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Twisted Bowel: Symptoms and Causes of Twisted Bowel Syndrome

Twisted bowel syndrome is characterized by abnormal intestinal twisting, and arises due to dietary factors, abnormal peristalsis, abdominal adhesions, etc. The current article describes this syndrome with respect to its etiology and symptoms.
Twisted bowel or volvulus implies an abnormal looping and twisting of the intestine (small or large), resulting in bowel obstruction. Such obstruction hampers intestinal blood supply, and may lead to death (necrosis) of the gut tissue.

Abnormal twisting of small intestine is termed as small bowel volvulus, whereas colonic volvulus refers to large intestinal twisting. Colonic volvulus is of two types - sigmoid and cecal - depending on the colonic region affected.

Given below are the causes behind such an abnormality, as well as the symptoms, diagnostic methods and treatment options available.

Symptoms
The symptoms experienced due to a twisted bowel may vary depending on the affected portion, extent of severity as well as age and medical history. In the initial stages, the individual may experience mild transient symptoms. However, if the problem persists for a long time, it may block the supply of blood, and hence oxygen and nutrients, to the remaining gastrointestinal tract. This severe medical condition is termed as intestinal strangulation, and may lead to bowel necrosis (death of bowel tissue), if untreated or ignored.

The common signs and symptoms associated with a twisted gut are:
  • • Nausea
  • • Abdominal pain
  • • Bowel sounds
  • • Constipation
  • • Bloating
  • • Flatulence
  • • Bloody stools
  • • Abdominal distention
  • • Abdominal tenderness

Causes

Precise cause behind the looping over of intestinal tissues is not clear. However, it has been attributed to the following causes:

► Increased Gut Motility
High intensity contractions of the peristaltic muscles may sometimes lead to twisting of certain intestinal parts. Such a high peristaltic tone can be the result of high-fiber diet, intestinal motility disorders or increased use of laxatives.

► Bulky Meals
A bulky bolus causes the intestinal part to loop or distend downwards. This can initiate a rotation in the peritoneal layers, and may lead to volvulus.

► Intestinal Malrotation
This is congenital condition involving an incomplete rotation of the intestine, resulting in abnormal intestinal positioning and shape. It has been observed that infants born with intestinal malrotation are at higher risk of developing volvulus.

► Diverticulosis
In this condition, protrusions arise from the intestinal lining, to form sac like structures called diverticula. Such sacs may be congenital (Meckel's diverticulum) or may develop later in life. The presence of multiple diverticula on a single part of the intestine causes it to distend out of position, and twist on itself, thereby causing volvulus.

► Abdominal Adhesions
Abnormal bands of tissue may develop between abdominal organs, due to infections or post-surgery complications. In women, bowel endometriosis (growth of endometrial cells in the intestines) may lead to the formation of such bands. These abdominal adhesions disturb the normal positioning of abdominal organs, and may introduce kinks and twists in the intestine.

► Other Causes
The development of volvulus may also arise during pregnancy or due to post-surgery complications or as a manifestation of certain intestinal cancers. It is also associated with old age and changes in dietary habits, etc.

Diagnosis and Treatment

Twisted bowel syndrome is diagnosed by conducting barium enema, stool analysis, and imaging techniques such as radiography, computed tomography (CT) and magnetic resonance imaging (MRI). Diagnostic or exploratory laparotomy, a minimally invasive surgical technique, may be advised to examine the abdominal organs.

The treatment options include surgical untwisting of the intestines through therapeutic laparotomy and laparoscopy. If necessary, the affected portion may be widened so as to prevent future complications. In severe cases, the necrotic part of the intestine is excised, and the healthy regions are joined together. Medications are often prescribed to avoid complications and infections.

Twisted bowel syndrome is a complex condition with an uncertain etiology. Although some causative factors have been identified, there exist instances wherein the precise cause cannot be identified. The incidence of twisted bowel is rare but serious, and demands an early diagnosis and treatment.

