Intestinal diverticulosis is a very common disease that people face regardless of gender and age (even newborns are sometimes diagnosed with a congenital form of the disease). The disease is accompanied by the formation of diverticula - protrusions of the intestinal walls. If left untreated, the pathology can lead to various complications, including intestinal perforation, the development of peritonitis, the appearance of massive bleeding.
Of course, many people are looking for more information about the disease. Why does intestinal diverticulosis develop? Symptoms and treatment, risk factors and possible complications are interesting facts worth exploring.
General information about pathology
As already mentioned, intestinal diverticulosis (ICD-10 assigned the disease code K57) is a pathology that is accompanied by the formation of protrusions of the intestinal wall. Despite the fact that the disease can affect any part of the digestive tube, in most cases, diverticula form from the tissues of the large intestine.(90% of all diverticula are localized in the colon).
According to statistics, the likelihood of developing the disease increases with age. In most cases, people over 40 years old experience a similar problem.
Why does the disease develop?
In fact, the reasons for the development of such a pathology may be different. Alas, they are not always found out.
If we are talking about a congenital form of the disease, then it may be associated with congenital weakness of the connective tissue. In this case, diverticula can appear not only in the intestines, but also in the bladder, stomach and other organs. As a rule, at first the wall of the protrusion consists of the same layers as the intestinal wall. However, as the disease progresses, muscle fibers gradually atrophy.
As for the acquired forms of the disease, many factors can provoke their development. For example, malnutrition is potentially dangerous. If a person eats only easily digestible foods, while refusing food rich in fiber, then this eventually leads to the formation of too hard feces that injure the intestinal wall. In addition, fiber deficiency is fraught with a violation of natural peristalsis. Together, these factors lead to chronic constipation and eventually diverticula.
There are other risk factors:
- being overweight, obese;
- lack of exercise;
- sedentary lifestyle;
- disturbance of motility of the intestinal tract(both congenital and that which is associated with the development of certain diseases);
- vitamin deficiency;
- constipation.
The formation of a diverticulum leads to impaired blood circulation in the intestinal tissues, thinning of the walls, gradual atrophy of the muscle layer.
Forms of diverticulosis
Intestinal diverticulosis can occur in different ways. That is why there are many classification schemes. Diverticula may be:
- congenital (formed during fetal development);
- acquired (formed after birth under the influence of various factors).
Diverticula can be either single or multiple. In addition, the pathological process can be localized in different parts of the large intestine, for example, the sigmoid, colon or blind (very rare) intestine. Diverticula in the walls of the small intestine are much less common (no more than 10% of cases).
The disease may be asymptomatic, but is often associated with inflammation or complications. Diverticula can be traction (formed, for example, during adhesions) or false (there are no muscle fibers in the wall of the protrusion).
Main symptoms of pathology
It is worth noting right away that sometimes the symptoms of diverticulosis of the large intestine may be completely absent. If there is an uncomplicated form of the disease, then patients for many years may not even be aware ofthe presence of an ailment.
However, as the disease progresses, some disorders begin to appear:
- Gradually, intestinal motility is disturbed, and the pressure in its cavity increases, which leads to spastic pains. Discomfort is paroxysmal - unpleasant sensations either increase or disappear. The pain is dull in nature and is usually localized in the lower abdomen, often on the left side.
- Sometimes pain and discomfort appears or worsens immediately after eating.
- In some cases, the pain becomes sharp and resembles an attack of appendicitis. In addition, discomfort can spread to the lower back, sacrum, buttocks, anus, groin and perineum.
- There are also problems with the chair. Protracted constipation is often replaced by diarrhea. Stools usually contain large amounts of mucus.
- Patients suffer from persistent bloating and flatulence. Palpation is accompanied by increased pain, but there is no tension in the abdominal wall. Gases emitted from the intestines have a very fetid odor.
- Some patients complain of false urges that do not end with defecation. Sometimes the patient has a sensation of incomplete bowel movement.
What complications can the disease lead to?
The symptoms of intestinal diverticulosis can worsen if there are certain complications. In the absence of timely and proper treatment, the disease canlead to dangerous, sometimes even fatal consequences. Their list includes:
- inflammation of the tissues of the diverticulum, which is accompanied by fever, tissue damage, swelling and exacerbation of pain;
- intestinal bleeding (both small and massive);
- perforation of the intestine (perforation of the intestinal wall occurs, which is accompanied by the release of the contents of the digestive tract into the abdominal cavity);
- the formation and accumulation of purulent masses, the formation of an abscess and its further rupture;
- external or internal fistulas (report a certain area of the intestine with nearby organs);
- adhesion formation;
- acute or chronic form of intestinal obstruction (there is a violation or a complete stop of the movement of food and feces through the intestinal tract).
Diagnostic measures
Unfortunately, intestinal diverticulosis is accompanied by very non-specific symptoms that may indicate a variety of diseases. That is why correct diagnosis is so important.
First, you need a general examination, consultation with a general practitioner and gastroenterologists. Physicians should collect as much information as possible to complete the history, as well as familiarize themselves with the patient's main complaints.
A blood test is mandatory. An increase in white blood cells indicates an inflammatory process, and a decrease in the number of red blood cells indicates internal bleeding.
Ongoingbacteriological examination of stool samples, coprogram, and analysis of stool for the presence of occult blood (again, helps to detect bleeding in the intestine).
An abdominal X-ray is also needed.
If no perforations and other complications were detected during the plain radiography, then an irrigography with double contrast is performed. In the pictures, the doctor will be able to see the protrusion of the intestinal wall, which communicate with the cavity of the digestive tube.
