The human intestine is responsible for the digestion and absorption of food, and also removes toxins from the body. Immune processes and the synthesis of peptide hormones are associated with its work. Therefore, it is very important that this organ be he althy and fully able to perform its functions. However, often the pathological processes in it develop almost imperceptibly or symptoms appear that at first do not cause any concern. And now, during the examination, a pathology is discovered that the person did not even suspect.
Diverticular bowel disease may be such a disease. It is worth noting that, oddly enough, it is more common in developed countries, and as a rule, in older people. People under the age of 40 are much less likely to suffer from it. So what is this disease, what are its symptoms and how is it treated? Consider further.
What does "diverticular disease" mean?
First, let's define what a diverticulum is. It is formed in the intestinal wall, where blood vessels enter the circular muscle. When the pressure in the intestine rises, in weak areas, the mucosa is pushed out into the lumen of the intestine between the muscle fibers. The so-calledbag-shaped protrusions. Their size can be from 1 to 2 centimeters. Here they are called diverticula. Diverticula can form in different parts of the intestinal tract, but most often it occurs in the large intestine.
All diseases in the international classification have their own code, and diverticular disease is no exception. ICD-10 includes this pathology under the code K57.
This disease can occur both asymptomatically and with an inflammatory process and complications. As mentioned earlier, the risk of developing this pathology is highest in elderly patients. It is much less common before the age of 40.
Depending on how the disease proceeds, it can be classified as follows:
- Asymptomatic diverticulosis.
- Diverticulosis with symptoms.
- Diverticulitis with complications.
Regardless of the course of the disease, if such a diagnosis is made, it is necessary to be observed by a doctor. If it is started and it takes a complicated form, then it can be fatal if the operation is not done in a timely manner. We will talk about this a little later. Now let's look at what symptoms can signal that there is diverticular bowel disease. How to recognize the impending problem on your own?
Symptoms of diverticular disease
Diseases such as diverticular disease (of the sigmoid colon, for example) are most often asymptomatic in the early stages, especially in young people. Only rarely cancomplaints like this:
- Constipation.
- Abdominal cramps.
- Belly enlargement.
Such symptoms may occur if diverticular disease occurs without complications, in which case there are no pronounced manifestations of the disease.
If diverticulosis progresses, then the symptoms appear much brighter. In this case, complaints might look like this:
- Nausea appears.
- Vomiting.
- Constipation.
- Pain in the abdomen, most often on the left side. It is pronounced on palpation.
- The body temperature rises.
- Chills, weakness appears.
- Intoxication of the body, headaches.
The more complex the case, the more pronounced the symptoms of the disease. If you suspect that you have diverticular disease, the symptoms described earlier should alert you. It is important not to miss the moment and seek help in a timely manner in order to avoid serious complications.
Why does diverticular disease occur in the sigmoid colon or other departments? Let's figure it out.
Causes of diverticular disease
Do not forget that such a disease as diverticular disease of the colon, is characteristic primarily of the elderly. Therefore, one of the causes of this pathology is associated with age, namely, a violation of cellular metabolism in the muscular layer of the intestine.
Also, the reasons include the following factors:
- Incorrect development of the connective tissuetissues and impaired collagen fiber synthesis.
- Irrational nutrition, namely insufficient intake of vegetable fiber and an excess of fatty, starchy foods in the diet.
- Insufficient contraction of the intestinal walls and untimely bowel movements.
- Excessive accumulation of gases in the intestines.
- Spasms of the muscular wall of the intestine, squeezing of blood vessels.
- Diseases of the cardiovascular system.
- Lack of exercise, sedentary lifestyle.
- Overweight.
Now you need to figure out how to recognize such a pathology as diverticular disease of the colon.
Diagnosis of diverticular bowel disease
Diagnosis of the disease is carried out as follows. First of all, the patient must be interviewed and examined. After carefully listening to the complaints, the doctor already assumes the presence of the disease, however, for a more thorough analysis, it is necessary to undergo examinations. Only after diverticular bowel disease has been diagnosed can treatment be given.
For a thorough examination, laboratory and instrumental methods are used:
- A complete blood count can show the presence of an inflammatory process in the body. Anemia will indicate possible internal bleeding.
- Coprogram.
- Colonoscopy.
- Irrigoscopy.
- Contrast X-ray.
When examining a patient, attention should be paid to his eating habits, lifestyle, as well as the frequency of constipation and abdominal pain.
Laboratory tests, blood tests and coprogram can confirm the presence of an inflammatory process and internal bleeding.
Colonoscopy allows you to find the source of intestinal bleeding. If the patient is diagnosed with an acute form of diverticular disease, he needs to do a computed tomography. In this case, the walls of the intestine and the condition of the tissues that are located nearby will be visible.
Apply this type of study as cystography. It is used to examine vesico-intestinal fistulas. Intravenous urography is performed in order to determine whether the ureter is involved in the inflammatory process.
