The intestine, which is described as the second brain in our body, is one of the most important determinants of your health status, even if you are not aware of it. It has been proven by medical studies that this organ, which has the most nerve cells after the brain, is also very effective on our psychological health, such as depression and stress that affect our daily life.
So what happens when this important organ of ours gets knotted and becomes dysfunctional? This term, which is used as intestinal knotting or intestinal obstruction among the people, is referred to as volvulus disease in the medical literature. Let’s answer the questions like what is intestinal knotting, what are the symptoms, how is the treatment, in all details.
What is intestinal knotting (Volvulus), why does it happen?
First of all, what is intestinal knotting (Volvulus)?
When intestinal knotting occurs, a part of the intestines rotates around itself and creates intestinal obstruction by preventing both nutrition and conduction within the intestine. This can happen suddenly, or it can happen gradually. In the event that the disease progresses and is not promptly intervened, it can be life-threatening by causing irreversible tissue loss called necrosis. Intestinal knotting is a more common ailment especially in the newborn age group.
This condition, which occurs in 1 out of every 6,000 births, is a complication that occurs while the baby is in the womb. It usually occurs in newborn babies and young children as small bowel obstruction, while in adults it occurs in the form of large bowel knotting called sigmoid volvulus. In adults, it has been determined that men are more prone to this disease than women. This condition is more common in elderly people. It has been determined that the probability of this ailment is higher, especially in people over the age of 50 and in people who do not have the opportunity to move much during the day.
So what causes intestinal knotting?
- Intestinal enlargement more than normal
- ailments such as Hirschsprung’s disease,
- Some transition parts of the column are narrower than they should be,
- Abdominal adhesions (intra-abdominal adhesions) due to previous surgery, injuries or infections
- Chronic (long-term) constipation,
- Pregnancy,
- Intestine not attached to the abdominal wall
- Laxative, constipation-relieving drugs and fiber foods used for rapid digestion can also cause this ailment.
The main factor that causes intestinal knotting has not been fully revealed yet. Various diseases and anatomical causes are among the causes of intestinal obstruction.
Is intestinal knotting fatal?
Immediate treatment is required to prevent the bowel with volvulus from developing complications. It is life-threatening if not treated promptly. In this case, it can lead to infection in the blood called sepsis, stomach infection called secondary peritonitis, or short bowel syndrome caused by small intestine deficiency.
With early diagnosis and intervention, the possibility of serious complications is greatly reduced. Therefore, if you observe the signs and symptoms of this ailment in yourself or in your environment, it is recommended that you contact the authorized health institutions as soon as possible and apply to the physicians working in this field.
So how do I know if I have a bowel knot?
- bloody stool,
- Pain and tenderness in the abdomen,
- green bile vomit,
- Nausea,
- tension in the abdomen,
- Constipation,
- Inability to get gas
- bloating in the abdomen,
- inability to defecate,
- Rapid breathing with rapid heartbeat.
Intestinal knotting symptoms can begin intensely and suddenly. In this case, people should apply directly to the emergency services of hospitals.
Intestinal knotting in infants and children
Small intestine knotting in babies is usually caused by the way the intestines develop while in the womb. The intestine, which starts to form as a flat tube while the baby is not yet born, and bends over time, sometimes settles differently, causing knotting or bending. This condition, which occurs in 1 out of every 6,000 births, is called malrotation.
In such a situation, babies pull their knees to their stomachs and cry loudly and non-stop. High fever also accompanies these symptoms. In this process, it is important for parents to be very careful. Small bowel obstructions, which are generally seen in infants and children, can reach a life-threatening level. It is essential that they consult a doctor without delay. In addition to these symptoms, the following symptoms may also be present:
- Diarrhea,
- acceleration of the heart rhythm,
- difficulty in sucking,
- Sleepiness due to lethargy,
- crying attacks,
- Rapid breathing.
How is the diagnosis of intestinal knotting made?
Abdominal swelling due to knotting of the intestine can be detected by physical examination by a gastroenterologist. In addition, some radiological imaging may be requested to make the diagnosis and determine the severity of the disease. As a result of these tests, the normal condition of the intestine is evaluated and a conclusion is reached about the treatment to be performed. By using computerized tomography of the abdomen, the amount of intestinal knotting can be determined, as well as visualizing the knotted part of the intestine. In addition, detailed information about whether there is a hole in the intestine can be obtained by computerized tomography examination. Colonoscopy is also a method that allows the investigation of the covering layer that covers the large intestine directly through the eye.
A definite diagnosis of the disorder that causes knots in the large intestine is made by examining it with a special colonoscopy device. In this method, popularly known as abdominal x-ray film, the film is taken of the part between the pelvis and the diaphragm for the evaluation of the abdominal region. Obstructions, abnormalities and other problems in the small and large intestines can be examined in the film taken through the oral barium (a type of chemical used for stomach and intestinal imaging). Intestinal film taken through barium (a type of chemical used for stomach and intestinal imaging) given through the rectum as an enema, shows more detail with intestinal blockages, abnormalities and other problems.
How is intestinal knotting treated?
Volvulus is a condition that requires immediate attention and is usually treated surgically. However, in some cases, surgery may not be needed. In knots occurring in the sigmoid colon, the procedure called sigmoidoscopy may be preferred.
Air is given through the tube that is advanced to the lower parts of the large intestine and the folded intestine is straightened. Because of the recurrence of knots fixed in this way, permanent surgical treatment is more common.
So, is intestinal knotting surgery dangerous?
There are different surgical procedures that can be performed within the scope of intestinal obstruction surgery. For example, a colectomy operation is an operation that involves the removal of part or all of the intestine. In the lower segments of the intestinal knot, the damaged part of the intestine is surgically removed. Then the healthy intestinal segments are connected to each other. It is very unlikely that the knot will reoccur after this surgery. In order to correct the knotting, the incision made mostly from the midline of the abdominal wall is entered and the clogged area is corrected. As a result of the intervention to the knotted part, the blood flow in the region is restored. If the blood flow to the relevant intestinal segment has not occurred for a long time and this part of the intestine has lost its living tissue, the affected intestinal segment should be removed.
In some patients, due to the size of the removed intestinal segment, it may not be possible to connect the remaining healthy intestinal ends to each other. In such cases, holes are made in the abdomen with colostomy surgery and the intestinal flow is carried out to the outside of the body. Then, a colostomy bag is attached to this opening, allowing the digestive wastes to accumulate in the colostomy bag. The positive outcome of the treatment generally depends on how advanced the disease is and how early the operation is performed. Intestinal knots that cannot be diagnosed early or whose intervention stage is delayed can lead to infections that affect the whole body and serious complications such as sepsis.
In this content, we talked about the disease Volvulus, which is popularly known as ‘Intestinal Knotting’. What we describe is for informational purposes only. You can get the most accurate and specific information by consulting your doctor.
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