This article looks at the symptoms and treatment of sigmoid diverticulosis.
According to statistics, every fifth person in the world is diagnosed with this disease. Its symptoms are manifested, in most cases, in older people, and are associated with age-related disorders in the body. After 80 years, a similar disease is detected in more than half of patients.
Description
Diverticulosis of the sigmoid colon is considered to be a pathological process, which is characterized by the formation of diverticula (saccular hernia-like protrusions on the walls of the intestine). As a rule, the disease develops closer to the age of 50, since it is at this age that the walls of the sigmoid colon begin to weaken and squeeze outward with an increase in intracavitary pressure.
The formation of diverticula is usually not a congenital disease, but manifests itself under the influence of adversefactors, as well as malnutrition. When the formation of multiple diverticula is noted in the sigmoid colon, such a disease is characterized as diverticulosis of the sigmoid colon (according to ICD-10, the code is assigned - K57), but it should be distinguished from diverticulitis, the main factor in the occurrence of which are inflammatory processes.
Reason for development
The underlying cause of the development of this pathological phenomenon in clinical medicine is considered to be age-related changes that lead to degeneration of the muscles of the intestinal walls and provoke general degenerative disorders in the body.
Another factor contributing to the development of diverticulosis is the weakness and underdevelopment of connective tissue, which occurs as a result of acquired or congenital failures in the synthesis of collagen fibers.
In addition, disruptions in intestinal motility are considered a common cause of this disease. This manifests itself in such a way that with an increase in intra-intestinal pressure, the fibers of the intestinal walls seem to stretch and form specific protrusions, which are called diverticula. They can form during spasms of the intestinal muscles, which lead to squeezing of the vessels inside the intestinal walls and impaired blood circulation in them. As a result, there is stretching and dystrophy of the spaces around such vessels, which eventually leads to similar protrusions.
The cause of the formation of diverticulum may be a hereditary factor, and the likelihood of developing this disease increases many times if the family has notedcases of diverticulosis of the sigmoid colon.
Diet also plays an important role in the development of pathology. Numerous scientific studies confirm that, for example, in India and African countries with the prevailing predominance of plant foods in the diet, the incidence of such a disease is much less than in Europe, where, as a rule, preference is given to food of animal origin.
Disease types
Depending on the initial factors that provoked the development of sigmoid diverticulosis, the pathology is classified as congenital or acquired.
Given the nature of the pathology, diverticulosis can be:
- asymptomatic;
- with pronounced, characteristic features;
- complicated.
False and true diverticulosis
In addition, the disease is divided into false and true diverticulosis. True refers, as a rule, to congenital forms of pathology, which is characterized by protrusion of all layers of the intestine, its mucous, muscular and submucosal membranes. The false form of diverticulosis is acquired and develops throughout life. It can manifest itself as a protrusion of the mucous membrane of the sigmoid colon.
Characteristic symptoms
It is best to start therapy for this disease when initial symptoms appear, but sometimes it is rather difficult to detect diverticulosis of the sigmoid colon, since in most patients the pathological process can proceed without visiblesigns and is detected, most often, by chance during the passage of any examinations.
The most common symptom of this disease is pain in the lower abdomen. Pain in this case can be of a very different nature and can be perceived by people as disorders in the digestive tract, and in women as disorders in the reproductive sphere. Patients often associate discomfort with dietary errors and do not seek medical attention, as the pain usually disappears after a bowel movement.
Very often the symptoms of sigmoid diverticulosis develop against the background of irritable bowel syndrome. When an inflammatory process occurs, the symptoms of the disease begin to increase significantly. Pain in the left iliac part becomes persistent and prolonged, and its intensity after the act of defecation, as a rule, does not decrease.
Pain syndrome can last for several days and intensify with palpation of the area and even during movements. The instability of the stool can be accompanied by nausea, vomiting, abdominal cramps and constant discomfort.
