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What is Volvulus? Know about Types and Treatments
Written by Medicover Team and Medically Reviewed by Dr U M Rao Srungavarapu , Gastroenterologists Medical
Volvulus is a condition where a loop of the intestine twists around itself and the surrounding tissue, causing an intestinal obstruction. It primarily affects the colon or small intestine and can lead to reduced blood flow, tissue damage, and digestive complications.
What Are the Symptoms of Volvulus?
Volvulus symptoms can appear suddenly and range from mild discomfort to serious complications. Early detection is important to avoid problems like tissue death or bowel perforation.
Common Symptoms
- Nausea and vomiting
- Constipation or trouble passing gas
- Feeling full even after eating a small meal
- Rapid heartbeat or low blood pressure
- Fever, which may signal infection
What are the Different Types of Volvulus?
Volvulus is classified based on where the intestine twists. Each type has its own symptoms and risks.
- Sigmoid Volvulus: The most common type. It affects the sigmoid colon and causes constipation, bloating, and belly pain.
- Cecal Volvulus: Involves the cecum (start of the large intestine) and usually causes pain in the lower right abdomen.
- Midgut Volvulus: Mostly seen in babies and children, due to abnormal bowel development. Symptoms include green vomiting and sudden pain.
- Gastric Volvulus: A twist in the stomach that can block food and cause upper abdominal pain and vomiting.
- Transverse Colon Volvulus (Rare): Affects the middle part of the colon and can be dangerous, though uncommon.
What are the Common Causes and Risk Factors of Volvulus?
Volvulus happens when a part of the intestine twists on itself. This can block the bowel and reduce blood flow. Here's what can lead to it.
Causes
- Congenital Factors: Intestinal malrotation, a birth defect where the intestines don't align properly during fetal development, increases the risk of volvulus, especially in infants.
- Anatomical Abnormalities: Conditions like an enlarged colon or redundant intestinal tissue can predispose individuals to volvulus.
- Chronic Constipation: Persistent constipation can lead to elongation and redundancy of the colon, increasing the likelihood of twisting.
- Adhesions: Scar tissue from previous abdominal surgeries, injuries, or infections can create bands that the intestines may twist around.
- Neurological Disorders: Conditions such as Parkinson's disease or vascular dementia can affect intestinal motility, contributing to the development of volvulus.
- Dietary Factors: A high-fiber diet, while generally beneficial, can sometimes contribute to volvulus in individuals with predisposing anatomical factors.
- Pregnancy: The physical displacement of abdominal organs during pregnancy can increase the risk of volvulus.
Risk Factors
- Age above 60: Slower bowel movement increases the risk
- Neurological or psychiatric conditions: These often cause chronic constipation
- Sedentary lifestyle: Less movement means poor gut motility
- Low-fiber diets: Processed food can slow digestion
- Long-term immobility: Common in institutional care settings
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Get Second OpinionHow is Volvulus Diagnosed?
Volvulus happens when part of the intestine twists and blocks the normal flow. This can quickly become dangerous if not treated. Thats why doctors move fast to find out whats wrong. The diagnosis usually starts with a physical exam and is followed by a few key tests.
Common Tests Used to Diagnose Volvulus
- Physical exam: Doctors check for signs like belly swelling, pain, or a blocked bowel.
- Blood tests: These help spot infections or reduced blood flow in the intestine.
- Sigmoid Volvulus Radiology: Radiological imaging is the cornerstone of diagnosing sigmoid volvulus. Plain abdominal X-rays can reveal a characteristic "coffee bean" sign, which indicates a twisted sigmoid colon. However, a more definitive diagnosis often requires a contrast enema or a computed tomography (CT scan).
- Upper GI Series: An upper GI series involves the ingestion of a contrast material, followed by X-ray imaging of the upper digestive tract. This can reveal the "corkscrew" appearance of the twisted intestine, which is characteristic of midgut volvulus.
- Abdominal Ultrasound: An abdominal ultrasound can help visualize the twisted intestines and assess blood flow to the affected area. The "whirlpool sign" on ultrasound is a classic indicator of midgut volvulus.
What are the Treatment Options for Volvulus?
Volvulus needs immediate care. Treatment depends on where the twist is, how severe it is, and whether the blood supply is affected.
Stabilization First
Before any procedure, we stabilize the patient.
- IV fluids for hydration
- Electrolyte correction
- Nasogastric tube to relieve pressure
Endoscopic Decompression
- Used mostly for sigmoid volvulus
- A tube is inserted through the rectum to untwist the bowel
- Provides quick relief and buys time before surgery
Surgical Treatment
If decompression doesn't work or the bowel is damaged, surgery is required.
- Laparotomy: Open surgery to untwist and inspect the bowel
- Bowel resection: Removing dead bowel tissue and reconnecting the healthy ends
- Colopexy: Stitching the bowel to prevent future twisting
Long-Term Management
- Regular follow-ups after surgery
- Monitoring for recurrence, especially in older adults
When Should You See a Doctor?
Don't wait if you experience
- Intense stomach pain
- Ongoing bloating or vomiting
- Inability to pass stool or gas
- Swelling in the abdomen
- Green vomit, dizziness, or low blood pressure
These signs could mean your intestine is twisted, a medical emergency.
Who's at Higher Risk?
- Older adults with past surgeries or constipation
- Infants with green vomit or belly pain
- People with nervous system disorders
- Those with known bowel conditions
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What is the Recovery Process After Volvulus Treatment?
Recovery doesn't end with surgery. It involves healing, lifestyle changes, and preventing a recurrence.
Follow-Up Timeline
- First visit: 7 to 10 days after surgery for wound check
- Ongoing visits: Every few weeks for 2 to 3 months to monitor healing and digestion
At-Home Recovery Tips
- Eat smaller meals more often
- Add fiber to your diet once cleared by your doctor
- Drink plenty of fluids
- Avoid straining during bowel movements
- Take light walks to aid digestion
What Precautions Can Help Prevent Volvulus?
Not every case can be avoided, but you can reduce your risk with some habits.
Healthy Habits
- Eat a high-fiber diet with fruits, veggies, and grains
- Avoid overusing laxatives
- Stay active to help your gut move
- Keep an eye on bowel patterns and treat constipation early
Regular Monitoring
- Get checked if you have had abdominal surgery
- Monitor digestive symptoms if you're elderly or have known gut issues
- Imaging may be needed if symptoms come back
What Happens If It's Left Untreated?
Untreated volvulus can lead to.
- Bowel ischemia: Loss of blood flow kills bowel tissue
- Bowel perforation: Can cause a life-threatening infection
- Sepsis: Body-wide infection from a burst bowel
- Ongoing bowel problems: Some may experience future digestive issues
Our Experience in Volvulus Care
At Medicover Hospitals, we've handled many complex volvulus cases from infants to the elderly. What makes our care different is speed, teamwork, and precision. Our emergency units start with fast imaging and stabilization. If non-surgical decompression is possible, we act immediately. If not, our surgical team is ready 24/7.
