Tortuous Colon and IBS: Overlap and Information

What Does It Mean If You Have a Tortuous Colon?

Doctor Explains Colonoscopy Images To Patient
leezsnow / Getty Images

Of the many health conditions that could plague a person, there are not many that are as unfortunately named as "tortuous colon." In this overview, you will learn all about this relatively rare condition and hopefully such information will put your concerns about the "tortuous" part at ease.

What Is a Tortuous Colon?

Your colon, otherwise known as your large intestine, is a long, hollow organ that is typically about five feet long.

A tortuous colon is one that is longer than normal. In order for this longer tube to fit in your abdomen, the colon ends up with extra twists and turns.

Tortuous colon is sometimes referred to as a redundant colon. Some make the distinction that a tortuous colon is one that has an excessive amount of sharp bends, while a redundant colon has an excessive amount of loops.

Although the condition sounds well, tortuous, most of the times it is not a serious health problem. And you may be relieved to know that it does not increase your risk of getting colon cancer.

Symptoms of a Tortuous Colon

Most of the time a tortuous colon produces no symptoms and is only identified through a diagnostic test. However, in some cases, it can contribute to the following symptoms:

  • Abdominal pain
  • Abdominal cramps
  • Abdomen distention
  • Bloating
  • Constipation
  • Excessive passing of gas
  • Fecal impaction

A rare, but quite serious complication associated with tortuous colon is when the loops in the colon twist so much that they create a condition known as bowel obstruction or colonic volvulus.

Symptoms of a bowel obstruction include:

  • Severe lower abdominal pain
  • Distended abdominal
  • Excessive abdominal swelling
  • Nausea
  • No bowel movement for longer than three days
  • Passing stool that contains mucus or blood
  • Vomiting

If you have any of the above symptoms you need to get immediate medical assistance.

What Causes a Tortuous Colon?

There are a variety of reasons why a person might have a tortuous colon.

Some people are born with it and there may even be a genetic predisposition for the condition. In some cases, the cause cannot be identified. But the colon can also become elongated and twisted as a result of a diet low in dietary fiber, chronic constipation, frequent hard stools and straining to eliminate.

Self-Care Treatment of a Tortuous Colon

If your elongated or twisted colon is causing you no symptoms, then your only self-care is to be sure to incorporate good digestive health habits into your life, including following a wholesome, high-fiber diet and responding promptly to urges for having a bowel movement.

If you are experiencing symptoms of gas, bloating, abdominal pain or constipation, you would focus on addressing each of these symptoms in turn. Eating a high-fiber diet and drinking lots of water may help to ease the constipation, and although there is no research on its effectiveness for a tortuous colon, a low-FODMAP diet may help to ease symptoms of gas and bloating. For abdominal pain relief, you may want to use a heating pad or hot water bottle on your abdomen where the pain seems to be coming from.

Medical Treatment for a Tortous Colon

There is no one specific treatment protocol for a tortuous colon. Your doctor may work with you to come up with a management plan for any chronic digestive symptoms that you may be experiencing, and this may include the use of prescription medications or over-the-counter products. Options include:

And although a bowel obstruction resulting from a tortuous colon is a very rare event, it can be life-threatening and typically requires surgical intervention.

Tortuous Colon and Irritable Bowel Syndrome

Many of the symptoms of a tortuous colon are similar to those of irritable bowel syndrome (IBS). By definition, IBS is diagnosed when there is no structural abnormality (or visible inflammation or injury) and thus IBS and tortuous colon are considered two separate health conditions. It is possible that a tortuous colon may be identified as you go through diagnostic testing for IBS. It is also possible that your doctor may lump your symptoms under the same IBS umbrella. Although there is no firm research on the matter, it is conceivable that having constipation-predominant IBS (IBS-C) may raise your risk of developing a tortuous colon (keeping in mind that a tortuous colon is a rare condition).

Colonoscopies and Tortuous Colon

As you probably know, the colonoscopy test is an essential test for colon cancer screening. The ideal situation is when the endoscope, the long, lighted tube used during the procedure, can be inserted all the way through the entire colon until it reaches the cecum, which is where the small and large intestine meet. During this procedure your doctor can view the health of your large intestine and remove any abnormal tissue, such as polyps. This tissue can then be tested for the presence of cancer cells. Typically, you would undergo your first colonoscopy at age 50 and repeat the procedure every 10 years. If you are at higher risk for colon cancer due to a family history or having had previous polyps, you may need to have the test done sooner than age 50 and at more frequent intervals.

A tortuous colon can present a challenge for your doctor as the twists, loops and/or sharp angles make it hard to get the endoscope all the way through the entire organ. Traditionally, doctors have utilized one of the following options:

Double-contrast barium enema (DCBE): In the past, this was the test most frequently used as an alternative to traditional colonoscopy for a tortuous colon. In this procedure, a liquid formulation containing barium is inserted into your rectum as a contrast agent and then a series of X-rays are taken of your lower abdomen. Next, the barium is allowed to drain out and air is pumped into your colon through your rectum and further X-ray images are taken. One of the reasons why the DCBE has fallen out of favor is that research has shown that it is not that good at identifying the presence of abnormal tissue within the large intestine.

Virtual colonoscopy: The virtual colonoscopy, also known as computed tomography colonography (CTC) offers another alternative to traditional colonoscopy for a tortuous colon. In this procedure, you must still undergo the bowel-emptying prep that is required in a traditional colonoscopy prior to the day of the test. For the procedure, you will then be asked to drink a liquid that contains a contrast dye. A short, thin tube will be inserted that will pump air into your colon. You will undergo a series of X-rays. Like the DCBE, this procedure has some limitations in its ability to detect small polyps. And if there is evidence of the presence of polyps, you will still have to undergo a follow-up traditional colonoscopy.

However, newer research suggests that there can be a high success rate for a full, optimal colonoscopy with a repeat try. This success may come about when a different size endoscope is used, such as one designed for children.

A Word From Verywell

As stated above, tortuous colon is an unfortunately named condition. Typically, this is a benign condition that causes no discomfort and rarely leads to serious health-problems. If you are having chronic digestive symptoms related to having a tortuous colon, be sure to work with your doctor on a symptom-management plan. And do not let a tortuous colon get in the way of you be adequately screened for the presence of colon cancer.

Sources:

Gawron AJ, Veerappan, Keswani RN. "High success rate of repeat colonoscopy with standard endoscopes in patients referred for prior incomplete colonoscopy" Canadian Journal of Gastroenterology 26, 589–592.

Brahmania M, Park J, Svarta S, Tong J, Kwok R, Enns R. "Incomplete colonoscopy: Maximizing completion rates of gastroenterologists" BMC Gastroenterology 2014;14:56.

Continue Reading