How long is a redundant colon

In addition to constipation, which is by far the most common symptom of redundant colon, according to a February report in the World Journal of Gastrointestinal Surgery , other symptoms, including non-specific ones, can develop too. Some of these symptoms include:. Of course, the absence of these symptoms doesn't mean that you don't have a redundant colon.

It's possible for constipation to be your only symptom, as well. One of the keys to alleviating constipation is making sure you get enough fiber in your diet. There are two major categories of fiber — soluble and insoluble — and while both can help get rid of constipation, it may be helpful to focus on getting more insoluble fiber.

According to the U. National Library of Medicine , soluble fiber pulls water into the digestive tract and turns into a gel-like substance during digestion.

This slows digestion down and decreases transit time. On the other hand, insoluble fiber adds bulk to your stool and speeds up transit time, which is the goal when you have redundant, or tortuous colon, and constipation. Sources of insoluble fiber include:. Although the bulk of your fiber intake should come from insoluble fiber, it's a good idea to get both forms in your diet.

Sources of soluble fiber are:. According to the Academy of Nutrition and Dietetics , men should aim for at least 38 grams of total fiber per day, while women should get at least 25 grams. While there are no set rules for how much should come from each type, Cleveland Clinic recommends that 10 to 15 grams are in the form of soluble fiber, which means the rest should come from insoluble fiber.

Studies have identified a triade of constipation, abdominal pain, and distension. Colon transit time was recently shown to increase significantly with increased number of redundancies, which increases abdominal pain, bloating and infrequent defecation. The diagnosis of dolichocolon is established by barium enema or CT-colonography. Treatment is conservative, or surgical in case of volvulus or refractory constipation.

Core tip: Dolichocolon is an inborn anatomic variant, where redundancies may be located in the right, middle and left part of the colon and at the flexures. This review investigated the literature on dolichocolon. The prevalence is not known. The incidence is 1. The dominating symptoms of dolichocolon are constipation, abdominal pain and volvulus. Colon transit time is prolonged and increases significantly with increased number of redundancies, which increases abdominal pain, bloating and infrequent defecation.

The diagnosis is established by a barium enema or CT-colonography. The redundant colon represents an unusually lengthened large bowel folded up upon itself, forming extra loops, tortuosities and kinks. The redundancy may involve the entire colon or it may be limited to certain areas as the hepatic flexure, transverse colon, splenic flexure, but the distal colon especially the region of the sigmoid is the most commonly affected.

There has long been a debate about whether a redundant colon gives rise to symptoms like constipation and volvulus. The objective of this review is to critically examine this issue. The development of the midgut in the embryo is characterized by a rapid elongation of the gut and its mesentery, resulting in formation of the primary intestinal loop.

The cephalic limb of the loop develops into the distal part of the duodenum, the jejunum, and part of the ileum. The caudal limb becomes the lower portion of the ileum, the caecum, the appendix, the ascending colon and the proximal two-thirds of the transverse colon.

In adults, the junction of the cranial and caudal limb can only be recognized if a portion of the vitelline duct persists as a Meckel's diverticulum[ 1 ]. Coinciding with the growth in length, the primitive intestinal loop rotates around an axis formed by the superior mesenteric artery.

Subsequently, elongation of the small intestinal loop continues, forming coiled loops. Similarly, the large intestine grows considerably in length, but fails to participate in the coiling phenomenon.

At the end of the third month, the intestinal loops return to the abdominal cavity from the extra-embryonic coelom. The caecal bud is temporarily located in the right upper quadrant below the liver before it descends into the right iliac fossa, thereby forming the ascending colon and hepatic flexure.

The distal end of the caecal swelling forms a narrow diverticulum, the appendix. As the intestine returns to the abdominal cavity, their mesenteries are pressed against the posterior abdominal wall where they fuse with the parietal peritoneum, fixing the right and left colon.

The colon is now as it is in the adult. In , Monterossi[ 2 ] noted from autopsies an increased length of the colon, which was depicted in handmade drawings showing sigmoid loops and duplication of the right and left colonic flexure Figure 1. Treves[ 3 ] dissected the bodies of patients who died from reasons other than abdominal diseases. He was convinced that the length of the bowel was independent of age, height, and weight. In the full-term fetus, he found that the length of the intestine, and especially the colon, was significantly constant.

Shober[ 4 ] reported 18 cases selected from different investigators between and in which the sigmoid flexure was found on the right side of the pelvis. Various other abnormalities were reported, including a caecum in the right hypochondriac region with extensive mesentery. It seems that the colon was likely to vary in length and in mode of disposition more than any other part of the intestinal canal[ 5 ].