Disclaimer: This Buzzle article is for informative purposes only, and should not be used as a substitute for professional medical advice.
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Last Updated: January 15, 2013
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I had my gallbladder removed in late 2009. Its now 2014, and my stomach has developed a malicious hate for me. I have debilitating pain that alternates between my left side, and under my ribs. I'm nauseous constantly, and have vommited a few times. I can't eat very much, even though I'm starving, for fear of getting sick. I wake up several times at night because I am in so much pain. I've had 4 ct scans in the last 4 months, despite not having insurance, and making less than $500 a month. I can't handle this pain anymore. They can't find anything, its starting to look like I'm crazy. But I swear, I know my body. I've been dealing with this for the last year. Last time this happened, when they finally gave in and actually tested me, my gallbladder had to be removed immediately. I'm only 23 years old, please, help me? Please! - Rachael [April 15, 2014]
What if after a surgery, you are told, the surgeon "nicked a nerve and left you with a droop in your bowel ", by your family doctor who didnt report the surgeon. Bowel problems ensued, complaints made to no avail, 25yrs later, bowels distended, almost nothing can get out, what then? - jane doe [February 18, 2014]
My husband has had a twisted bowel in the past. He suffers from diverticulitis. He is currently having symptoms of rectal bleeding( day 4), abdominal cramping (4 days)), nausea (4),.He refuses to seek treatment because of piling medical bills for me due to a G.I. bleed last March. I told him that a funeral is also expensive. I believe he is scared with this but he knows what complications can arise by NOT being seen by E.R. docs ( he doesnt have a regular gastro doctor. Am lost on what to do...short of knocking him out and driving him to the hospital. Any suggestions from the medical/psych docs? - Tamara [January 9, 2014]
I had an operation in 2007 to remove a cancer tumour in my Lymph Nodes then 4 years later the adhesions from the original operation had interfered with my Bowel. the Bowel became twisted and caused excrutiating pain. I had an operation in which they removed 10 cm of Bowel. The Bowel operation isn't too bad (compared to what i had had in 2007) and the recovery was quick. The Surgeoon has said that due to haveing 2 operations in the same region that there is a good chance of the problem recurring every few years. Diet seems to be quite important and lifestyle changes a small bit. Eating foods that aren't going to block or cause problems in the bowels help. It's been 2 years since the Bowel operation and each belly pain does scare you a bit but why worry about something until it happens. - Stuart [January 4, 2014]
i had a laparotomy for bowel resection 7 weeks ago today i have still got infection in the wound been on 3 different antibotics and now i have a herina i am 56 quite fit not over weight should i still have infection i am fed up - yvonne henwood [January 4, 2014]
I had a kidney stone removed and the nerve to my left stomach muscles was cut by the surgeon. As a result I now have a large incisional hernia. What are my chances of avoiding a twisted gut? - Mike [December 30, 2013]
I have just come back from hospital after having emergency bowel surgery.
I was admitted with severe pains and operated on 6 hrs later where the bowel was untwisted and 10 cm was removed because it was so damaged.
The surgeon basically said it was the hernia repair that caused the problem. The mesh that was put in 2 months earlier had adhesed itself to the lower intestine wall.
It hopefully is repaired now. But I am paranoid of it happening again as now there is more scar tissue.
How can I regularly check if the bowel is not twisting or adhesed itself together.
How can I prevent it happening. Does intensive yoga increase the chances of this occurring with body twists?
Thanks
- Lula [November 20, 2013]
I just found this site. Though my response is to the following post in January 2013; this may help others: "i have had abdominal pain on my left side for nearly 5 years now after a lot of scans all they said was i had a malformation of the bowel a hiatus hernia and gastritis but they said these should not be causing me the amount of pain i am in no end of medication helps ease the pain and they have tried many :( - Annonymous [January 19, 2013]"

