How Do You Treat a Twisted Bowel?

A twisted bowel is a serious condition that needs quick care. Your treatment plan depends on where the twist is in your intestine and your overall health. Explore the options, then talk with your doctor to figure out the best option for you.

What Is Twisted Bowel?

Your doctor may call it volvulus. It happens when your intestine twists around itself or the tissue that holds it in place. The affected spot blocks food and liquid from passing through. It may even be tight enough to cut off blood flow. If this happens, the tissue in that area of the intestine can die. That can cause serious problems.

The most common form of twisted bowel is sigmoid volvulus. It’s the twisting of the last part of your colon, called the sigmoid colon. It can also happen in the beginning of the large intestine (the cecum and ascending colon). If it's twisted there, that’s called cecal volvulus.

Nonsurgical Options

In some cases, you won't need surgery to straighten things out.

If the twist is in the sigmoid colon, your doctor may first try a sigmoidoscopy. He’ll put a flexible tube (or sigmoidoscope) through your rectum and into the lower part of your colon. Small amounts of air get pumped into the colon to open it. This is usually enough to straighten your intestine. But the chance of the bowel twisting again in the same spot is very high. Your doctor may suggest surgery as a permanent solution.

A similar procedure, colonoscopy, can fix twists in the beginning of the colon. But the chance of it twisting again is high. Most cases in this area need surgery.

Surgeries

Surgery is an option to treat volvulus and stop the intestine from twisting again. Types of surgeries for twisted bowel include:

Colectomy: This is a surgery that removes all or part of your colon. For a twist in the lower colon, your doctor will take out the affected part of your intestine. Then, he’ll put the two healthy ends together in a procedure called bowel resection. The chance of volvulus coming back after this surgery is very low.

Continued

If you have cecal volvulus, the beginning of your large intestine is removed, including the cecum and ascending colon. The part that's left is then attached to the end of your small intestine.

Colostomy: Like a colectomy, this surgery involves taking out the twisted portion of the lower intestine. With a colostomy, instead of putting the two parts of the colon back together, one end attaches to a hole made in your belly. Then a colostomy bag gets attached to the opening to catch bodily waste.

If you show signs of infection or other serious symptoms from a twisted bowel, your doctor may do what’s called a Hartmann procedure. It’s the same as a colostomy, except that it can be reversed in 3 to 6 months if you’re feeling better.

Cecostomy: The twist in the beginning of the colon gets straightened out. Then, your doctor puts a thin tube in your cecum through a small cut in your belly. The tube helps get rid of waste and attaches your cecum to your stomach’s inner wall.

People with cecal volvulus may get a cecostomy if they’re not healthy enough for other surgeries. Your chance of an infection is high, but your colon probably won’t twist again.

Cecopexy: This can also treat cecal volvulus. Doctors will untwist the beginning of the colon and stitch it to the inner belly wall. After this procedure, there's a high chance the same area will twist again. So it's usually saved for people whose condition is unstable.

WebMD Medical Reference Reviewed by Minesh Khatri, MD on December 10, 2017

Sources

SOURCES:

The National Institute of Diabetes and Digestive and Kidney Diseases: “Anatomic Problems of the Lower GI Tract.”

Medscape: “Sigmoid and Cecal Volvulus Treatment & Management.”

Diseases of the Colon & Rectum: “Clinical Practice Guidelines for Colon Volvulus and Acute Colonic Pseudo-Obstruction.”

Mayo Clinic: “Flexible Sigmoidoscopy,” “Colectomy,” “Colostomy.”

Clinics in Colon and Rectal Surgery: “Management of Colonic Volvulus.”

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