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Treat sigmoid diverticula. How to treat diverticulosis of the sigmoid colon? Features of the clinical picture

Statistics confirm that this disease is diagnosed in every fourth person in the world. Its symptoms appear in middle-aged and elderly people and are provoked by age-related changes in the body. At the age of 70-80 years, this disease is detected in more than 50% of patients. We are talking about such a disease as diverticulosis of the sigmoid colon.

The pathological process, called diverticulosis of the sigmoid colon, is characterized by the formation of diverticula (hernial sac-like protrusions of the intestinal walls). Often, the disease reveals itself by the age of 50, it is at this age that the walls of the sigmoid colon begin to weaken and squeeze them out with an increase in intracavitary pressure.

In the vast majority of cases, the diagnosis of diverticulum formation is not congenital, but manifests itself under the influence of adverse factors and malnutrition. If the formation of multiple diverticula is observed in the sigmoid colon, the disease is characterized as diverticulosis of the sigmoid colon, while it must be distinguished from diverticulitis, the main factor of which is the inflammatory process.

Causes of diverticulosis of the sigmoid colon

What are the provoking factors that cause pathological changes in the state of the body? These may be age-related changes leading to degeneration of the muscles of the intestinal wall and causing general degenerative changes in the body.

Another reason contributing to the development of diverticulosis can be considered underdevelopment and weakness of the connective tissue resulting from a congenital or acquired failure in the synthesis of collagen fibers.

Malfunctions in intestinal motility are considered a common cause of the onset of the disease. This is manifested by the fact that with increased intra-intestinal pressure, the fibers of the intestinal wall, as it were, "disperse" and form characteristic protrusions (diverticula).

Diverticula can form with spasm of the muscles of the intestinal wall. These manifestations lead to squeezing of blood vessels inside the intestinal walls and disruption of blood circulation. As a result, dystrophy and stretching of the spaces around the vessels are noted, leading to protrusion of the intestinal walls.

The cause of diverticulum may be a hereditary predisposition. The likelihood of the disease increases many times if there have been cases of sigmoid diverticulosis in the family.

Diet plays an important role in the development of the disease. Thus, numerous studies confirm that in countries of Africa and India with a historically established predominance of a plant-based diet, there are significantly fewer cases of the disease than in European countries, where food of animal origin is preferred.

Classification of diverticulosis

Depending on the origin, diverticulosis of the sigmoid colon can be congenital or acquired. Depending on the nature of the flow, it can be:

  1. Asymptomatic
  2. With characteristic, pronounced manifestations
  3. Complicated

In addition, diverticulosis is divided into true and false. True refers to congenital diseases and occurs when all layers of the intestine, its muscular, mucosal and submucous membranes protrude. False diverticulosis is acquired, is formed during life and is manifested by the protrusion of the mucous membrane.

It is necessary to start treatment of this disease when the first symptoms appear. But sometimes it is difficult to do this, since in most patients diverticulosis can occur without visible manifestations and is discovered by chance during an appointment with a doctor for a completely different reason.

The most characteristic symptom of the disease is pain in the lower abdomen, which is of a very different nature and can be perceived by patients as disorders in the gastrointestinal tract. Patients associate discomfort with dietary errors and do not seek medical help, since pain usually disappears after a bowel movement.

Often diverticulosis occurs against the background and when the inflammatory process is attached, the symptoms of the disease begin to manifest themselves especially strongly. Pain in the left iliac region becomes persistent and prolonged, their intensity after the stool does not decrease.

The pain syndrome lasts for several days and increases with palpation of the specified area and even while walking. Unsteady stools can be accompanied by nausea and vomiting, abdominal cramps, and a constant feeling of discomfort.

Even if at first the disease is asymptomatic, then over time, disturbances in the body make themselves felt. As a result of stagnation of stool, a complication of diverticulosis develops - inflammation of the protrusions of the intestinal walls (diverticulitis). In this state, the pain becomes constant and is accompanied by symptoms of intoxication of the body and a significant increase in temperature.