If you have documented Congenital Bowel Malrotation and having symptoms need to find a doctor that will listen to you (need surgeon). This defect should have been identified at birth. If you are truly receiving potent narcotics for pain and not getting relief this is a red flag of possible bowel ischemia which is lack of blood supply to tissues (If narcotic dependent--could skew perceived pain relief). Signs can be very sneaky at first then when it is crystal clear there just might be complete bowel obstruction and a much bigger problem. You have to be your own advocate. Get your test reports know what they say before you go back to discuss with doctors. Just because a diagnostic imaging report has reported something "normal" does not mean it is correct. Ask for a re-evaluation of scans if you have. These reports are only as good as the persons ability to read the scans correctly. Ask questions and be persistent.
- Unknown [November 3, 2013]
I didn't feel good for months and my groin hurt bad,and pains in my right side of my body! I was sick in my stomach and would get sick in my stomach and sometimes would vomit-I had no energy at all! Iwas rushed to the hospital and they did emergency surgery! But before surgery the outcome was grim-blood supply not working and the twisted knot was filled with gangerine that was about 8 inches long and if the toxic disease spread it would be fatal. I was so hurting and they ran me down the hall and when surgery was over I was very much in pain and shocked to my body-My Dr did also a exploratory and I was blessed that it didn't spread to other organs-Talk about Blessed I cant thank my Dr for saving my life! Recovery is very slow and pretty unpleasant-Its going to take time to retrain my bowel! - Deb S. [June 6, 2013]
i have had abdominal pain on my left side for nearly 5 years now after a lot of scans all they said was i had a malformation of the bowel a hiatus hernia and gastritis but they said these should not be causing me the amount of pain i am in no end of medication helps ease the pain and they have tried many :( - annonymous [January 19, 2013]
my daughter-in-law suffers from stomach pain,vomiting and gloating of stomach frequently say once every 2 months.She underwent operation while trying to donate her liver in 2006. Abdominal adhesions may be the cause.The pain disappears in 1day. this time the intestine twisting has not detwisted even after 12days.She is on drips since even liquids taken orally,she vomits.What is the solution? - V.R.SASTRY [February 27, 2012]
i have adheison on my bowels should i be worry about them.also i have a lot of pain in my luq - joann [December 16, 2011]
If a patient had a bowel obstruction from a twisted bowel - had surgery, removed part of the colon, had a colostomy bag and did not seem to have pain - is this normal? - Carol Doucette [October 16, 2011]
My nanna had a twisted tummy as a result of being left to long at the hospital that was meant to be taking care of her as she battled cancer. She went in the hospital walking and talking fine and after they neglected her so much she never walked and died a week later - Charlotte [July 10, 2011]
I am a male, 74 years of age and had twisted bowel 52 years ago. Two daughters of mine have also had twisted bowel. A grandaughter has recently had the same and has been extremely poorly, and yet the powers that be say that it is not hereditary, has anybody got any comments to make. - G. D. McGrath [July 4, 2011]
Some of this is correct,however you have not mentioned adhesions or endometrioious that can cause a twisted bowel. And the pain is very severe - Jenny Hasler [June 6, 2011]
Thanks so much for this info. I think i have just found my problem. - Jess [April 17, 2011]
motivating write-up. what of differential diagnosis? - oprah [April 4, 2011]
I have been told i have this but my gp has yet to get back to me for an op? I am 17 years old what do i do? - Jodie [April 1, 2011]
I recently underwent a twisted bowel surgical procedure. It came on quite suddenly...Is it possible that being on the HCG DIET DROPS as well as taking bio identical hormones could have been the cause...I hope you can answer this for me... SOOZIE IN FLORIDA - SOOZIE S [March 19, 2011]
Oka lol thanks x - emma x [March 13, 2011]
