Many people wonder where the rectosigmoid colon is located. What diseases are associated with this area? Let's figure it out in this article.
Rectosigmoiditis is an inflammation of the distal regions of the large intestine, that is, the rectum and sigmoid colon. This disease can be acute, and can also become chronic. The acute form of the disease is manifested by cramping pain, diarrhea, nausea, tenesmus, weakness, and, in addition, chills and hyperthermia. Against the background of chronic rectosigmoiditis, the pains are aching or pulling. In addition, there are false urges with diarrhea, intoxication syndrome is possible.
Diseases of the rectosigmoid rectum are diagnosed based on complaints, on the basis of examination, rectal and endoscopic examination. Also, patients take stool tests, and a biopsy is performed. Treatment involves diet, antibiotic therapy, symptomatic treatmentand the use of topical anti-inflammatory agents.
So where is the rectosigmoid colon?
Anatomy
The rectosigmoid junction is the area of the rectum that is fifteen centimeters above the anus. The human rectum extends from the anorectal junction all the way to the sigmoid colon.
The rectosigmoid section is located in the bone pelvis, this area is surrounded by muscles, organs of the genitourinary system, and, in addition, ligaments and various connective tissue structures. In this department, the natural mechanism of bowel movement is controlled. The human rectum is partially located extraperitoneally. Its proximal border is the rectosigmoid junction.
The rectosigmoid section usually consists of a mucous membrane, and, in addition, a submucosal layer. It is also formed by the muscular coat. Outside, it is covered with a powerful fascia.
The mucous membrane of the rectosigmoid section of the rectum is covered with a cylindrical epithelium, which has a large number of goblet cells. This shell, among other things, contains a lot of Lieberkühn glands, which are almost entirely composed of mucous cells. It is for this reason that in the presence of pathological processes, an abundant amount of various mucus is released from the rectum.
The blood supply in the rectosigmoid section of the rectum is carried out by the lower, and at the same time the middle and upper hemorrhoidal arteries. Of these, the superior artery is unpaired, and the other two are paired,they approach the rectum from the sides.
Basic information about rectosigmoiditis
What pathologies occur in the rectosigmoid colon?
Rectosigmoiditis refers to a group of acute and chronic inflammatory pathologies of various origins that affect the rectum and sigmoid colon. Rectosigmoiditis is the most common type of colitis. It occupies a leading position in frequency among proctological pathologies. It is often diagnosed in adults. In particular, the likelihood of developing this disease increases between the ages of twenty and forty and after fifty-five.
Rectosigmoiditis and its causes
Inflammation of the rectosigmoid colon occurs with specific and some non-specific infections, and, in addition, against the background of inflammatory bowel diseases, in the presence of helminthiases, malnutrition and as a result of stagnation of feces. Among other things, the cause of rectosigmoiditis may be poisoning with toxic compounds along with local circulatory disorders. Also, the causes of this disease may be:
- Spread of inflammatory processes from neighboring organs.
- The presence of chronic diseases in the areas of digestion.
- Diseases of the pancreas and liver.
- Performing radiotherapy.
Infectious rectosigmoiditis can develop under the influence of pathogens. Inflammation is a non-specific diseaselower intestines in the presence of salmonellosis, dysentery, cholera and other similar infections with oral transmission. A specific type of rectosigmoiditis can be observed against the background of local infection with the causative agent of syphilis, gonorrhea and a number of other sexually transmitted diseases.
The parasitic nature of the disease of the sigmoid department can occur in the presence of giardiasis, ascariasis, enterobiasis and other helminthiases. The causes of alimentary rectosigmoiditis are the following factors:
- Alcohol abuse.
- The presence of an excessive addiction to spicy, and at the same time to s alty and fatty foods.
The congestive form of the disease develops with constipation due to traumatization of the intestinal walls by excessively dense feces. The toxic nature of rectosigmoiditis can be diagnosed against the background of an overdose of certain drugs, due to mushroom poisoning, and so on.
Sometimes this disease occurs due to the transfer of infection from nearby tissues and organs, for example, against the background of paraproctitis, vaginitis or urethritis. Rectosigmoiditis often affects patients who have other chronic diseases of the digestive system. For example, rectosigmoiditis can occur in the presence of gastritis, cholecystitis, diseases of the pancreas, gallbladder or liver. Among other things, the cause of rectosigmoiditis, as well as cancer of the rectosigmoid region, may be radiation therapy for oncological pathologies of the small pelvis.
