Internal Medicine

Pain in a loop of intestine

introduction

Depending on the location, abdominal pain can have different causes. In some cases, it is possible to deduce the possible cause from the localization of the pain. Diseases of the intestine, i.e. the intestinal loops, usually cause abdominal pain that is localized in the middle to lower abdomen.

Since the intestine extends over the entire abdomen, pain in a loop of intestine can occur on the right, left or in the middle.

Causes of a loop of bowel pain

There are several conditions that can cause a loop of bowel pain.

The uppermost part of the intestine is the duodenum (Duodenum). Ulcers that resemble gastric ulcers can develop here. Such ulcers can cause severe pain, mostly localized in the upper abdomen.

Read more about this under: Duodenal ulcer

Entrapment of parts of the intestine (hernias) can occur in inguinal hernias, umbilical hernias and incisional hernias. A small part of the intestine passes through a gap in the abdominal wall or through the inguinal canal; this is called a rupture. If it is narrowed within this gap, it is called an entrapment. Such entrapment can cause severe pain.

An insufficient supply of the intestines with blood (Intestinal ischemia) can cause severe pain in the affected intestinal loops.
Also an acute intestinal obstruction (Ileus), in which the intestinal contents can no longer be transported due to an obstacle.

Furthermore, inflammatory bowel diseases such as Crohn's disease or ulcerative colitis can lead to abdominal pain.

Read on this topic too: Chronic inflammatory bowel disease

Diverticulitis, an inflammation of large intestinal bulges, also leads to pain in the affected intestinal sections.

But even relatively harmless diseases, such as simple gastrointestinal flu, can cause pain in the intestinal area.

Pain in loops of the intestine from diverticulitis

In some people, small protrusions of the mucous membrane, the so-called diverticula, develop in old age. One speaks of diverticulosis. In most cases, such diverticulosis is localized in the sigmoid colon, part of the large intestine.

Risk factors for the development of diverticula are a low-fiber diet and - as a result - frequent constipation. Diverticulosis in itself does not cause any symptoms. However, inflammation in the area of the diverticula can occur, which is referred to as diverticulitis. This is accompanied by pain in the left lower abdomen. A fever can also occur.

Are you interested in this topic? Read more about this under: Pain associated with diverticulitis

Pain from twisted bowel loop

In rare cases, the bowel can turn on itself. One then speaks of a bowel entanglement. As a result of this twisting, the intestinal contents can no longer be transported and the blood supply to the intestine is often impaired. There is severe pain in the affected section of the intestine.

A bowel entanglement is potentially life-threatening, as the affected part of the bowel can die without intervention. Surgical treatment is usually necessary.

Pain from pinched bowel loop

A loop of intestine can become trapped in various hernias (inguinal hernia, umbilical hernia, incisional hernia) in which parts of the intestine can penetrate and become narrowed through a gap in the abdominal wall.

Small breaks without entrapment usually do not cause any discomfort, but can be felt as a small protrusion through the skin.
If an entrapment occurs, the blood supply to the stuck intestine can be significantly restricted and the intestinal contents can no longer be transported. There is severe pain in the affected section of the intestine. If a loop of intestine is trapped, rapid surgical treatment is usually necessary.

Where does the pain in the bowel loops occur?

Pain in a loop of intestine in the right abdomen

Pain in a loop of intestine located in the right half of the abdomen can indicate various possible diseases.

In the case of an entrapment as part of a hernia, a loop of intestine on the right side may be involved. For example, with a right-sided hernia (Inguinal hernia) or with a right-sided hernia (Incisional hernia).
In the case of an incisional hernia, a break occurs in the area of a scar, for example after previous operations in the abdomen. Even if the intestine is insufficiently supplied with oxygenated blood, parts of the intestine located on the right side can be involved and right-sided abdominal pain can occur.

Chronic inflammatory bowel diseases such as Crohn's disease or ulcerative colitis can also cause right-sided abdominal pain. Irritable bowel syndrome can cause pain in any part of the bowel.

