnormalities | Can be associated with previous surgeries or malrotation |
| Small Intestine Volvulus | Can occur at any age, often related to adhesions or congenital anomalies | May present with acute abdominal pain and obstruction symptoms |
Volvulus rates vary by place and are affected by diet, age, and health issues. For example, sigmoid colon volvulus is more common in some parts of Africa, Asia, and South America. This is because diets there are often high in fiber.
In the United States, volvulus can happen to anyone, but some groups are at higher risk. Older adults are more likely to get sigmoid colon volvulus. Younger people might get it due to birth defects or other health problems.
To understand intestinal twisting, we must first know how the intestines work. The intestines are key in our digestive system. They break down and absorb nutrients from our food.
The intestines split into two main parts: the small intestine and the large intestine. The small intestine is long and thin, with the duodenum, jejunum, and ileum. It’s where most nutrient absorption happens.
The walls of the small intestine have villi, which increase its surface area for absorption. The large intestine, or colon, is wider and shorter. It absorbs water, stores feces, and ferments undigested carbs.
The mesentery is a membrane that attaches the intestine to the abdominal wall. It supports the intestines and contains blood vessels, nerves, and lymphatic vessels. The mesentery is key to the intestines’ function and position.
Intestinal motility is the movement of the intestines. It mixes food with digestive enzymes, absorbs nutrients, and moves waste. This motility is vital for digestion and preventing issues like constipation.
In summary, knowing how the intestines work is crucial for understanding intestinal twisting. The structure of the intestines, the role of the mesentery, and normal motility all play a part in digestion and nutrient absorption.
It’s important to know what causes a twisted intestine. This condition, also known as volvulus, can happen for many reasons. These reasons affect how the intestines work and their shape.
Congenital malrotation is when the intestines don’t rotate right in the womb. This leads to intestines that are not in the right place in the belly. This can make twisting more likely, especially in babies and young kids.
Adhesions are like sticky bands between the intestines or other organs. They can come from surgeries, infections, or inflammation. Over time, these adhesions can twist the intestines, causing a volvulus.
Chronic constipation can also lead to a twisted intestine. When stool stays in the intestines too long, it can twist them. This is especially risky for older adults or those with motility disorders.
Key factors associated with chronic constipation include:
Knowing these causes helps prevent a twisted intestine. Eating well, drinking enough water, and managing health issues are key steps.
Some health issues can make people more likely to get a twisted intestine. This is a serious problem that needs quick medical help. We will look at the health conditions that raise the risk of a twisted intestine.
Hirschsprung’s disease is a birth defect where some parts of the colon and rectum lack nerve cells. This makes it hard for stool to pass through, causing a buildup. This buildup can lead to the intestine twisting.
Key aspects of Hirschsprung’s disease include:
Crohn’s disease is an inflammatory bowel disease that can affect any part of the gut. It causes inflammation, which can lead to narrowing of the intestine, fistulas, and a higher risk of twisting.
The relationship between Crohn’s disease and volvulus is complex:
Megacolon is when the colon gets very big, often because of long-term constipation or blockage. This big colon is more likely to twist, increasing the risk of volvulus.
The link between megacolon and intestinal twisting involves:
Knowing about these conditions and their link to twisted intestines is key for early treatment. By understanding the risks of Hirschsprung’s disease, Crohn’s disease, and megacolon, doctors can take steps to prevent twisting and manage its effects.
Knowing the risk factors for twisted intestine can help prevent it. Several factors increase the chance of getting a twisted intestine. These include age, certain mental health disorders, diet, and weak colon structure.
Getting older raises the risk of a twisted intestine. Older people are less active and may eat differently. They also have more health issues. Older adults often have chronic constipation, which can lead to a twisted intestine.
Some mental health conditions raise the risk of a twisted intestine. Diseases like Parkinson’s and multiple sclerosis can cause it. These conditions can change how the bowel moves, making twisting more likely.
“The presence of neuropsychiatric disorders can significantly impact bowel habits and increase the risk of intestinal volvulus.”
Diet is key in twisted intestine risk. High-fiber diets are good but can raise volvulus risk in some. A sudden fiber increase can change bowel habits and cause twisting.
A weak colon is a big risk factor. Conditions like chronic constipation or past surgeries can weaken it. Weakened areas are more likely to twist under pressure.
Understanding these risks is crucial for early detection and treatment. Healthcare providers can take steps to prevent twisted intestine. They can also watch for early signs to avoid complications.
To understand how the bowel twists, we need to look at how intestines move. This twisting, called volvulus, is a complex issue. It involves several important factors.
The twisting of the intestine happens when a part of it rotates abnormally. This can be due to how it developed or changes that affect its structure.