If at the first stages of occurrence the symptoms of diverticulosis of the sigmoid colon are practically absent, then over time they make themselves felt. Due to the stagnation of feces, the development of complications of this disease begins - inflammation of the protrusions of the intestinal walls (diverticulitis). In this case, the pain syndrome becomes constant and is accompanied by pronounced symptoms of intoxication in the body and fever.
Whenprolonged course of diverticulosis of the sigmoid colon and the formation of large diverticula, the following symptoms may occur:
- drawing pain in the left lower abdomen caused by spasm of the sigmoid colon;
- constipation or loose stools for a long time;
- bloating on the left side and flatulence;
- Feeling of heaviness and fullness in the abdomen, especially in its left side, which passes after stool.
It is important to know how to treat sigmoid diverticulosis.
Possible consequences
When complications occur, the patient's condition deteriorates, which is accompanied by severe weakness and fever. If left untreated, the following pathologies develop:
- Intestinal bleeding, which occurs in most cases suddenly and is caused by vascular damage due to the formation of erosions or ulcers inside the inflamed diverticulum. The patient notes the appearance of blood in the feces, the amount of which depends on the size of the affected vessel. Sometimes bleeding can be very profuse, and if this symptom becomes chronic, the patient begins to develop anemia, dizziness, shortness of breath, weakness, and palpitations.
- Development of diverticulitis. This complication is provoked by bacteria that accumulate and multiply in the feces. This pathological process is manifested by severe pain, hyperthermia and the appearance of mucous elements in the feces.
- Perforationdiverticulum, when its contents exit the sigmoid colon into the abdominal cavity and peritonitis begins, a life-threatening condition. If it enters the retroperitoneal cavity, phlegmon (tissue suppuration) is formed.
- Abscess in the cavity of the pathological protrusion of the intestine. If this formation breaks into the intestine, an improvement in the patient's condition is observed. In the event of a breakthrough into one of the neighboring organs, the formation of an internal fistula begins. With an enterovaginal fistula, patients have abundant discharge with an unpleasant odor and admixture of feces from the genital tract. Fistulas in the gastrointestinal tract are manifested by repeated vomiting, and intestinal-bladder provoke frequent cystitis, characterized by the excretion of particles of feces and pus in the urine.
- Intestinal obstruction, which develops as a result of long-term diverticulitis and the formation of adhesions in the intestine.
How to detect diverticulosis of the sigmoid colon (ICD-10 code - K57)?
Diagnostic measures
The development of this disease threatens with very unpleasant and serious complications, therefore, correct and timely diagnosis will help to take measures in order to avoid life-threatening conditions.
When examining a patient, a specialist should pay attention to a number of specific factors: age, characteristic complaints, lifestyle, tendency to develop constipation, diet. The doctor also examines the patient, identifying painful areas characteristic of such a pathological process with the help of palpation.
Determine the clinical picture of the pathology and identify diverticulosis will also help a detailed history.
To make a diagnosis, a person is also prescribed a number of hardware and laboratory tests. Their list includes:
- Colonoscopy, which is a research method that allows you to assess the condition of the intestinal cavity from the inside. This procedure is carried out using a special flexible probe equipped with a video camera at the end. The probe is inserted into the intestine through the anus. The picture is displayed on the monitor, and the specialist has the opportunity to visually assess the condition of the intestine, determine the presence of diverticula and take a tissue fragment for a specific study.
- Irrigoscopy is an examination in which an X-ray of the intestine is taken, previously filled with a contrast agent. If diverticula are present in the sigmoid colon, such a substance fills them, and in the picture such saccular protrusions are visualized very well.
- Laparoscopy, which is a method of diagnosis and therapy at the same time. During this procedure, surgeons make three punctures in the patient's abdominal wall, through which they insert a miniature camera that allows you to examine the surface of the organs and, under magnification, detect even the slightest changes on the intestinal walls. If necessary, a specialist can remove the diverticulum. The procedure is performed under general anesthesia.
