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Twisted Colon: Untangling the Cause of Abdominal Cramping

Have you doubled over with stomach cramps again? Could it be something you ate? Or could your symptoms indicate another issue? 

Abdominal cramping or stomach pains can be a distressing experience that can leave you wondering about its underlying cause. While there can be various reasons for this discomfort, one potential culprit worth exploring is a twisted colon, also known as colonic volvulus.  

“This condition occurs when a section of the colon rotates and twists,” said Jason Weiss, MD, a colon and rectal surgeon with Banner – University Medicine. “This causes a bowel obstruction or blockage of the intestines, disrupting the flow of stool (poop) and blood supply.” 

A twisted colon can lead to severe pain and discomfort, digestive issues and serious, life threatening health complications. 

Read on as we delve into the world of the twisted colon, shedding light on its symptoms, causes and the link between stomach cramps and this condition.  

Common forms of volvulus 

The main types of colonic volvulus are cecal volvulus (volvulus of the cecum), sigmoid volvulus (sigmoid colon volvulus) and midgut volvulus (volvulus of the transverse colon).  

“Of these, sigmoid volvulus, located in the lower left side of the abdomen, is the most common type of volvulus and only accounts for about 5% of intestinal obstructions in the United States,” Dr. Weiss said.  

Causes and risk factors for volvulus 

The causes of volvulus are not entirely known. However, it is more frequently seen in older adult males, African Americans and people with neuropsychiatric disorders. 

Some other factors that can increase your risk for a twisted colon or volvulus include: 

  • Chronic constipation 
  • Previous abdominal, pelvic or bowel surgery 
  • Certain medical conditions, including intestinal adhesion, colon polyps and Hirschsprung disease (a disease that affects the large intestine) 
  • Congenital disorder (condition you are born with) 
  • Crohn's disease

“Infants born with malrotation (an abnormality in the rotation of the gut) are at risk for volvulus. Otherwise, it is rare in children,” Dr. Weiss said.  

Symptoms of volvulus 

Common signs and symptoms of a twisted colon include the following: 

  • Abdominal pain (intermittent or constant) 
  • Bloating and distension (swelling of the belly) 
  • Inability to pass gas
  • Vomiting 
  • Decreased bowel function (constipation or complete absence of stool) 
  • Rectal bleeding (blood in stool) 

“These symptoms can vary in severity depending on the type of volvulus you have,” Dr. Weiss noted. “They can also commonly occur with other gastrointestinal issues, so discussing your symptoms with your health care provider is important.” 

If left untreated, a twisted colon can result in serious health complications, including fecal peritonitis, perforation of the bowel and gangrene. 

Diagnosis and treatment 

Diagnosing a twisted colon typically involves a combination of a physical exam, medical history review and diagnostic tests, such as an abdominal X-ray and CT scan (computerized tomography). 

Your health care provider will look for tell-tale signs of a twisted shape in the bowel. A contrast or barium enema may be given to enhance the imaging of the potential obstruction. 

Treatment for a twisted colon involves attempts to unblock the obstruction or untwist the colon. If your colon is twisted and blood flow is intact, it can be treated with non-operative endoscopic detorsion using a sigmoidoscope or colonoscope. 

A colonoscopy can be performed to untwist the colon and evaluate the health of the involved colon,” Dr. Weiss said. 

In severe cases or when non-surgical methods fail, surgical intervention may be necessary to correct the twisted segment. “This may involve removing a part of the colon and reattaching the healthy portions,” Dr. Weiss said. 

A procedure called a laparotomy is a common option for most surgical treatments of a twisted colon. This involves a cut (incision) made in the abdomen. Another option is laparoscopy, which uses small incisions and instruments to perform the procedure.  

In cases of gangrenous volvulus, a colon or bowel resection will be performed to remove the affected colon. 

Preventing volvulus 

Avoiding chronic constipation is the best deterrent from volvulus,” Dr. Weiss said. 

While some risk factors cannot be controlled, there are things you can do to reduce your risk of developing a twisted colon. These include: 

  • Adequate hydration: Maintain proper hydration levels by drinking enough water throughout your day. 
  • High-fiber diet: Incorporate fiber-rich foods, such as fruits, vegetables and whole grains, to promote regular bowel movements. 
  • Regular exercise: Engaging in regular physical activity helps maintain healthy bowel function. 
  • Prompt medical attention: Seek medical assistance for persistent abdominal pain, bloating or changes in your bowel habits. “If you have issues with chronic constipation, discuss bowel care strategies with your provider, a gastroenterologist or colorectal surgeon,” Dr. Weiss said. 

[For more tips to improve your gut health, check out these natural tips.] 


A twisted colon, or volvulus, is a serious condition that requires timely medical attention. Recognizing the symptoms, understanding your potential risk factors and seeking a proper diagnosis and treatment are crucial for a successful recovery. 

By adopting preventative measures, you can reduce the likelihood of developing a twisted colon and maintain optimal gastrointestinal health.  

Remember, it is always wise to consult with your health care provider or gastrointestinal specialist for an accurate diagnosis and personalized care.  

To find a Banner Health specialist near you, visit bannerhealth.com.  

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