Key factors contributing to the rotation process include:
Intestinal mobility and peristalsis are key in bowel twisting. Peristalsis is the movement that pushes contents through the intestine. If this is disrupted, twisting can occur.
Factors influencing intestinal mobility and peristalsis include:
Mechanical factors also play a big role in bowel twisting. These include adhesions, the length and mobility of the mesentery, and any masses or lesions that can cause obstruction or twisting.
Mechanical factors to consider:
| Factor | Description |
| Adhesions | Scar tissue from previous surgeries or inflammation |
| Mesenteric length and mobility | A longer or more mobile mesentery can increase the risk of twisting |
| Masses or lesions | Tumors, cysts, or other abnormalities that can cause obstruction |
Intestinal volvulus can happen in different parts of the gut. Each area has its own risks and symptoms. Knowing where volvulus can occur helps doctors treat it better.
The sigmoid colon is the most common spot for volvulus in adults. It’s more common in older people and in places like Africa, the Middle East, and South America. It’s linked to constipation, eating a lot of fiber, and some brain disorders.
Cecal volvulus happens when the cecum twists. It’s not as common as sigmoid colon volvulus but still causes a lot of problems. It often happens in people with unusual cecum shapes.
Small intestine volvulus is less common but can happen, especially in kids and young adults. It’s often linked to birth defects or malrotation.
Transverse colon volvulus is very rare. It makes up a small part of all volvulus cases. It’s usually seen in people with a long, floppy transverse colon. It can be caused by constipation or eating too much fiber.
| Location | Frequency | Common Associations |
| Sigmoid Colon | Most common in adults | Chronic constipation, high-fiber diet, neurological disorders |
| Cecum | Less common | Anatomical abnormalities, mobile cecum |
| Small Intestine | Less common, often in children and young adults | Malrotation, congenital anomalies |
| Transverse Colon | Rare | Redundant transverse colon, chronic constipation, high-fiber diet |
Knowing where volvulus happens and its causes is key to treating it well. Each area has its own risks and symptoms. Doctors need to tailor treatment to each case.
It’s key to spot the signs of bowel twisting early to avoid serious issues. Bowel twisting, or volvulus, shows itself in many ways, from mild to severe.
Symptoms of bowel twisting fall into two groups: acute and chronic. Acute symptoms come on fast and are serious, needing quick doctor visits. They include sudden stomach pain, vomiting, and constipation. Chronic symptoms take longer to show up and can come and go, making it harder to diagnose.
Stomach pain is a big sign of bowel twisting. The pain can be in one spot or all over and can change in strength. Sometimes, the pain feels like waves. Knowing how the pain moves can help figure out what’s wrong.
Digestive issues are also common with bowel twisting. These can be nausea, vomiting, and changes in how often you go to the bathroom. Sometimes, the belly will look bigger than usual.
Some symptoms mean you need to get help right away. Look out for severe stomach pain, bloody stools, fever, and signs of shock like pale skin or a fast heartbeat. If you see these, call for help fast.
Knowing these signs is important to avoid bigger problems.
Key Takeaways:
Ignoring a twisted intestine can cause serious problems. The blood flow to the twisted part can be cut off. This can lead to severe issues.
Untreated intestinal twisting can cause ischemia. This is when the intestine doesn’t get enough blood. It can also cause tissue death due to lack of oxygen and nutrients.
If not treated quickly, it can lead to intestine perforation and peritonitis.
Intestinal ischemia symptoms include:
Bowel perforation happens when the twisted intestine bursts. This spills its contents into the belly. It can cause peritonitis, an inflammation of the belly lining.
Peritonitis is a serious condition that can turn into sepsis. Sepsis is a deadly reaction to infection. It needs immediate treatment.
The symptoms of peritonitis and sepsis include:
Even after treatment, intestinal twisting can cause long-term problems. These include chronic pain, bowel obstruction, and malabsorption of nutrients. Sometimes, part of the intestine may need to be removed, leading to short bowel syndrome.
| Complication | Description | Potential Consequences |
| Intestinal Ischemia | Reduced blood flow to the intestine | Tissue necrosis, perforation |
| Bowel Perforation | Rupture of the intestine | Peritonitis, sepsis |
| Peritonitis and Sepsis | Inflammation of the peritoneum and systemic infection | Life-threatening, organ failure |
| Long-term Complications | Chronic issues following treatment | Chronic pain, bowel obstruction, malabsorption |
We stress the need for quick medical help to avoid these problems. Early treatment can greatly improve outcomes for those with intestinal twisting.
Diagnosing intestinal volvulus needs a detailed approach. This includes clinical evaluation, imaging, and lab tests. We will explain how to identify this complex condition.
The first step is a thorough clinical evaluation. We look at the patient’s medical history for symptoms like abdominal pain and vomiting. A physical exam is also key, checking for tenderness and swelling.
