After two years of persistent abdominal and back pain my doctors have made a tentative CT-based diagnosis of intussuception, which my dictionary defines as "the taking of one part of the intestine into an adjacent part." This sounds to me more like a scene from Alien 2 than a routine medical disorder, though my doctors say they have recently seen five other HIV/AIDS patients with the condition. The problem seems to have developed in the wake of severe GI problems from three years of Viracept and Combivir, and I am wondering if the Viracept contributed to this development. I am now on Ziagen/Combivir and am doing OK except for the pain (VL is 76 and CD4 is 389 at 24%). Is intussuception a common or serious problem? Should I pursue it with a GI specialist? Thanks for your great work on this forum, which my friends and I read regularly. Jay from Nashville.

Hi Jay,

Intussusception is primarily a problem among children, although it can occur at any age. It is relatively uncommon even among children and quite rare in adults. I am fascinated that your doctors feel they have seen 5 other cases. There may be something going on, although I am not aware of any other reports of increased problems with intussusception among people with HIV.

There is no real Alien-like weirdness about intussusception - no aliens erupting from the stomach, and not even Sigourney Weaver in a skin tight space suit... It is caused by one portion of small intestine looping back into the neighboring small intestine. The best way I know to explain it is to take a long balloon that is not to firmly inflated, and poke your finger into one end so that it doubles back into itself.

Usually intussusception is a more acute process, and it would be unusual to have pain for two years. A consultation with a GI doctor sounds like a good idea, since it is possible that something caused the intussusception, or that may not be the whole story. A study called an enteroclysis may be useful, where barium is dripped into your stomach by a tube and xrays are taken. It beats tryin to drink the stuff. Good luck, and happy new year.

ATP