With a long course of the disease and large diverticula, the following symptoms are characteristic:

  • Drawing pains in the left lower abdomen caused by spasm of the walls of the sigmoid colon
  • or loose stools for a long time
  • Bloating on the left side and flatulence
  • Feeling of heaviness and fullness in the left side of the abdomen, which disappear after stool

With the development of complications, there is a persistent deterioration in the patient's condition, accompanied by severe weakness and a sharp increase in temperature. What complications occur most often?

It is clear that the development of the disease threatens with serious and unpleasant complications, so timely diagnosis and proper treatment will help to avoid life-threatening conditions and improve the patient's well-being.

When examining a patient, a specialist draws attention to a number of factors: characteristic complaints, the patient's age, lifestyle, diet, and a tendency to constipation. The doctor examines the patient, identifying painful areas characteristic of this disease with the help of palpation.

A detailed history will help clarify the clinical picture and suspect diverticulosis. To confirm the diagnosis, the patient is prescribed a series of laboratory tests and hardware examinations.

In some complex cases, the patient may be assigned a survey radiography of the abdominal organs or such visual examination methods as computed tomography and MRI. Such a method as ultrasound in this case is not informative and is not used to clarify the diagnosis.

Methods of treatment of diverticulosis of the sigmoid colon will depend on many factors: the stage of the disease, the risk of complications, the age and general well-being of the patient, his lifestyle and diet. Uncomplicated diverticulosis is treated conservatively, the treatment of severe forms of the disease involves surgical intervention.

Conservative treatment involves an integrated approach that includes a special diet and drug therapy. The patient is prescribed:

  • Broad spectrum antibiotics (cephalosporins, penicillins)
  • Painkillers and antispasmodics that reduce muscle spasm (drotaverine, no-shpa, mebeverine)
  • Prokinetics that stimulate intestinal motility
  • Laxatives based on lactulose (duphalac)
  • Enzymes to improve digestion (mezim, pancreatin, festal)
  • Preparations that restore the intestinal microflora (Linex, Bifidumbacterin)
  • Means, and flatulence (biseptol, sulgin)

In severe forms of diverticulosis, the following therapeutic measures are carried out:

  • Perform gastric lavage
  • Unload the intestines with siphon enemas
  • Carry out infusion therapy with crystalloid solutions
  • Use fresh frozen plasma

Surgical intervention is performed in cases where life-threatening complications occur: heavy bleeding, peritonitis, intestinal obstruction. Indications for surgical intervention are:

  • frequent exacerbations with severe pain,
  • the risk of developing other oncological neoplasms.

The operation is carried out in two stages. At the first stage, resection is carried out, that is, the affected areas of the sigmoid colon are removed, at the second stage, an anastomosis is formed, connecting the remaining sections of the intestine. In addition to resection, drainage of the abdominal cavity is carried out and subsequent intravenous administration of antibiotics.

Timely medical care and properly selected treatment tactics allow you to make a favorable prognosis and save the patient from unwanted complications.

Diet for diverticulosis of the sigmoid colon

To alleviate the condition, the patient is prescribed a special diet with a predominance of plant fiber. The diet is formed on the basis of the following products: fruits and vegetables, brown rice, cereals and legumes. To avoid intestinal irritation, products are recommended to be steamed, baked or boiled.

Nutrition should be fractional, you need to eat 5-6 times a day in small portions. Many nutritionists advise adhering to the principles of separate nutrition so that food is better absorbed by the body.

The diet for diverticulosis includes wholemeal bread, bran, whole grain cereals. Limit the consumption of refined foods:

  • confectionery,
  • semi-finished products,
  • chips,
  • flour products.

The following foods are excluded from the diet:

  • whole milk,
  • chocolate,
  • carbonated drinks,
  • coffee,
  • strong tea,
  • alcohol.