We also consider the patient’s overall health and past surgeries. This helps us figure out if they might have intestinal volvulus. It guides us to the next steps in testing.
Imaging is crucial for diagnosing intestinal volvulus. We use X-rays, CT scans, and ultrasound to see the intestines. These help spot twists or blockages.
CT scans give detailed views of the abdomen. They help us see how bad the volvulus is and if there are complications. Sometimes, a barium enema is used for sigmoid colon volvulus.
Laboratory tests are key in diagnosing intestinal volvulus. We do a complete blood count (CBC) to check for infection signs. We also check for electrolyte imbalances from vomiting or blockage.
These tests, along with clinical evaluation and imaging, help us make an accurate diagnosis. This allows us to create a proper treatment plan.
There are many ways to treat a twisted intestine, including emergency care, surgery, and non-surgical methods. The right treatment depends on how bad the twist is, the patient’s health, and if there are any complications.
For acute intestinal volvulus, quick emergency care is key. It helps prevent serious problems like ischemia and necrosis. Emergency decompression is often done to clear the blockage and get blood flowing again.
Doctors say, “Quick action is vital to avoid long-term harm and better patient results.”
“The goal of emergency treatment is to stabilize the patient and prepare them for further management, whether surgical or non-surgical.”
Medical Guidelines
Surgery is often needed to fix the twisted intestine and any underlying problems. Surgical options include:
| Surgical Procedure | Description | Indications |
| Resection | Removal of the affected bowel segment | Necrosis or significant damage |
| Detorsion | Untwisting the intestine | Viable bowel with minimal damage |
| Pexy | Fixing the intestine in place | Recurrent volvulus |
For some, non-surgical care might be the best option. This is especially true for those who can’t have surgery or have a mild twist. Non-surgical care includes:
Non-surgical management is often used in conjunction with other treatments and is tailored to the individual patient’s needs.
How well a patient recovers from a twisted intestine depends on many things. These include how quickly and well they were treated, if there were any complications, and their overall health.
When treating patients with twisted intestine, it’s important to give them full care. This care should meet their immediate needs and help them in the long run. By knowing all the treatment options, we can help patients get better and reduce the chance of serious problems.
Understanding the causes and symptoms of intestinal volvulus is key. We’ve talked about why the intestine twists, like congenital malrotation and adhesions. Chronic constipation also plays a role.
Preventing intestinal volvulus is possible with a healthy diet and managing chronic conditions. At Liv Hospital, we focus on comprehensive care for these patients. Awareness and timely action are crucial.
Managing twisted intestine needs a team effort. This includes emergency care, surgery, and non-surgical treatments. By focusing on prevention and management, we can help patients recover better and avoid long-term problems.
If symptoms don’t get better or get worse, seek medical help. With the right care, patients with intestinal volvulus can get better and live a healthy life.
A twisted intestine, or volvulus, is a serious issue. It happens when a part of the intestine twists around its base. This cuts off blood flow and can cause tissue death.
Several things can cause a twisted intestine. These include being born with a twisted intestine, scar tissue, chronic constipation, and diseases like Hirschsprung’s and Crohn’s.
Symptoms of a twisted intestine vary. They can include severe pain, nausea, vomiting, constipation, and swelling. In bad cases, you might see bloody stools, fever, and very tender stomach.
To diagnose a twisted intestine, doctors use several methods. They do a physical check, take X-rays, CT scans, or MRI, and run lab tests. This helps figure out how bad it is and rule out other problems.
Treatment for a twisted intestine can be urgent. It might involve surgery to fix the twist. Sometimes, not surgery is needed. The best choice depends on how bad it is and the patient’s health.
If not treated, a twisted intestine can cause serious problems. These include damage to the intestine, holes in the bowel, infection, sepsis, and long-term issues like blockages or adhesions.
While some risks can’t be avoided, there are steps to lower the chance of a twisted intestine. Eating well, managing health conditions, and seeing a doctor quickly for symptoms can help.
The bowel twists due to several reasons. These include how the intestines move, their function, and mechanical issues. Conditions affecting the intestines can trigger the twisting.
Intestinal volvulus can happen in different parts of the intestine. Common areas include the sigmoid colon, cecum, small intestine, and transverse colon. Each area has its own risks and characteristics.
The mesentery is key in supporting the intestines and helping them work. Problems with the mesentery can increase the risk of twisting.
Diet can affect the risk of a twisted intestine. Eating a balanced diet and healthy foods is important for keeping the intestines healthy.
Antoniv, M., et al. (2025). Impact of Multi-Institutional Enhanced Recovery after Surgery (ERAS) on morbidity following elective colorectal surgery: A retrospective cohort study. Annals of Surgery. https://pubmed.ncbi.nlm.nih.gov/39812414/