Sorry, I forgot to put that this is my niece that is only 37 hrs old. - Jennifer [February 14, 2011]
what if the small intestins are dead? - jennifer [February 14, 2011]
I have been to the Dr 3 times in 3 weeks, started with severe constipation, I was given a clear liquid to take, it didnt seem to do anything, on my second visit (different Dr) he gave me sachets of white powder to take 3 times a day, after 2 days such a small amount of feces very loose came away, on the 3rd day I did curry for my family and decided I would try about a tablespoon, the following day, I woke with tummy ache, I went to the loo, and felt as though I had been properly even though it was still runny. After that back to usual little bits swollen belly, feeling tired, pain in left groin, really feel unwell, back to Dr today, she (another Dr) decided I had a bladder problem and gave me anti biotics? Think I will go back Monday and insist on hospital appoint - Anne [January 27, 2011]
The symptoms you show for twisted bowel are exactly what my mum was suffering. She was already diagnosed with Diverticular Disease and they thought that her ongoing pain was diverticulitis. Today she had emergency surgery, they thought her bowel had perforated and her chance of survival was 5% - turns out it was twisted bowel. Hopefully she will pull through OK now, and I hope that the obvious symptoms (D&V, nausea, dizziness, bloating, severe pain) will go away, along with the very painful back that she has been complaining about for months and months...which she thought was just trapped wind. - ED SMITH [November 25, 2010]
Have had a sharp pain in right side off my back for 3 days, un able to move some times due to the pain . This morning wake up and the pain is in the right side off my stomach , both pains are like a knife is being stabbed into these areas. When i cough or sneeze the pain is worse. - david [October 24, 2010]
Doc says,"you have a twisted colon you to eat more fiber fruits and vegetables not much meat.; if you follow this you will be happier with the having of less pain in your stomach." dont they have someone who can sit down and explain exactly what to eat or not to eat. He evven told me dont eat pasta or only a little and make sure it is high in fiber. Okay new word in my vocabulary so i research what I can and study this is only my first stop. - Danna [October 13, 2010]
Once a day is enough. Dont listen to the media. - Simmo [August 12, 2010]
In other words, you dont know. I know! People eat too often - Simmo [August 12, 2010]
I HAVE JUST HAD SURGERY FOR TWISTED BOWL THE CELLS HAD DIED I NEED TO KNOW WHAT IMPACT THIS WILL HAVE ON MY BODY WILL THE DEAD BOWL MAKE MY BODY TOXIC THEY ALSO TOOK MY APENDIX OUT BUT WHAT I NEED TO KNOW WHAT HAPPENS WHEN IF YOU STOP BREATHING DURNING A OPERATION AS THIS HAPPEND TO ME AS WELL I HAVE LEFT THE GOLD COAST HOSPITAL WITH MANY QUESTIONS I ALSO SPENT MY FIRST 24 HOURS IN THE EMERGANCY DEPARTMENT I CAME IN ON WEDNESDAY NIGHT AND DIDNT HAVE OPERATION UNTIL 1.00 PM FRIDAY AND SENT HOME BY MONDAY MORNING I STILL FEEL SICK I WAS GIVEN A SCRIPT TO FILL ALSO - ROBBIE MCINTYRE [July 19, 2010]
My grandmother is in hospital with a twisted bowel and I'm wondering if the bowel can be drained at all to relieve discomfort? - Michelle [July 9, 2010]
was trying to locate info on twisted bowel syndrome...found good info here thank you very much - dennis c [May 1, 2010]
I hv suffered a twisted bowel and went through surgery, however at time of surgery the situation had corrected itself. It was also observed that there was a healing lesion to the intestine. However, I hv lost appetite and did not get much guidence in terms of diet to follwo. Any suggestions pse - Mark M [April 28, 2010]
Could a severe Fall cause this condition? - cindy [December 23, 2009]
very imformative. especially to read when home from hospital and can take info onboard - deborah hall [October 2, 2009]
This article is so informative and alerts people of the primary and secondary risks of dying.I know someone who as just had a twisted bowel and is recovering and he had a laporotmy - joseph Peka [September 25, 2009]
my father who is 83yrs old has just be diagnosed with twisted bowel what are his chances of full recovery? - Tonny Duncanson [August 14, 2009]