It is recommended to include natural laxatives in the menu: prunes, dried apricots, fermented milk products, herbal infusions. It is advised to use garlic, it helps to normalize the intestinal microflora.

Every day you should eat salads of fresh vegetables with vegetable oil and drink plenty of fluids (up to 2 liters). Freshly prepared juices from vegetables and fruits, broths and first courses are of great benefit.

Useful fiber contains bran, seeds, nuts, unrefined cereals. A lot of it in zucchini, asparagus, cabbage, carrots, spinach. In the diet, they try to adhere to the "rule of three" - they eat three servings of vegetables, three pieces of grain bread, three fruits and 300 grams daily. brown rice porridge or oatmeal. This will help you get the fiber you need.

Try not to overeat, lead a healthy lifestyle and refuse to eat food with artificial food additives. In addition to proper and rational nutrition, an increase in physical activity, long walks and special gymnastics are welcome.

Treatment of diverticulosis of the sigmoid colon with folk remedies

Treatment with the help of traditional medicine recipes helps to alleviate the patient's condition and improve his well-being. Let's talk about the most effective and common methods.

Treatment of diverticulosis of the sigmoid colon with folk remedies should be carried out in combination with drug therapy and carried out after consultation with a doctor and under his supervision. It is dangerous to engage in self-medication so as not to worsen the situation and avoid the development of complications.

Remember that the use of folk remedies should not replace a visit to the doctor. Only a competent specialist can make a correct diagnosis, conduct the necessary examination and choose the right treatment tactics that guarantee relief of the condition and help defeat the disease.

Content

Due to the influence of certain adverse factors or an improper diet, the structure of the intestine and its sections, for example, the sigmoid, may be disturbed. This is especially true for people of mature age, when some organs become weakened. Such diseases include diverticulosis of the sigmoid colon. What symptoms indicate this pathology? The instructions below will tell you about the causes, symptoms, and treatment of diverticulosis.

What is the sigmoid colon

The name of the sigmoid colon, one of the sections of the large intestine, is directly related to its shape, similar to the Greek Latin letter "sigma". It begins in the upper part of the small pelvis with a slope to the left side of the abdomen. Then the sigmoid section passes into the rectum, and its bends can reach the right hypochondrium. The organ itself is completely covered by the mesentery, which consists of a large number of vessels and nerves.

The disease is a neoplasm on the walls of the sigmoid colon in the form of a diverticulum. The latter look like thinned sections of the mucous membrane that protrude on the surface of the organ. Diverticula of the sigmoid colon can also be congenital due to a developmental defect. The acquired form is more often diagnosed in the older generation, and equally in males and females. The formation of such protrusions is diverticulosis, and their inflammation due to pathogenic bacteria already leads to diverticulitis.

Causes of diverticulitis

The following factors cause sigmoid diverticulitis to develop:

  1. Age over 50 years. In the process of natural aging, the condition of the intestinal walls worsens, which leads to their weakening.
  2. genetic predisposition. Those whose relatives have experienced diverticulitis are more likely to develop it.
  3. Nutrition. The predominance of plant foods in the diet increases the risk of sigmoid diverticulitis.
  4. Chronic constipation. A condition characterized by an increase in pressure in the sigmoid colon, which provokes protrusions.

Symptoms of inflammation of the sigmoid colon

Diverticulitis of the sigmoid colon is characterized by a latent course. In some patients, the symptoms appear very brightly, accompanied even by cramping pains. Diverticulosis of the sigmoid colon in the stage of inflammation has other symptoms:

  • aching pain on the left below in relation to the abdomen;
  • unstable stool with frequent constipation;
  • bloating with a bias to the left side;
  • heaviness in the abdomen, passing only after bowel movement;
  • in a more severe form - nausea and vomiting;
  • the presence of blood in the stool;
  • heat;
  • general malaise.

