🧒🚑 Intussusception in Children: A Parent-Friendly Guide

⚠️ Intussusception is when one part of the intestine slides into another part, like a telescope folding in.
This can cause intermittent severe belly pain and can block blood flow to the bowel if not treated quickly.
It is treatable, and many children improve fast once reduced (often without surgery).

1) 🧾 Quick “At-a-glance” box (top of page)

✅ Condition name: Intussusception
Common names: Telescoping bowel, bowel “folding in”

Plain-language summary (2–3 lines):
Intussusception causes episodes of severe crampy abdominal pain because the bowel slides into itself. Many children look fine between pain episodes, which can be confusing. It often needs urgent evaluation and is commonly treated by an air/contrast enema that “pushes” the bowel back into place.

Who it affects (typical ages):
Most common in infants and toddlers (often 6 months to 3 years), but can happen at any age.

✅ What parents should do today:

• If your child has repeated sudden severe belly pain episodes, seek urgent care
• Watch for vomiting (especially green), lethargy, or bloody stools
• Do not give heavy foods until assessed
• Go to an emergency department with pediatric imaging capability if possible

⚠️ Red flags that need urgent/ER care:

• Child extremely sleepy, weak, or difficult to wake
• Green (bilious) vomiting
• Bloody “currant jelly” stool
• Severe ongoing pain or belly swelling

🟡 When to see the family doctor/clinic:
Intussusception is usually not a clinic issue—urgent assessment is needed if suspected.

2) 🧠 What it is (plain language)

The intestine is a long tube. In intussusception:

• one segment slides into the next
• this can cause blockage
• swelling can worsen the blockage
• blood flow can be reduced (rare but dangerous if delayed)

What part of the body is involved? (small diagram required)

Common myths vs facts

• Myth: “If my child is fine between pains, it can’t be serious.”
  Fact: Many children look normal between episodes.
• Myth: “It’s always caused by something the child ate.”
  Fact: Often no clear cause; sometimes follows a viral illness.
• Myth: “Surgery is always required.”
  Fact: Many cases can be reduced with an enema procedure.

3) 🧩 Why it happens (causes & triggers)

Common cause in toddlers/infants

• often idiopathic (no clear cause)
• may follow viral illness with swollen lymph tissue in the intestine

Less common but important causes (more likely in older children)

• a “lead point” (something pulling the bowel in), such as:
  • polyp
  • Meckel’s diverticulum
  • enlarged lymph tissue
  • tumor (rare in children)

Triggers

• recent viral gastroenteritis or upper respiratory infection

4) 👀 What parents might notice (symptoms)

Classic symptoms (not always all present)

• sudden severe crampy belly pain
• child may draw knees up, cry, then calm down
• vomiting (can become green/bilious)
• lethargy (can be prominent)
• stool with blood/mucus (“currant jelly” — late sign)

What’s normal vs what’s not

⚠️ Not normal:

• repeated severe pain episodes
• green vomiting
• blood in stool
• extreme lethargy

Symptom tracker (helpful in the ER)

• timing of pain episodes
• vomiting color and frequency
• stool appearance
• fever presence
• child’s alertness between episodes

5) 🏠 Home care and what helps (step-by-step)

⚠️ Intussusception is an emergency evaluation problem. Home care is mainly: do not delay.

First 24–48 hours (what to do immediately)

✅ Do this now:

• go to the emergency department urgently
• keep your child hydrated with small sips if allowed (but many need to be kept “NPO”)
• bring a record of symptoms and times
• do not give solid foods until assessed

6) ⛔ What NOT to do (common mistakes)

• Don’t wait for “one more episode” if pain is severe/recurrent.
• Don’t give laxatives at home.
• Don’t assume it is “gas” if episodes are intense and repetitive.
• Don’t ignore lethargy.

7) 🚦 When to worry: triage guidance

🔴 Call 911 / Emergency now

• child very difficult to wake
• severe weakness/collapse
• trouble breathing
• signs of shock

🟠 Same-day urgent visit (ER now)

• repeated intense belly pain episodes
• vomiting (especially green)
• blood in stool
• belly swelling

Example: “My toddler screams in pain for 5 minutes, then is okay, then repeats every 20 minutes.”

🟡 Book a routine appointment

Not appropriate if intussusception is suspected.

🟢 Watch at home

Not appropriate if intussusception is suspected.

8) 🩺 How doctors diagnose it (what to expect)

What the clinician will ask

• pain pattern (episodic vs constant)
• vomiting and stool changes
• recent illness
• prior episodes

Physical exam basics

• belly tenderness or mass (sometimes)
• hydration status
• alertness

Possible tests (and why)

• ultrasound (most common and best test)
• abdominal x-ray (if obstruction or perforation concern)
• labs (hydration, infection indicators in some cases)

What tests are usually not needed

• CT scan in typical infant/toddler cases if ultrasound confirms (varies by center)

9) 🧰 Treatment options

✅ The goal is to “reduce” (un-telescope) the bowel quickly.

