Intussusception – Symptoms and Causes
Overview
Intestinal telescoping (intussusception) happens when part of the intestine folds into itself, like a telescope closing. This serious condition blocks food and fluids from moving through the digestive system.
When this happens, blood flow gets cut off to that section of intestine, which can cause tissue damage, infection, or even a hole in the bowel wall.
This condition affects children most often, particularly those under 3 years old, making it the leading cause of intestinal blockage in young children. Most childhood cases happen without any clear reason.
In adults, this condition is much less common and usually happens because of another medical issue, often a tumor.
Different approaches work for different age groups:
For children:
- Non-surgical procedures often work
- Air or fluid pressure can push the intestine back to normal position
- Success rates are high with early treatment
For adults:
- Surgery is typically needed
- Doctors must address the underlying cause
- Treatment varies based on what caused the problem
Early diagnosis is crucial for preventing serious complications like intestinal damage or infection.
Signs and Symptoms
In Young Children
Young, healthy infants with intussusception often show sudden, loud crying due to stomach pain. When experiencing this pain, babies might pull their knees toward their chest.
The pain typically comes and goes at first, usually every 15-20 minutes. As time passes, these painful episodes become longer and more frequent.
Other important signs to watch for include:
- Unusual stool with blood and mucus (sometimes described as looking like currant jelly)
- Vomiting
- Noticeable lump in the stomach area
- Weakness or low energy
- Diarrhea
Not all children show all symptoms. Some infants might not have obvious pain, while others might not pass bloody stool or have a visible stomach lump. Older children sometimes experience pain without other symptoms.
In Adults
Intussusception happens rarely in adults. The condition is harder to identify in adults because symptoms often match those of other stomach problems.
The most common symptom is intermittent stomach pain that comes and goes. Adults might also experience:
- Nausea
- Vomiting
- Ongoing discomfort
Some adults have symptoms for weeks before they seek medical help, making diagnosis more challenging.
When to Get Medical Help
Intussusception is a medical emergency that needs immediate care. If you notice symptoms in yourself or your child, go to the emergency room right away.
Watch for signs of stomach pain in babies, such as pulling their knees to their chest and crying without being able to be comforted. These symptoms should not be ignored.
Why Intussusception Happens
In Young People
Intussusception in children often has no clear cause. This condition happens more frequently during the autumn and winter months. Many children with intussusception also show flu-like symptoms, which suggests viruses might play a role in causing it.
Sometimes doctors can find a specific reason for the telescoping. The most common cause is a small pouch in the lining of the small intestine called Meckel’s diverticulum.
This pouch can act as a starting point for the intestine to fold into itself.
The intestine normally moves food through your body with wave-like motions. In intussusception, these movements can cause one part of the intestine to slide into another part.
In Grown-Ups
For adults, intussusception typically results from an existing medical condition or after certain procedures. Here are the common causes:
- Growths in the Intestine: Polyps or tumors can serve as the starting point for telescoping.
- Adhesions: Scar tissue that forms in the intestine after surgery or inflammation.
- Surgical Procedures: Especially weight-loss surgeries like gastric bypass.
- Inflammatory Conditions: Diseases that cause intestinal swelling, such as Crohn’s disease.
When the intestine has a growth or abnormal area, normal digestive contractions can grab this spot (called a “lead point”) and pull it – along with the intestinal lining – into the section of bowel ahead of it.
Unlike in children, adult cases almost always have an identifiable cause that triggers the telescoping effect.
Risk Factors
Several factors can increase the chance of developing intussusception:
Age and Sex:
- Young children (especially 6 months to 3 years old) face the highest risk
- Boys are affected more frequently than girls
Birth Conditions:
- Intestinal malrotation (improper intestinal development or rotation) raises risk levels
Medical Conditions:
| Condition | Connection to Risk |
|---|---|
| Cystic fibrosis | Associated with increased risk |
| IgA vasculitis (Henoch-Schonlein purpura) | Can trigger intestinal issues |
| Crohn’s disease | Inflammation may contribute |
| Celiac disease | Linked to higher occurrence |
Complications
Intussusception can disrupt blood flow to the affected intestinal section. Without treatment, this lack of blood causes intestinal tissue death.
When tissue dies, the intestinal wall may tear, creating a perforation. This dangerous situation often leads to peritonitis, an infection of the abdominal cavity lining.
Peritonitis requires immediate medical attention as it can be life-threatening. Watch for these warning signs:
- Abdominal pain
- Swollen belly
- Fever
- Vomiting
The condition may progress to shock, which shows these symptoms:
| Shock Warning Signs | Description |
|---|---|
| Skin changes | Cool, clammy, pale or grayish skin |
| Pulse | Weak and rapid |
| Breathing | Either very slow/shallow or unusually rapid |
| Mental state | Anxiety, agitation, or extreme listlessness |
A child experiencing shock may remain conscious or become unconscious. If you notice these symptoms, seek emergency medical care immediately.
