Intestinal knotting, also known as volvulus, occurs when the intestine twists around itself or around the tissue holding the intestine in place. It is among the causes of intestinal obstruction. While the flow of food and fluids can be blocked in the area where the knot is located, this can progress to stagnation of blood flow. As a result of stagnation of blood flow, the tissue in that area may die. While it can usually be seen in infants and children, it is a problem that requires urgent medical intervention.
Intestinal obstruction, which is common in infants and children, can manifest itself with symptoms such as severe crying and rapid breathing. After the development of volvulus, some discomforts that may occur suddenly may occur in the person.
Why does intestinal knotting occur?
Although the causes of intestinal knotting are not completely clear, there are some factors that increase the risk of occurrence. This condition can be seen mostly due to advancing age. In addition, since it is more common in men than women, the gender factor can also be taken into consideration.
Neurological and psychological factors are also thought to be linked to this condition. It can occur in people who are exposed to situations such as stress for a long time. Although the underlying cause of the disease has not been fully determined, a number of diseases and certain conditions may be among the causes.
Its occurrence in infants in the neonatal period may be caused by a condition that causes serious problems as a result of impaired blood circulation in the intestine. This condition is called malrotation. While it can be life-threatening, it can lead to knotting or blockage of the intestines.
While it can usually be seen in infants and children, it is a rare condition in adulthood. Factors among the reasons for its occurrence in adults are as follows:
- Colon enlargement
- Intra-abdominal adhesions resulting from surgical intervention or infection
- Hirschsprung's disease
- Narrowing in the transition zones of the column
- Constipation (chronic and prolonged)
- Pregnancy
- Old age
- Gender factor (more likely to occur in men)
Hirschsprung's disease is a congenital dilatation of the large intestine that can result in the lower rectum being unable to pass stool.
It can also be caused by a number of diseases, disorders and physical problems. In some cases, it can also develop spontaneously, so the person should be careful. If symptoms and complaints begin, a doctor should be consulted and treated immediately.
What are the symptoms of intestinal knotting?
Symptoms of intestinal knotting can manifest themselves suddenly and severely. While people may experience intense pain in such cases, they usually go to the emergency services of hospitals and report the situation. While pain is usually experienced in the abdomen, other symptoms that occur in adults can be listed as follows:
- Cramps and pain in the abdomen
- Abdominal swelling and tension in the area
- Nausea and vomiting
- Loss of appetite
- Blood in the stool
- Constipation
- Inability to pass gas
The symptoms observed in infants may be different from the complaints experienced by adults. The symptoms that occur in infants are as follows:
- Sudden onset of severe crying spells
- Pulling the legs towards you and movement of the legs
- Tendency to sleep
- Accelerated breathing and rapid heartbeat
Diagnosis of Intestinal Knotting
A doctor's examination is required after symptoms appear in people. The doctor may ask some questions and take a medical history to get information about the person's condition.
After the physical examination, the doctor may prefer an abdominal X-ray or some imaging techniques to detect the disease. Imaging techniques such as computed tomography (CT), ultrasound or colonoscopy may be used.
The specialist may also use enemas to clarify the situation. In addition, a number of tests may be required and methods may be applied. Some of the methods used to diagnose intestinal knotting are as follows:
- Some blood tests
- Some tests for the examination of bloody stool
- Barium X-rays
- Sigmoidoscopy
During sigmoidoscopy, which is used to identify obstructions in the large intestine, the intestine can return to its normal state. However, this method is not included as a treatment method and is used in the diagnosis of the disease.
Intestinal Knotting Treatment
Intestinal knotting is a condition that requires urgent medical intervention and treatment. In treatments, operations are usually performed to correct the intestine and the developing obstruction. Treatment of intestinal knotting is mostly performed by surgery and surgical methods.
Bowel knot surgery
In order to remove the knot in the intestines and correct the condition, an incision is made in the abdominal wall, usually in the midline, and the intestine is entered through this incision. With the surgical operation, blood flow is restored in the corrected area.
In areas where blood flow has not been restored for a long time and blood cannot be delivered, the section of the intestine must be removed because it is no longer viable. In some cases, it may be difficult to join healthy ends together because of the large size of the problem area.
The surgeon can connect the ends of the intestine to openings in the abdominal wall called stomas. Through the colostomy stomas, the person can pass stool. This can be temporary or permanent.
Nutrition after bowel knot surgery
Among the complaints seen after surgery are diarrhea and fluid loss problems. It is a problem caused by the loss of intestinal function. For this reason, the person may need to consume foods such as boiled rice and potatoes, bananas, pasta, white bread and yogurt after surgery.
However, people who may be allergic to any of these foods should definitely get information from their doctor for postoperative nutrition.
What is good for intestinal obstruction?
The treatment method is usually done with surgical interventions and operations. It is a condition that needs to be treated urgently. However, surgical intervention may not be necessary in some cases.
In knots that occur in the sigmoid colon, a procedure called sigmoidoscopy, which is among the imaging methods, can be performed. While the intestines may improve during this procedure, this condition may recur afterwards.
For this reason, it is not considered a permanent solution and treatment with surgery may be required later. Patients treated with surgery achieve a permanent solution.