Diverticulosis and its types

For an adequate assessment of the patient's condition, proctologists have developed a classification of diverticular disease of the sigmoid colon. It has 3 main forms:

  1. Diverticulosis without pronounced symptoms.
  2. Diverticular disease with clinical signs.
  3. The advanced stage, accompanied by complications.

Asymptomatic course of the disease

Most cases of sigmoid diverticulosis are diagnosed incidentally when patients are examined for other pathologies. A person sometimes feels a mild pain that radiates in the abdomen, specifically in the lower left side. The patient attributes this to poor-quality food, because everything goes away after a bowel movement or with gases released. The doctor recommends a diet for this form of diverticulosis, and in case of constipation, he prescribes laxatives.

with clinical manifestations

The gradual aggravation of the symptoms of such a pathology of the sigmoid colon, if the doctor's recommendations are not followed, leads to more serious consequences. This is how diverticulitis develops, which can already lead to complications of the disease. The severity of symptoms depends on the number of diverticula in the intestine, concomitant ailments and the age of the patient. At the same time, the pains become more acute, become stronger after meals and spread to the buttocks and even the lower back. This form of sigmoid diverticulitis requires medical or even surgical treatment.

Diagnostics of the formation of a diverticulum of the sigmoid colon

Diverticular disease of the sigmoid colon can be confirmed only by laboratory and instrumental methods. The patient has to go through several stages to establish an accurate diagnosis:

  1. Survey on complaints and collection of anamnesis.
  2. Palpation of the abdomen for the presence of pain characteristic of diverticulitis of the sigmoid colon.
  3. Irrigoscopy - an x-ray of the colon when it is filled with a solution of barium sulfate to detect narrowing of the sigmoid colon and protrusions on it.
  4. Colonoscopy - endoscopy of the colon, which allows to detect the mouth of the diverticulum.

Treatment of diverticular bowel disease

Any form of sigmoid diverticulitis requires an appeal to a proctologist or gastroenterologist for the appointment of the correct therapy, and the treatment is divided into several points:

  1. Medications - antibacterial, antispasmodics to reduce pain, laxatives, prokinetics to improve digestion and enzymatic agents.
  2. Compliance with a dietary diet with the use of products useful for the intestines.
  3. Folk remedies - the use of non-official medicine recipes to normalize the stool and restore the condition of the intestines.
  4. Surgical intervention - the help of surgeons with diverticulitis of the sigmoid colon with complications.

Conservative therapy

Early stage sigmoid diverticulosis can be treated conservatively, ie. taking drugs from different groups, characterized by their effect on the body. First on the list are antibiotics, for example:

  1. Alpha Normix. Antibiotic belonging to the group of a wide spectrum of action. Indicated in the treatment of infectious diseases of the gastrointestinal tract, diverticulosis of the colon and its departments, including the sigmoid. The instructions indicate the recommended dose of 200 mg for adults and children from 12 years of age. It should be taken every 8 hours. The duration of therapy does not exceed a week, and a repeated cycle of administration is carried out no earlier than after 20-40 days. Price from 650 rubles.
  2. "Amoxiclav". An antibiotic belonging to the penicillin group. Indicated for inflammation of the urinary and respiratory tract, skin, mucous membrane of the digestive tract. Mild and moderate course of the disease requires taking 1 tablet with a break of 8 hours. The dose is intended for adults and children over 12 years of age. Price from 200 rubles.

Among the antispasmodic drugs, you can take the following:

  1. "No-shpa". It has a relaxing effect on spasms of the smooth muscles of the digestive tract, characteristic of diverticulitis. Adults need to take daily from 120 to 240 mg, divided into 2-3 doses, always after meals. Price from 50 rubles.
  2. "Buscopan". Blocks nerve impulses in smooth muscles. According to the instructions, you need to take 1-2 tablets after meals up to 3-5 times daily. Plus, you can enter rectal suppositories - 1-2 pcs. before bedtime. Price from 330 rubles.