Ultrasound of the abdominal organs is also carried out. Diverticula themselves cannot be seen during the procedure, but some other diseases can be ruled out and the absence of complications can be confirmed.
Endoscopic examination methods, in particular, colonoscopy, are also informative. With the help of special equipment, the doctor can carefully examine the intestinal mucosa, determine the presence of adhesions, protrusions and other deformities.
During endoscopy, sometimes a biopsy is also performed - samples of damaged tissues are taken with their further microscopic examination.
Computer and/or magnetic resonance imaging is additionally performed.
Treatment of intestinal diverticulosis directly depends on the causes of its development and the presence of complications. It is this information that you need to find out during the diagnosis.
Drug treatment of intestinal diverticulosis
The appearance of digestive disorders is a good reason to make an appointment withdoctor. The symptoms and treatment of intestinal diverticulosis are related. Methods of therapy will directly depend on the appearance of certain disorders, as well as the intensity of symptoms.
If intestinal diverticulosis was discovered by accident (the disease is at an early stage, there are no symptoms), then patients are prescribed a special diet high in plant fibers. In addition, a person needs to undergo regular examinations so that the doctor can monitor the progression of the disease.
Sometimes, in addition to the treatment regimen, enzyme preparations are included (ensure the improvement of digestive processes), as well as agents that reduce the amount of gases formed in the intestines. Probiotics will also be useful, which ensure the colonization of the digestive system with beneficial bacteria.
If diverticulosis of the large intestine is accompanied by an inflammatory process, then it is advisable to take antibiotics. As a rule, doctors prescribe broad-spectrum antibacterial drugs (you can’t take them on your own).
Anspasmodic drugs ("Spazmalgon", "Spazmol", "Drotaverine", "No-shpa") help relieve abdominal pain.
Gastrointestinal motility stimulants are used. Medicines such as Motilac, Motilium, Domperidone are considered effective.
Some prebiotics are used to combat constipation, in particular, Lactulose Poly, Normaze, Portalac, Duphalac.
If no improvement occurs within three days after the start of drug treatment, the patient needs hospitalization. Patientss alt solutions and glucose are administered, which helps maintain the water-s alt balance and natural metabolism. In such cases, the doctor conducts additional diagnostics and decides on surgical treatment.
Diet for intestinal diverticulosis
You already know what medicines are used for such a disease. Nevertheless, proper nutrition in intestinal diverticulosis is no less important than the use of drugs.
Diet rules are quite simple:
- Wheat bran is useful, as it can reduce pressure inside the intestines, as well as facilitate the formation and promotion of feces. Brewed bran can be added to soups, cereals, vegetable dishes, mixed with fermented milk products. Since the abundance of vegetable fibers can increase abdominal pain, it is recommended to start with a minimum daily dose of bran, gradually increasing it.
- The diet should also include kefir, yogurt and other fermented milk products. Useful will be cereals from buckwheat and wheat groats. Doctors also recommend including vegetable soups (can be cooked in meat broth), vegetable casseroles.
- It is worth giving up rice and semolina, pasta, bread and pastries made from premium flour. You also need to exclude cocoa and chocolate, strong brewed tea, coffee, jelly, red wine from the diet. These foods slow down intestinal motility and have astringent properties.
- It is important to maintain water balance - it is advisable to drink about 2 liters per daypure water.
When is surgery needed?
The symptoms and treatment of colonic diverticulosis are closely related. And with the appearance of certain complications, surgical intervention is indispensable. The operation is performed in the presence of the following indications:
- formation or opening of an existing abscess;
- presence of fistulas;
- damage to the diverticulum, especially if the process is associated with the development of phlegmon or peritonitis;
- acute intestinal obstruction;
- presence of severe intestinal bleeding;
- frequent relapses of the disease, lack of effect from drug therapy.
Surgical treatment of diverticulosis of the large intestine is to remove the affected area with further stitching. According to statistics, the procedure is well tolerated by patients and provides a lasting effect. The chance of recurrence (provided proper diet and other precautions are followed) is about 2%.
Folk treatments
Traditional medicine also offers medicines to help manage abdominal pain, constipation, and other symptoms of intestinal diverticulosis. Of course, you can use such funds only with the permission of the treating specialist.
Herbal collection will help to cope with digestive disorders. First you need to mix in equal quantities chopped rose hips, as well as dried chamomile flowers, dill, nettle leaves and motherwort. A tablespoon of the mixture should be poured with a glass of boiling water andinsist (2-3 hours will be enough). Strained infusion is taken half a cup twice a day, preferably with meals. The medicine is used daily for 6 weeks.
Green apples and germinated wheat grains need to be crushed in a blender (we take the components in equal amounts). It is recommended to eat 200-300 g per day. This helps to saturate the body with plant fibers and improve bowel function. The course lasts a month, after which you need to take a break for 4 - 5 weeks.
- Prevention measures
- We have already learned about the symptoms and treatment of intestinal diverticulosis in adults. According to the reviews of doctors and statistical studies, the disease in most cases responds well to treatment.
- Unfortunately, it is impossible to prevent the development of congenital forms of the disease. As for acquired diverticulosis, you can prevent its occurrence by adhering to the right diet (you need to include foods rich in vegetable fibers in the diet). In addition, it is important to maintain physical fitness, strengthen muscles, improve the functioning of the immune system. Since obesity is a risk factor, it is important to control body weight. If there are warning signs, you should immediately contact a specialist.