Symptoms of rectosigmoiditis
For the acute form of the disease, a typical sudden onset with the onset of weakness, in addition, the patient may feel weakness, a pronounced deterioration in well-being, hyperthermia, chills, nausea and vomiting. Patients suffering from rectosigmoiditis usually complain of intense cutting cramping pain in the left side of the abdomen. In addition, diarrhea can be observed along with frequent tenesmus, accompanied by the release of a certain amount of feces, mucus and blood as well. There may be flatulence with a feeling of incomplete intestinal emptying. As part of the initial stages of rectal examination, a spasm may be detected, and subsequently complete relaxation of the sphincter.
In the presence of chronic rectosigmoiditis, the clinical picture is usually less bright, exacerbation, in turn, may alternate with remissions of different duration. Symptoms are usually caused by malnutrition along with alcohol abuse. Against the background of an exacerbation, patients suffering from rectosigmoiditis may complain of aching or pulling pain in the left side of the abdomen. Pain is often given to the lower back and perineum. Against the background of bowel movements, the pain syndrome may intensify. Very often there is itching around the anus along with frequent stools, tenesmus and bloating. Spasms and relaxation of the sphincter are less pronounced than in acute rectosigmoiditis.
Diagnosis of pathology
The diagnosis of this disease exposesproctologist, taking into account complaints, history of pathology and data on examination of the anal region. In addition, the abdomen is palpated, digital rectal examination is performed, sigmoidoscopy and a number of laboratory tests are performed.
Against the background of palpation of the abdomen of a patient suffering from rectosigmoiditis, the pain that the patient feels in the left iliac region is usually determined. During the study of the perianal zone, areas of maceration and irritation are often detected. As a result of a rectal examination, spasms or relaxation of the sphincter along with swelling of the intestinal mucosa may be detected. Traces of mucus and blood may remain on the glove. Sigmoidoscopy, as a rule, confirms the presence of inflammation in the patient, making it possible to determine the type and severity of inflammatory processes.
Based on blood tests, leukocytosis is detected along with an increase in ESR. A coprogram usually indicates the presence of blood and elements of the intestinal mucosa in the feces. Against the background of rectosigmoiditis caused by helminthiasis, pinworms with ascaris and other parasites can be found in the feces. In rectosigmoiditis, which develops due to infection, pathogens may be present in the fecal matter. In doubtful situations, a biopsy is performed during the sigmoidoscopy. As for the final diagnosis, it is made taking into account the results of the histological examination. Now let's look at how a disease such as rectosigmoiditis is treated.
Methods of therapyrectosigmoiditis: main directions
Treatment of this disease is often conservative. As a rule, it includes the implementation of etiopathogenetic and symptomatic therapy.
Patients are assigned a sparing diet to reduce irritation of the intestinal walls. Coarse fiber, too cold and too hot, spicy, smoked, fried and fatty foods are excluded from the diet. It is recommended to consume warm soups, and, in addition, dietary steamed main courses.
Against the background of the parasitic form of rectosigmoiditis, antiparasitic drugs are prescribed. In the presence of a radiation form of the disease, the corresponding therapy is stopped, and if pathogenic bacteria are detected, antibacterial treatment is carried out.
Cleansing enemas are used for any kind of rectosigmoiditis. Enemas are usually performed with a decoction based on chamomile, with the addition of fish oil, collargol solution or sea buckthorn oil. Sitz baths are also used along with candles with anti-inflammatory and regenerating effects.
Covering and astringent preparations may be prescribed. In the presence of severe pain, patients are shown antispasmodics, and against the background of flatulence, medications are required to reduce gas formation. In the presence of ulcerative rectosigmoiditis, hormone therapy may be needed, which is usually carried out in the form of local remedies - suppositories or microenemas.
After the elimination of the inflammatory process in the rectosigmoid colon, it is recommended to take drugs that helprestore intestinal microflora. Subject to timely and adequate treatment of rectosigmoiditis, the prognosis is usually favorable.
Treatment of rectosigmoiditis
From the established cause and the diagnosis made, what treatment awaits the patient depends. Quite often, doctors prescribe conservative therapy using traditional methods. Based on the information received, the treatment is carried out in a hospital so that the doctor can monitor the patient's condition and respond in time to any changes. The patient is given etiotropic therapy and the symptoms are eliminated. As part of this treatment, the following recommendations are required:
- When developing radiation injury to the intestines, it is necessary to stop the appropriate therapy or adjust the dosage of radiation.
- Prescribing an antibacterial drug to reduce the impact of negative organisms.