Angiography is used for bleeding from a diverticulum.
After a thorough examination of the patient, the doctor makes a diagnosis and prescribes the appropriate treatment. How is diverticular disease of the colon treated, see below.
Treatments for diverticular disease
If diverticulosis occurs with actively expressed symptoms, then physical activity is contraindicated. Treatment of diverticular disease of the colon depends entirely on how the disease progresses.
The following treatments may be prescribed:
- Outpatient therapy is indicated if there is no intoxication of the body, while leukocytes are not elevated, but there are clinical manifestations of the disease.
- Inpatient therapy in the departmentColoproctology is necessary if the disease is difficult.
- If the patient's life is threatened as a result of complicated diverticular bowel disease, surgery is indicated.
And now a little more about each type of treatment.
If there are clinical manifestations of the disease, but there is no inflammatory process, they can prescribe a diet and the following medications:
- Anspasmodic drugs ("No-shpa", "Spazmol", "Mebeverin").
- Drugs that normalize the intestinal microflora ("Lineks", "Baktisubtil", "Acipol").
- Enzymes ("Festal", "Creon").
If diverticular disease has strong clinical manifestations, the treatment is prescribed as follows:
- Gastrointestinal motility stimulants ("Motilium", "Pasazhiks", "Motilak").
- Antibiotics ("Sulgin", "Biseptol").
- Intestinal antiseptics ("Intestopan", "Intetrix", "Enterosediv", "Sumetrolim", "Ersefuril").
- Laxatives ("Duphalac", "Normaze").
Surgery is possible if:
- Diverticular disease of the large intestine gave complications.
- There are fistulas.
- There are chronic accumulations in tissues mixed with blood and lymph.
- Chronic diverticular disease often gets worse.
- Severe diverticular disease is not amenable to complex treatment. This ispossible with repeated exacerbation of the disease.
When choosing a method of surgical intervention, the following factors must be taken into account:
- What is the nature of the complications.
- How far the process has spread.
- What changes as a result of the inflammatory process occurred in the muscular wall of the intestine and surrounding tissues.
- Is there perifocal inflammation or peritonitis.
- What comorbidities does the patient have, as most often they are elderly people.
Surgical intervention is carried out in 2 stages. At the first, the affected area of the intestine is removed. At the second stage, anastomoses are formed between the segments of the intestine in order to restore its continuity.
It should be remembered that diverticula after surgery or successful treatment may reappear. Therefore, you should follow the diet, which will be discussed later.
Diet for diverticular disease of the colon
As we noted, in the treatment of any type of diverticular disease, first of all, the doctor will prescribe a diet. If you stick to it, you can significantly alleviate the course of the disease or prevent the development of its complications.
What foods are recommended if a diagnosis of diverticular disease is made? The diet is a balanced diet. The menu should include the following he althy foods:
- Porridge from whole grains.
- Sprouted grain.
- Whole grain bread, cereals.
- Plenty of fruits and vegetables both fresh and cooked.
- Dried fruits.
- Dairy products.
And you also need to drink enough liquid per day, at least one and a half to two liters of clean water.
Foods that are recommended to be excluded from the diet:
- Sugar, sweets.
- Strong tea, coffee.
- Soda and alcoholic drinks.
- Spices and spices.
- Fresh bread.
- Semi-finished products.
- Fast food.
It should be noted that you can not eat foods with poorly digestible components. This, for example, kiwi, grapes, seeds. If you eat fish, you should carefully clean it from small bones.
Doctors recommend using bran, gradually increasing the dosage from 5 to 20 g per day.
If you do not follow the diet, the disease will progress significantly, and complications may appear.
When diagnosed with diverticular disease, diet is one of the most effective means to prevent complications and facilitate the current process.
Dangerous complications of diverticular disease
Diverticular disease of the colon can cause dangerous complications that can become a serious threat to the patient's life. These complications include:
- Bleeding at the site of ulcer formations. Clots are one of the symptoms of bleeding.blood in stools.
- Development of intestinal obstruction, as due to the protrusion, the intestinal lumen may narrow.
- Formation of abscesses. Pus may enter the abdominal cavity.
- Local necrotic changes resulting in peritonitis.
- Perforation of the wall of a nearby organ with the formation of a fistulous tract. As a rule, these are infections of the urinary system, in women the infection can go to the vagina.
Prevention of diverticular disease
A large number of studies have been conducted to determine how to prevent the development of intestinal diverticulosis and how to keep the disease from progressing. Scientists have come to the following conclusions: if you follow a diet high in fiber, then diverticular disease will not progress. People who consumed at least 32 grams of fiber per day had the best results. Insoluble fiber is primarily vegetables and fruits.
Also noted the benefits of physical activity in the prevention of diverticular bowel disease.
