What is pneumatosis intestinalis?

Pneumatosis intestinalis is a condition in which gas is present in the mucosal lining of the small or large intestine. The condition itself is not considered a disease, and many cases do not cause any symptoms or health problems. However, pneumatosis intestinalis can be indicative of several different gastrointestinal disorders or chronic obstructive pulmonary disease. Babies with this condition are also likely to experience necrotizing enterocolitis, or death of intestinal tissue. Doctors usually try to identify and treat the underlying cause of pneumatosis intestinalis to prevent serious health problems.

A person showing signs of pneumatosis intestinalis likely has an inflammatory gastrointestinal disorder or pulmonary obstruction. Bacterial infections, Crohn's disease, and ulcerative colitis can cause inflammation, irritation, and gas buildup. Also, blood flow to the intestines can be interrupted in a condition called ischemia. The lack of oxygenated blood causes the accumulation of hydrogen gases in the intestinal walls and ultimately results in necrosis of the intestinal tissue. Patients with symptomatic pneumatosis intestinalis may experience diarrhea, chronic abdominal pain and bloating, constipation, and fatigue.

Treatment of the underlying cause, when it can be determined, is essential to prevent permanent and sometimes life-threatening complications. Many types of inflammatory bowel disease and pulmonary obstructions can be controlled with corticosteroids and antibiotics. Cases of intestinal ischemia often require surgical intervention to remove damaged tissue and restore proper blood flow to the intestines. Regular checkups are often important after treatment to ensure the gas buildup dissipates and the underlying cause is kept under control.

Pneumatosis intestinalis may not be discovered until a patient undergoes a medical exam for a different problem. If a doctor notices gas buildup in the intestinal walls, she may perform more imaging scans, take blood samples, and remove a piece of intestinal tissue for laboratory testing. In cases where the condition is idiopathic and does not cause any adverse symptoms, patients usually do not need treatment. Benign pneumatosis intestinalis tends to go away over weeks or months.

Most cases of pneumatosis intestinalis in infants are associated with intestinal tissue necrosis, in which the lining of the intestines dies and erodes. Necrotizing entercolitis is more common in premature newborns and can cause bloody diarrhea, bloating, and vomiting. The disease can be fatal if treatment is not immediate. An emergency surgeon may try to relieve symptoms by removing dead tissue from the intestine and administering antibiotics. Gas and irritation are usually relieved when necrotizing entercolitis is treated effectively.

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