A redundant or tortuous colon is an abnormally long colon that cannot fit inside the body without looping or twisting. There is no obvious cause, but it can lead to complications and gastrointestinal problems, including constipation.

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The colon is part of the digestive system. It is the longest part of the large intestine and connects the small intestine to the anus.

The colon removes some electrolytes, nutrients, and water from partially digested food and passes the remaining solid waste — stool. The rectum stores stool, which exits through the anus.

Doctors refer to the colon as redundant if it is abnormally long. Another term for this is a “tortuous” colon.

This article explains a redundant colon, its signs and symptoms, causes, when to seek help, diagnosis, and treatment. We also look at home care remedies and the outlook for those with the condition.

A redundant colon is an abnormally long, tortuous colon that twists and loops to fit inside the body. It can affect the entire colon, but it most often affects a part of the colon called the sigmoid.

Signs and symptoms may include:

Experts do not know what causes a redundant colon. Part of what defines the condition is that it has no obvious cause. It may result from a single cause or group of conditions.

A redundant colon is a congenital condition, which means it is something a person is born with rather than something that develops over time due to external factors.

A person may be unaware that they have a redundant colon, as they may be asymptomatic. However, the condition can have serious implications and may lead to severe digestive, urinary, or vascular complications.

A redundant colon is a risk factor for sigmoid volvulus. This condition involves a portion of the intestine wrapping around its blood supply and cutting it off.

A person should see a doctor if they:

  • have severe abdominal pain
  • are vomiting green bile, which could signal a blockage or obstruction in the bowel
  • have been experiencing constipation that does not respond to over-the-counter (OTC) treatment

It can be difficult for doctors to diagnose a redundant colon using endoscopic methods. The looping of the colon can make it difficult for doctors to use imaging instruments.

Other procedures doctors may use include:

Sigmoidoscopy

A sigmoidoscopy is a procedure in which a doctor inserts a thin tube with a light and camera into the rectum and pushes it into the sigmoid area of the colon. This allows a doctor to view the sigmoid colon on a monitor.

Due to the looping of the sigmoid colon often present in a redundant colon, a doctor may not be able to maneuver the tube effectively or see the inside the sigmoid.

Colonoscopy

A colonoscopy is similar to a sigmoidoscopy, except the doctor may examine the entire colon. While a doctor may have difficulty examining the redundant colon, a colonoscopy can help identify the condition, revealing the twists and loops that help confirm the diagnosis.

CT scan

A doctor may use a CT scan to diagnose a redundant bowel and rule out other potential causes of symptoms, such as tumors and other obstructions.

A redundant colon can be a medical emergency that requires immediate attention. Treatments include:

Decompression of the sigmoid volvulus

During this procedure, a doctor inserts a soft tube into the rectum and maneuvers it into the obstructed loop with the guidance of a sigmoidoscope. Successful decompression will result in the rectum evacuating liquid and gas, which will resolve abdominal distension and cause the abdomen to soften.

Surgery

If patients cannot undergo decompression or their condition has progressed significantly, they may require surgery. Surgeons typically perform a sigmoid colectomy with either a primary anastomosis or an end colostomy.

  • Sigmoid colectomy: In this procedure, surgeons remove a piece of the bowel. They will make an incision in the abdomen, remove the affected length of the colon, and then join the remaining ends of the bowel by stapling or stitching them.
  • Primary anastomosis: This procedure involves surgeons joining two parts of the colon after removing the affected length.
  • End colostomy: Instead of joining the open ends of the colon together, the surgeon may pull the end of the colon out through an incision in the abdomen and stitch it to the skin to create a stoma. The stoma removes waste into a colostomy bag outside of the body. A colostomy can be temporary or permanent.

A person with a redundant colon may experience frequent constipation. They can treat and avoid constipation by:

  • eating more high fiber foods — adults should have 22–34 grams of fiber daily
  • taking a fiber supplement
  • drinking plenty of water every day
  • trying OTC medications, such as:
  • speaking with a doctor about stopping medications or supplements that may worsen constipation

Learn more about home remedies for constipation.

A person may have a completely asymptomatic redundant colon, which they can live with without a problem. However, if symptoms do occur, they may signal a severe medical complication.

For symptomatic people, sigmoidoscopic decompression is highly successful and effective in 40–90% of cases. If a patient requires surgery due to sigmoid volvulus, there is a high likelihood of success. However, a person may require a colostomy stoma.

A redundant colon is an abnormally long colon that twists and loops to fit into the body. A person can be born with the condition, but experts are unsure of the exact causes.

Doctors may have difficulty maneuvering imaging equipment inside a redundant colon, such as a sigmoidoscope. However, a colonoscopy or CT scan may help a doctor identify loops and curves, which can help with diagnosis.

A redundant colon can lead to severe complications. If a person experiences symptoms, they may require medical intervention. Treatments include decompression of the sigmoid volvulus, which allows gas and feces to move through the obstructed area and clear it, or surgery to remove a piece of the colon.