- In some complicated cases, x-rays of internal organs are prescribedabdominal cavity or imaging techniques such as MRI and computed tomography.
Treatment of sigmoid diverticulosis
Methods of treating pathology depend on the stage of the disease, the development of complications, the state of he alth and age of the patient, dietary habits and lifestyle. Uncomplicated forms of diverticulosis are treated conservatively, and the treatment of severe stages of the disease involves surgery.
Conservative methods of treatment of sigmoid diverticulosis imply an integrated approach that includes a special diet and the use of medications. The patient is prescribed:
- Broad spectrum antibacterials (penicillins, cephalosporins).
- Anspasmodic and analgesic medicines that eliminate spasms of the intestinal muscles ("Drotaverin", "Mebeverin", "No-shpa", etc.).
- Motor-stimulating prokinetics.
- Enzymes to normalize digestion ("Festal", "Pancreatin").
- Laxatives containing lactulose (Duphalac).
- Drugs that restore intestinal flora ("Bifidumbacterin").
- Medicines that relieve flatulence and diarrhea ("Sulgin").
In complex forms of the disease, the following activities are carried out:
- Gastric lavage.
- Siphon enemas.
- Infusion therapy with crystalloid solutions.
Surgical treatment is carried out in cases where such dangerous complications develop,like heavy bleeding, intestinal obstruction, peritonitis.
Treating sigmoid diverticulosis at home can be very effective.
Diet for diverticulosis
To improve the patient's condition, a special diet is prescribed, in which the presence of vegetable fiber predominates. The diet is formed on the basis of fruits and vegetables, cereals, brown rice and legumes. In order to avoid irritation of the intestines, it is recommended to bake, steam or boil the products. What else does the diet for diverticulosis of the sigmoid colon mean?
Eat should be fractional, eating 5-6 times a day in small portions. Nutritionists also advise to adhere to a separate diet, which contributes to better absorption of food by the body.
Diet for diverticulosis includes bran, whole grain cereals. It is necessary to limit the use of confectionery, semi-finished products, chips, flour products.
Whole milk, carbonated drinks, chocolate, coffee and strong tea, alcohol are completely excluded from the diet. Diet in the treatment of sigmoid diverticulosis is very important.
In addition, it is necessary to include natural laxatives in the menu: dried apricots, prunes, herbal infusions, fermented milk products. It is also advised to consume garlic, which helps to cleanse the intestines and neutralizes many pathogenic bacteria.
Recommended daily salads of fresh vegetables in vegetable oil and largeamount of liquid. Useful for diverticulosis are also freshly squeezed vegetable or fruit juices and liquid dishes. A large amount of fiber contains nuts, bran, cereals, zucchini, asparagus, cabbage, carrots, spinach.
Consider also the treatment of diverticulosis of the sigmoid colon with folk remedies.
Therapy with folk remedies
Treatment with traditional medicine prescriptions greatly alleviates the patient's condition, but they should be used after consultation with your doctor. The following folk remedies are used:
- Linen or olive oil. They help relieve constipation and reduce inflammation. At the same time, it is recommended to take one tablespoon of oil every day during the day and at bedtime, and also use it for dressing salads. What other folk remedies for diverticulosis of the sigmoid colon are used?
- Herbal tea. For its preparation, dry nettle leaves, chamomile flowers, motherwort, dill seeds and rose hips are mixed in equal proportions. Pour a tablespoon of this mixture into a thermos and pour 200 ml of hot water, after which it is allowed to brew for an hour. Then the infusion should be filtered and drunk 100 ml in the morning and evening.
- Decoction of elm bark. One spoon of crushed bark is poured into 200 ml of water and boiled for 20 minutes, then the broth must be filtered and taken every day for 100 ml.
We looked at the symptoms and treatment of sigmoid diverticulosis.