- Prescription of probiotics used to normalize the intestinal microflora.
- To combat spasms, the patient is prescribed antispasmodics.
- The use of infusion therapy is used to restore water balance in the body. This measure is used to reduce intoxication, and, in addition, helps with diarrhea.
- The use of special preparations to improve the intestinal microflora and mucosal structure.
Adenocarcinoma and rectosigmoiditis
Adenocarcinoma is a malignant tumor that usually develops from glandular cells. be locatedthis malignant formation can be in different mucous membranes, internal organs or on the skin. But often the tumor in the rectosigmoid intestine is located, which is its most frequent localization. This is observed in ninety-five percent of cases. The tumor is often a complication of rectosigmoiditis. Next, let's take a closer look at what this adenocarcinoma is.
Description of pathology
So, as we already know, the rectosigmoid junction is the part of the rectum that is fifteen centimeters above the anus. Adenocarcinoma located in this area is also called a sigmoid tumor. During diagnosis using magnetic resonance imaging, the anus, as a rule, is not displayed, in connection with this, the area of localization of the tumor is determined by measuring the gap from the anorectal junction to the neoplasm itself.
Rectosigmoid colon adenocarcinoma tends to develop very quickly, and, in addition, is one of the most progressive cancer variations. Adenocarcinoma quickly forms metastases, accompanied by the most painful symptoms for the patient.
Symptomatics
The main symptoms of a tumor of the rectosigmoid colon include the following symptoms:
- The occurrence of pain in the intestines.
- The appearance of blood in the stool.
- The occurrence of bloating with a strong release of gases that have a sharpputrid smell.
- Complete refusal of the patient from food along with the disappearance of appetite.
- The appearance of lethargy, apathy, depression and unwillingness to live in a person. It must be said that such symptoms can be observed in a patient even before he knows his immediate diagnosis.
- Deterioration of the complexion, and, in addition, the skin throughout the body.
- The occurrence of vomiting, nausea, along with the rejection of the stomach of any food immediately after eating.
- Complete lack of interest in food along with the rejection of various, previously very favorite smells.
- Lightning fast weight loss, and at the same time the loss of more than ten kilograms of weight in less than three months.
- Occurrence of bad breath along with belching of air before and after eating.
- Appearance of sticky skin and cold sweat.
- Cloudy pupils and yellowness of the face.
Unfortunately, at the initial stage of development of a tumor of the rectosigmoid colon, the symptoms are imperceptible or completely absent. In this regard, without an accurate preliminary diagnosis and without screening, it is difficult for the patient to suspect them on their own. The earlier adenocarcinoma is detected, the greater the patient's chances of survival and the more comforting the prognosis will be. It is also worth noting that depending on the patient's he alth, age, race and gender, the propensity for cancer of the rectosigmoid region of the rectum may be greater or lesser.
Main causes of adenocarcinoma
The causes of rectosigmoid adenocarcinoma may be as follows:
- Two or more close relatives have had this cancer.
- Lack of fiber in food, and, in addition, the use of raw plant foods.
- The presence of weak peristalsis.
- A person's strong addiction to meat food, especially pork.
- Complete lack of physical activity in a person.
- Being obese and overweight along with diabetes.
- Passion for smoking and alcohol in large quantities. It is worth noting that alcoholics are several times more likely to develop this type of cancer than moderate drinkers.
- Presence of inflammatory diseases of the stomach or intestines.
- Presence of chronic dysbacteriosis.
- Indulgence in promiscuity.
How is rectosigmoid colon cancer treated?
Treatment of this pathology
The main treatment for this cancer is surgical resection. It can be complete or partial. In addition to the area affected by cancer, regional lymph nodes are also removed. Tissue samples from nearby lymph nodes must be histologically examined for the presence of cancer cells.
But the situation becomes more complicated if the tumor of the rectosigmoid junction is inoperable. When the operation is not possible, a small section of the intestine is completely removed with the formation of a colostomy (this is a special tube for removing digestive waste).
Another way to treat cancer of the rectosigmoid colon is radiation therapy, which is postoperative and preoperative. The first may be required if the cancer has spread to the abdominal wall and the area behind the peritoneum. The timing of postoperative radiotherapy is two weeks after surgery.
Chemotherapy is used for rectosigmoid adenocarcinoma in combination with other treatment options. Chemotherapy drugs are Fluorouracil along with Capecitabine, Oxaliplatin, Tegafur and others. The course of treatment is usually about three months.
