Is your little one suddenly crying and clutching his stomach? Let's learn about intussusception

Does your little one suddenly start crying loudly while playing? Does he pull his knees to his chest, hold his stomach, and cry non-stop? Does the crying stop after a while, but after about 15-20 minutes, he starts crying like the old man? It is reasonable for any mother or father to be scared when he sees something like this. Symptoms like this can sometimes be a sign of a medical condition that we have not heard of very often, but which requires immediate medical attention. That is what Intussusception is. Let's talk about this in detail today.

Simply put, what is Intussusception?

Intussusception is a painful and serious condition that occurs in the intestines . Specifically, it occurs when one part of the intestine slips into the other part in front of it.

Think of an old telescope. When we open it, one part comes out from the other. When we close it again, the parts go back in, right? That's what happens to our intestines in this situation. But unlike telescopes, our intestines are always open.

What are the causes and risk factors for this condition?

Intussusception is the most common emergency in children under 2 years of age. However, it can also occur in older children and young adults. It is rare in adults. When it does occur, it is usually caused by another medical condition, such as a tumor in the colon.

There are several factors that increase the risk of this condition among young children.

Causes in adults

If an adult develops this condition, the cause is most likely one of the following:

• A polyp or tumor in the intestine.
• Adhesions or scar tissue in the intestine from previous surgery.
• Conditions that cause inflammation of the intestines, such as Crohn's disease .
• Weight loss surgeries such as gastric bypass.

What exactly are the symptoms of this?

If this happens to a young child who has not yet started talking, he will show his pain by suddenly screaming and crying loudly. At the same time, he will draw his knees up to his chest.

This pain only comes for a short time at first. It comes and goes every 15-20 minutes. But over time, the pain increases in frequency and duration.

But not all children are the same. Some children may not have any pain at all. So, be careful about the following symptoms.

For adults, this condition may initially start as a simple stomach ache. If the stomach pain , accompanied by nausea and vomiting , comes and goes, and the pain gets worse with each occurrence, you should be concerned.

When should I see a doctor?

When blood flow to a part of the intestine is cut off, the tissue in that part begins to die. If this happens, an infection can spread to the lining of the abdominal cavity. This is a very dangerous, life-threatening condition called Peritonitis .

If left untreated, the child may go into shock. Symptoms include:

• The child shows a restless nature.
• Abnormal pulse rate (either very slow or very fast).
• Abnormal breathing (either very shallow or very rapid).
• Skin becomes cold, clammy, pale, or gray.
• Lifeless state of the body.
• Loss of consciousness.

What should you do before going to see the doctor?

Since this is an emergency, everything will happen very quickly when you get to the hospital. So don't panic. The most important thing is, don't give your child anything to eat, drink, or take any over-the-counter painkillers until you get to the hospital.

If you have time, memorize the answers to the questions the doctor is likely to ask. Then you can provide details quickly.

• When did symptoms such as stomach pain start?
• Was the pain constant or did it come and go?
• Have you had nausea, vomiting, or diarrhea?
• Have you seen blood in your stool?
• Did you notice a swelling or lump in your stomach?

How is the diagnosis made?

Your doctor will ask about your child's symptoms and medical history. Then they will examine your child. They may also give you an IV line to control your child's fluid levels and may insert a nasogastric tube to help relieve pressure in your child's intestines.

In addition, they will order several tests to look inside the stomach.

• Abdominal X-ray: This helps to see if there is a blockage in the intestine.
• Ultrasound: This test uses sound waves to produce images of the internal organs of the abdomen. This is a very important test to diagnose intussusception.
• Air or contrast enema: In this, a soft tube is inserted through the anus and a special liquid, such as air or barium, is passed into the colon. This allows the blockage to be clearly seen on an X-ray. Sometimes, the pressure from the enema can help the colon move back into place. If that happens, it can also be a treatment.

What are the treatment options?

Some cases are temporary and may resolve without any treatment, but most cases require treatment.

As mentioned earlier, if an enema does not cure the condition, the next step is surgery. Don't be afraid of surgery, the doctors will do everything they can to make sure the child doesn't feel any pain.

This is what happens during surgery:

• A pediatric anesthesiologist (a specialist in administering anesthesia to children) will put the child completely to sleep.
• If the surgery is performed laparoscopically, which means "keyhole surgery," the doctor makes several small incisions in the abdomen and inserts a camera and small instruments through them to perform the surgery.
• Otherwise, a small incision is made on the right side of the abdomen, and the part of the intestine that has been inserted is manually removed and placed back in its place.
• If a section of the intestine is damaged in some way and cannot be repaired, the doctor will remove the damaged section of intestine and reconnect the two healthy parts.

What happens after treatment?

About one in 10 children who are treated will have a recurrence within 72 hours. Therefore, whether the treatment is an enema or surgery, the child will be kept in the hospital for about a day for observation.

• If you were cured by an enema:
• The air will be released from the baby's body over the next few hours.
• Paracetamol (Acetaminophen) can be given for fever.
• No food or drink is given for the first 12 hours. After that, clear liquids are given first, and then solid foods are introduced.

• If you had surgery:
• After the surgery, the child is kept in a recovery room for a few hours and then transferred to the ward.
• Painkillers will be given through an IV for the pain.
• If the incision is covered with a gauze bandage, it can be removed in a few days. If it is covered with something like Dermabond, it will dissolve on its own.
• If they are given liquids first and they do not vomit, they will start giving them solid foods.
• Once the child starts eating and drinking well and feels better, they can go home.
• You can bathe your child two days after surgery, but keep him away from running, jumping, and other physical activities until you see the doctor again (usually in 2-3 weeks).