This was further demonstrated by Black[ 6 ] in a series of drawings from textbooks and journal papers between and , showing a multitude of displacement and elongation of the left colon. The hepatic and splenic flexures were permanently in place. Bryant[ 7 ] measured the intestines after removed from the body. His data showed that Treves[ 3 ] was incorrect in stating that all children start life with practically the same length of intestine.

He found great variations in the small intestine and colon before the fifth month of fetal life. At the age of 10 years, the child has a length of colon considered normal for the adult. He also found that the colon varied in length from 1. Furthermore, he reported that the length of the colon increased about 20 cm between 20 and 80 years of age.

Phillips et al [ 8 ] reported colon length from several studies of cadavers, using laparotomy, barium enema or CT-colonography, between and The mean length of the colon varied between A redundant colon with loops was not mentioned. In their own study, they found a significant proportion of colons had mobility of the ascending and descending segments, with the length of the latter being highly variable.

This may indicate loose redundancies. An extremely long mobile descending colon and sigmoid ran from the left flexure through the abdomen up under the liver and then distally superimposed to the ascending colon and caecum, before joining the rectum. A few years later, Lardennois and Aubourg[ 10 ] using the same technique demonstrated various redundancies in all parts of the colon, in both adults and children. These investigators named the anatomic variant dolichocolon dolicho-, Greek: long.

During the following years, many case-series with all positions of colonic redundancies were published, using this new X-ray technique[ 11 - 14 ]. The colon length or that of the redundancies was not measured. Years later, the redundant colon was characterized by the following criteria: a sigmoid loop rising over the line between the iliac crests, a transverse colon below the same line and extra loops at the hepatic and splenic flexure.

A fully developed dolichocolon occurs when all redundancies are present simultaneously[ 15 - 17 ] Figures 2 and 3. A long colon may result in an incomplete colonoscopy, as demonstrated in a study in which the colorectal length was 45 cm longer than the length in a group who underwent complete colonoscopy[ 18 ]. Redundancy of the colon is a far from seldom variant. In , Kantor[ 19 ] reported cases from patients who underwent roentgenography, an incidence of However, Moeller[ 13 ] found redundant colon in 18 out of cases, an incidence of 2.

A high incidence of Thus, redundancy seems to occur at any age, in either sex, and without special preference to any habitus[ 20 ]. For the next half century, the interest in redundant colon seemed to wane. The prevalence of dolichocolon in a population is not known, because healthy people have not been investigated for that purpose. The closest to such an evaluation is a study by Brumer[ 21 ] in which 53 patients had a barium enema for reasons other than constipation; one patient 1.

In , Raahave et al [ 17 ] published a study of patients with constipation disorders, finding high frequencies of colonic redundancies. The question for many authors has been whether dolichocolon is a congenital anatomic variant, an abnormal growth, or pathological stretching. Treves[ 3 ] and Bryant[ 7 ] assumed that colon growth is associated with activity and function depending on the diet.

Very recently, the large bowel was shown in mice to undergo substantial changes in length, as it fills with fecal matter, and that the stretching of longitudinal muscles results in slow colonic transit[ 22 ]. However, using barium enema, several authors have shown that fetuses, newborns, and infants exhibit colonic redundancies[ 10 , 12 , 23 ]. Recently, colonic elongation has been shown in children by nuclear transit scintigraphy[ 24 ].

A familiar occurrence of dolichocolon has also been observed[ 25 ]. 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 the 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.

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. Newer research suggests that there can be a high success rate for a full, optimal colonoscopy with a repeat try if you have a tortuous colon.

As stated above, a 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 healthcare provider 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. Often, a tortuous colon has no symptoms and creates no medical problems.

In rare instances, your bowel may become obstructed , though, which can lead to perforation of the intestines and other very serious complications. If you have a distended stomach, are vomiting, and severe abdominal pain, go to the emergency room to check for these problems.

A longer colon seems to be more common in women and older adults. Following a low-fiber diet and frequent constipation may increase your chances of developing a redundant colon. One of the most challenging aspects of having IBS is trying to figure out what's safe to eat. Our recipe guide makes it easier. Sign up and get yours now! American Cancer Society.

Colorectal Cancer Risk Factors. Updated February 21, National Institute of Health. Redundant colon as a cause of constipation. Gingold D, Murrell Z. Management of colonic volvulus. Clin Colon Rectal Surg. MedlinePlus , U. National Library of Medicine. Coronavirus Resource Center. Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy Continue.

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