First-line treatment

• Air or contrast enema reduction under imaging guidance
  • often fixes it without surgery
  • also confirms diagnosis in many cases

If not improving (next steps)

• surgical reduction if enema fails or if child is unstable
• surgery also needed if there is bowel perforation or a lead point

Severe cases (hospital care)

• IV fluids
• antibiotics if perforation/infection suspected
• bowel resection if bowel is damaged (uncommon with early treatment)

Treatment notes (parent-friendly)

• Enema reduction is a procedure done by specialists; it is not the same as an at-home enema.
• After reduction, children are observed because it can recur.

10) ⏳ Expected course & prognosis

• Many children improve quickly after successful enema reduction.
• Some need brief observation and then go home.
• Recurrence can happen, most often within the first day or two.

What “getting better” looks like

• pain stops
• child becomes more alert
• vomiting settles
• normal feeding gradually returns

What “getting worse” looks like

• persistent severe pain
• worsening lethargy
• green vomiting
• blood in stool

11) ⚠️ Complications (brief but clear)

Potential complications

• recurrence
• bowel obstruction
• reduced blood flow to bowel (if delayed)
• perforation (rare, usually related to advanced disease or procedures)

12) 🛡️ Prevention and reducing future episodes

Most cases cannot be prevented. But you can reduce risk of delayed diagnosis by:

• recognizing the pattern of episodic severe pain
• seeking urgent care early

13) 🌟 Special situations

Infants

May present mainly with lethargy and vomiting.

Older children

More likely to have a lead point; evaluation may be broader.

Kids with chronic conditions

Lower threshold for ER assessment.

Neurodevelopmental differences/autism

Pain signs may look like agitation or withdrawal; trust caregiver instincts.

Travel considerations

Seek care immediately; don’t try to “wait it out” while traveling.

School/daycare notes

Not applicable during acute event; after recovery usually no restrictions.

14) 📅 Follow-up plan

• follow-up as advised after reduction or surgery
• return to ER if pain episodes recur
• surgical follow-up if lead point or surgery occurred

15) ❓ Parent FAQs

“Is it contagious?”

No.

“Can my child eat ___?”

After treatment, feeding is advanced gradually as advised.

“Can they bathe/swim/exercise?”

Once recovered, yes.

“Will they outgrow it?”

Most infants/toddlers do not have repeated episodes long-term.

“When can we stop treatment?”

Treatment is immediate; follow-up depends on whether it was reduced or surgery occurred.

16) 🧾 Printable tools (high-value add-ons)

🧾 Printable: Intussusception One-Page Action Plan

Suspect intussusception if:

• severe episodic belly pain
• vomiting (especially green)
• lethargy
• blood/mucus in stool

Action:

• Go to ER now
• Do not give solid foods
• Bring symptom timing notes

ER/911 immediately if:

• child collapses
• cannot wake child
• severe weakness

🧾 Printable: Symptom Timing Log

Time: ______ Pain episode: yes/no Duration: ______
Vomiting: yes/no Color: ______
Stool: normal / mucus / blood
Alertness between episodes: normal / sleepy / very sleepy

🧾 Printable: “Red Flags” Fridge Sheet

⚠️ Urgent: episodic severe pain, green vomiting, blood in stool, extreme lethargy.

17) 📚 Credible sources + last updated date

Trusted references:

• Children’s hospital emergency and surgical education pages on intussusception
• Pediatric radiology resources for ultrasound diagnosis

Last reviewed/updated on: 2025-12-30
Local protocols may differ for observation time and recurrence management.

18) 🧡 Safety disclaimer

This guide supports—not replaces—medical advice. Intussusception can be urgent—seek emergency care for repeated severe abdominal pain, green vomiting, or lethargy.

🧡 Safety disclaimer

This guide supports—not replaces—medical care. If you are worried about your child, trust your instincts and seek urgent medical assessment.

This guide was fully developed & reviewed by Dr. Mohammad Hussein, MD, FRCPC ROYAL COLLEGE–CERTIFIED PEDIATRICIAN & PEDIATRIC GASTROENTEROLOGIST Board-certified pediatrician and pediatric gastroenterologist (Royal College of Physicians and Surgeons of Canada) with expertise in inflammatory bowel disease, eosinophilic gastrointestinal disorders, motility and functional testing, and complex nutrition across diverse international practice settings.

To book an online assessment Email Dr. Hussein’s Assistant Elizabeth Gray at: Elizabeth.Gray@pedsgimind.ca
In the email subject, please write: New Assessment Appointment with Dr. Hussein

Important: This appointment is completely online as Dr. Hussein is currently working overseas. This service is not covered by OHIP