The effect of alcohol, smoking, and caffeine consumption was studied in conjunction with a diet rich in fruits and vegetables. In this case, a decrease in the effectiveness of the use of vegetable fiber was noted.
It must be remembered that the patient should be warned that it is necessary to gradually increase the amount of this component in the diet, it is also desirable to exclude the harmful products that we talked about earlier. It is best to give up bad habits so that the diet has a positive effect onorganism.
Measures to prevent diverticular bowel disease include timely treatment of disorders in the gastrointestinal tract. Prevention of constipation and an active lifestyle will help to avoid this unpleasant pathology.
What is the treatment prognosis?
If diverticular disease is asymptomatic, surgery is not required. She may no longer be disturbed if the patient adheres to the diet and recommendations of the doctor.
If the disease is in an acute stage, then conservative treatment is prescribed, which, as a rule, the patient tolerates well, and one does not have to resort to surgical intervention. Only 15 percent of cases require surgery.
Recurrence of acute diverticulitis is considered possible in 1 out of 4 cases. Repeated exacerbations of the disease are much worse. In this case, the body does not respond well to conservative drug treatment. In such situations, surgical intervention is more often indicated. After an uncomplicated second attack, elective surgery may be scheduled. Recurrent acute diverticulitis has a significantly higher mortality rate.
If the help of a surgeon is required, then it is advisable not to postpone it, since postponing the operation increases the risk of mortality by up to 18%. In the presence of perforation in the abdominal cavity with peritonitis, the patient must be urgently operated on, since the death rate in such cases is 35%.
There are studies that confirm that younger patients are at a much higher risk of disease recurrence than older ones.elderly patients. In immunocompromised patients, the recurrence of attacks of diverticular disease is higher than in people with normal immunity.
After surgery, 10% of cases require a second operation. In 20% of patients, if there was bleeding, it may recur after some period of time. In 33% of cases, the inflammatory process may recur.
In general, we can say that with timely treatment and subsequent diet and regular prevention of intestinal disorders, a good prognosis can be given.
Folk treatments
Since ancient times, there are many recipes for traditional medicine for various diseases. Diverticular disease of the colon or any other part of the intestine is no exception.
These prescriptions should only be used after consulting a doctor. Better yet, after a full examination, because the main thing is not to harm the body.
Treatment of diverticular disease with folk remedies can only be effective if, in addition to them, the patient adheres to the recommended diet and leads a he althy lifestyle.
Here are some recipes and recommendations:
- Oil and flax seeds. Before using the seeds, pour them with warm water at the rate of one tablespoon per glass of water. After a while, the seeds will swell, and the liquid will look like jelly. This composition perfectly protects the mucosa of the gastrointestinal tract, and also improves its functioning. It is necessary to use on an empty stomach one tablespoonspoon.
- Psyllium seeds are a storehouse of essential fiber for a disease such as diverticular disease. In terms of the amount of valuable substances, they surpass oats and barley. Regular consumption of seeds allows you to establish the work of the gastrointestinal tract, improves peristalsis. You need to use them in this way. Pour one tablespoon with a glass of water or juice, you can use yogurt. This mixture should be drunk immediately. After 30 minutes, be sure to take a glass of water. A sufficient amount of liquid is the main condition when using psyllium seeds. The seeds inside swell and do their useful work. Drink three times a day until you feel better.
- According to folk recipes, it is very important to cleanse the intestines from toxins, fecal stones, and food decay products. It is very useful for the intestines to carry out cleansing by collecting herbs. These are flowers and branches of thorns. Three tablespoons of the collection must be poured with a liter of boiling water and insisted, for this it is better to use a thermos, since the infusion should stand warm overnight. Then strain it and drink 3 times a day, an hour before meals, 1 glass. Within three days it is necessary to take this remedy. If constipation appears, you do not need to drink the infusion. Drink plenty of water and yogurt, at least a liter a day.
- In the acute course of diverticular disease, it is recommended to use the following folk recipe. It is necessary to take 100 grams of peony root, mistletoe grass, nettle leaves. Pour two tablespoons of the collection with a liter of cold water and put on fire. Bring to a boil, but do not boil. Then cool downstrain and take one glass twice a day, morning and evening, an hour should pass after eating. The decoction can be used for enemas. Cannot be used for hemorrhoids. Continue treatment for 10-14 days.
- A good remedy for diverticular disease based on slippery elm bark. It is prepared in the following way. Half a teaspoon of powdered bark and a teaspoon of granulated bark are poured into one glass of water. On low heat, everything should boil for 20 minutes. Then strain, bring the volume of liquid to one glass and take 200 ml in the morning and evening.
Before using folk remedies, be sure to consult your doctor. Sometimes doctors themselves can recommend some effective remedies that can be used along with medications. It is also worth noting that any treatment must be carried out under the supervision of a specialist, especially in cases that are accompanied by the manifestation of acute symptoms.