Read more about this under: Treatment of irritable bowel syndrome

Pain in a loop of intestine in the left abdomen

The most typical cause of left-sided lower abdominal pain is sigmoid diverticulitis, i.e. the inflammation of large intestinal protuberances in the area of the so-called sigmoid colon.

However, entrapment in fractures such as a left inguinal hernia or incisional hernias can also cause pain in the area of a loop of intestine on the left.

An intestinal obstruction can be localized in any area of the intestine and thus cause abdominal pain on the right as well as on the left or in the middle. A bowel obstruction is usually caused by obstacles in the passage. These include, for example, tumors or adhesions after previous operations.

Diagnosis of pain in intestinal loops

If there is pain in the bowel area, the triggering cause must be found. First, the anamnesis takes place, so it is asked exactly since when the symptoms exist, how often they occur and how long they last, what kind of pain they have, where they are located and whether there are accompanying symptoms. The presence of comorbidities is also asked about.

On the basis of a clinical examination of the abdomen, the next clues for the possible cause can be gathered. This is usually followed by an ultrasound scan of the abdomen and blood tests.
It is not uncommon for further imaging diagnostics such as a CT or MRI examination to be necessary.

Further accompanying symptoms with pain in the intestinal loops

The accompanying symptoms depend on the triggering cause. Often a cause can already be suspected from a certain symptom constellation.

Pain in one or more loops of the intestine that occurs in combination with a fever can indicate the presence of an inflammatory reaction, such as occurs in diverticulitis.
In the case of chronic inflammatory bowel disease, in addition to abdominal pain, watery or watery-bloody diarrhea often occurs.
A bowel obstruction often leads to stool retention, and vomiting can also occur.
If there is intestinal ischemia, there is often severe abdominal pain, vomiting and diarrhea.
In the case of a pinched hernia, the pinching can lead to an intestinal obstruction and associated symptoms.
If there is a duodenal ulcer, epigastric pain, nausea, a feeling of fullness and loss of appetite occur. The pain often improves immediately after eating.
In the case of a gastrointestinal infection, in addition to abdominal pain, acute diarrhea, often accompanied by vomiting, occurs. Often other people in the immediate vicinity are also affected.
With irritable bowel syndrome, a wide variety of accompanying symptoms can occur. These include, for example, diarrhea or constipation, flatulence, belching, bloating and loss of appetite.

Therapy of painful intestinal loops

The type of treatment depends largely on the cause of the pain in the loop of intestine.

Some diseases require quick action in terms of a surgical procedure. These include intestinal obstruction, entrapment of an intestinal loop, intestinal entanglement and intestinal ischemia. Only in rare cases is this diagnosed not operated on. For example, if the risk of anesthesia and surgery is too high, as can be the case with patients with other serious pre-existing conditions.

Antibiotic therapy is often necessary for diverticulitis. In some cases, however, it is sufficient to take a food break and rest.

If there is a chronic inflammatory bowel disease, long-term drug therapy is necessary in most cases. Medications of choice include mesalazine, steroids, immunosuppressants, and biologics.

In the case of an ulcer in the area of the duodenum, acid-inhibiting drug therapy is started. Avoiding triggering factors such as alcohol, nicotine, stress and painkillers from the group of non-steroidal anti-inflammatory drugs such as ibuprofen or ASA is also crucial.

In the case of gastrointestinal flu, sufficient fluid intake is usually sufficient, and the symptoms disappear on their own within 1-3 days.

There is currently no specific therapy for treating irritable bowel syndrome. Different approaches include eating a special high-fiber diet and taking probiotics.

Duration and prognosis for pain in an intestinal loop

The prognosis of pain in the area of an intestinal loop depends largely on the triggering cause. While a viral disease of the gastrointestinal tract is usually harmless and regresses on its own after a few days, diseases such as intestinal obstruction, intestinal ischemia or intestinal obstruction are in many cases life-threatening if left untreated.
Rapid therapy is necessary.

Other diseases such as Crohn's disease or ulcerative colitis are often chronic and recurrent, i.e. in recurring attacks.