Volvulus is a condition that occurs when your bowel (which makes up your small intestine, colon, and rectum) twists around itself, causing a bowel blockage. This twist can block blood flow to the bowel, leading to severe damage if not treated quickly.

Several things can cause your bowel to become twisted, such as an enlarged colon, pregnancy, and underlying health conditions like multiple sclerosis. While volvulus is not common, knowing the warning signs is important so you know when to reach out for medical care and reduce the risk of complications.

Volvulus can occur anywhere in the gastrointestinal tract (the long tube in your body that connects your mouth to your anus). The exact type of volvulus you have will depend on where the twisting occurs. Every kind of volvulus can lead to serious complications if not treated promptly, so recognizing the signs and seeking medical attention early is crucial.

Sigmoid Volvulus

Sigmoid volvulus happens when the sigmoid colon, the part of the large intestine closest to the rectum, twists around itself. It’s the most common type of volvulus in adults. When the sigmoid colon and mesentery (the tissues that attach your intestines to the abdominal wall) twist, blood flow to that part of the colon can be cut off. As a result, you may experience severe pain, bloating, and constipation. If not treated quickly, this can cause serious problems like tissue damage, perforation (holes in the bowel), or infection, which can be life-threatening.

Cecal Volvulus

Cecal volvulus occurs when the cecum and ascending colon, which are parts of the large intestine, become rotated or twisted. This type of volvulus accounts for a smaller percentage of large bowel obstructions but can lead to serious complications if untreated.

Midgut Volvulus

Midgut volvulus is more common in infants and children and occurs when the small intestine and parts of the large intestine twist. This type is commonly associated with congenital malrotation, which happens when the intestines don’t develop properly before birth. In midgut volvulus, the intestines might be more prone to twisting or getting blocked because they’re not in their usual position.

Gastric Volvulus

Gastric volvulus is a rare condition in which the stomach twists on itself. This can occur when the stomach rotates at least 180 degrees. When this happens, your stomach can lose its blood supply, increasing your risk of serious complications. Urgent medical treatment is necessary for this condition.

Volvulus can cause a range of symptoms depending on its location and severity. Common signs include:

• Severe cramping
• Abdominal pain or tenderness
• Bloating
• Nausea and vomiting
• Constipation
• Diarrhea
• Changes in bowel movements
• Bloody stools
• Fever
• Signs of shock such as rapid heartbeat, low blood pressure, and dizziness

Certain conditions and situations can make you more likely to experience volvulus. Sometimes, it’s unclear why volvulus happens, but it can result from a mix of factors affecting the intestines. The most common risk factors for volvulus include:

• Intestinal malrotation: A congenital (meaning, present at birth) disability where the intestines are not positioned correctly
• Hirschsprung disease: A condition affecting colon nerve cells, leading to bowel movement problems
• Enlarged colon: An abnormal increase in the size of the colon
• Pregnancy: The growing uterus can push the intestines, leading to twisting
• Abdominal adhesions: Scar tissue from previous surgeries or infections can cause the intestines to stick together or tangle
• Conditions like Parkinson’s disease and multiple sclerosis: Movement disorders that can affect the bowels, especially if you’ve been hospitalized
• High fiber diet: Eating a diet with excess fiber intake, in combination with chronic constipation, can increase the risk of volvulus
• Chronic use of laxatives or enemas: Regular use of these medications can affect bowel movements and raise the risk of bowel rotation
• Myopathy: Muscle disorders such as Duchenne muscular dystrophy can be associated with a higher risk of volvulus

If you’re experiencing symptoms of volvulus, it’s important to seek care from a healthcare provider as soon as possible to reduce the risk of complications. At your appointment, you can expect your healthcare provider to ask about your symptoms and medical history. They may also perform a physical exam before ordering the following tests:

These tests can check for signs of infection, inflammation, and bowel obstruction. Your exact diagnostics will depend on your symptoms. Combining diagnostic methods helps your provider accurately identify volvulus and plan appropriate treatment.

The primary goal of treatment for a volvulus diagnosis is to fix the twisted part of your bowel so it starts to function properly. Your healthcare provider will always focus on strategies to prevent this condition from reoccurring in the future. Surgical and medical procedures are the most common treatments for this condition and may include:

• Sigmoidoscopy: This procedure uses a flexible tube with a camera to look inside the rectum and the lower part of the colon. While this is often a diagnostic test, a sigmoidoscopy can also help relieve the twist in some cases.
• Bowel resection: This surgery removes the twisted and damaged part of the bowel. Most providers prefer this method as it reduces the chances of volvulus coming back. However, older people with volvulus may benefit from a more minimally invasive surgery.

For cecal volvulus specifically, other treatments may include a cecopexy (which attaches the cecum to the abdominal wall) and right hemicolectomy (which removes the affected part of the colon).

Volvulus can’t be prevented if your bowel rotation is due to a congenital disorder that you were born with. However, there are some things you can do to prevent other types of volvulus from developing. These strategies include:

• Reducing your fiber intake
• Limiting the use of laxatives or enemas
• Getting treatment for chronic constipation

If not treated promptly, volvulus can lead to several serious complications. These include:

• Bowel ischemia: This occurs when the blood supply to the twisted part of the intestine is cut off, leading to tissue damage. Without proper blood flow, the affected parts of the bowel can start to die, which may require surgical removal.
• Bowel perforation: The bowel can tear if the pressure from the twisted bowel becomes too high. This perforation allows intestinal contents to leak into the abdominal cavity, potentially causing a severe infection called peritonitis.
• Sepsis: This serious infection spreads throughout the body and can occur due to bowel perforation, necrosis, or not receiving volvulus treatment on time. Sepsis is a life-threatening condition that requires immediate medical treatment and can lead to widespread organ failure if not promptly addressed.

Volvulus is a serious but rare condition that occurs when part of the bowel twists around itself, causing blockages and potential complications. With this condition, you may experience symptoms like abdominal pain, bowel changes, and vomiting. Early diagnosis and prompt treatment are crucial to avoid severe complications. This condition can be life-threatening, so if you or a loved one experience symptoms, it’s important to seek treatment right away.