The following drugs are aimed at relieving the symptoms of diverticulosis and improving bowel function:


Learn more about the drug for adults and children.

Surgery

Diverticulitis of the sigmoid colon with complications requires surgical treatment. Indications for surgical intervention are:

  • peritonitis;
  • profuse bleeding;
  • the likelihood of developing a cancerous tumor;
  • fistula formation;
  • frequent exacerbations with sharp pain.

The operation was directed to resection, i.e. removal of the affected area of ​​the sigmoid colon. After removing it, the surgeon can go one of two ways:

  1. Form an anastomosis, i.e. connect the healthy parts of the sigmoid colon. This is done in the case of implicit inflammation, when it is possible to restore integrity to the organ.
  2. Apply a colostomy, i.e. bring a healthy and closer to the stomach part to the anterior abdominal wall. In this way, severe inflammation of the sigmoid colon is eliminated, when it is impossible to connect parts of the organ after removing the damage. Before the second stage of the operation, i.e. anastomosis, feces are excreted in special disposable bags. The patient is discharged 10 days after the last stage.

Diet

The basis of dietary nutrition in diverticular disease of the sigmoid colon is an increase in fiber. The list of high-fiber foods includes the following:

  • fruits - persimmon, apples;
  • vegetables - pumpkin and its seeds, cucumbers, tomatoes, eggplants, zucchini, beets;
  • cereals - buckwheat, brown rice, oatmeal, oatmeal;
  • soups on meat, but low-fat broth;
  • fermented milk products - cottage cheese, kefir, fermented baked milk, natural yogurt;
  • bran bread;
  • dried fruits - dried apricots, prunes.
  • berries - strawberries, raspberries, strawberries;
  • cereals - semolina, white rice;
  • drinks - alcohol, cocoa, strong tea and coffee;
  • bakery products - pastries and white bread;
  • pasta;
  • smoked meats and canned goods.

How to treat sigma diverticulosis with folk remedies

Informal medicine offers patients with diverticulosis of the sigmoid colon several effective recipes:

  1. carrot powder. Take 4-5 tablespoons of carrot seeds, grind them to a powder. Take 1 tsp. up to 3 times a day with plenty of fluids. Carry out a course of treatment up to 2 weeks, and then repeat after a week break.
  2. Olive or linseed oil. You don't need to cook anything - just use 1 tbsp. on an empty stomach every day.
  3. Aloe tincture. Take 200 g of crushed leaves of this plant, add about 300 g of honey to them. Leave for a day, and then take 1 tbsp. l. at least one hour before meals for a course of up to 2 weeks.

Video: How to get rid of pain in the sigmoid colon

Attention! The information provided in the article is for informational purposes only. The materials of the article do not call for self-treatment. Only a qualified doctor can make a diagnosis and give recommendations for treatment, based on the individual characteristics of a particular patient.

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Discuss

Diverticular disease of the large intestine

Diverticulosis is a medical condition in which small pockets known as diverticula develop in the colon. Some doctors talk about several foods to avoid for this condition, but studies have not proven that they cause problems. Has diverticulosis of the sigmoid colon symptoms and treatment, the latter can only be proceeded after a thorough diagnosis. The patient should keep a food diary to determine which foods he should avoid.

Collapse

Before proceeding to the treatment of sigmoid diverticulitis, consider the symptoms and causes of the disease. Diseases of the gastrointestinal tract can be congenital or acquired. Congenital pathologies are characterized by underdevelopment, or a violation in the development of the vitelline duct. In the later development of the child, it is expressed in intestinal obstruction, problems with the work of the gastrointestinal tract.

Colon diverticulum

Not everyone knows what sigmoid diverticula are. - this is a blind protrusion of the intestinal walls, which are formed with excessive consumption of flour, meat foods. Monotony in nutrition and food poor in fiber leads to the development of constipation, which provoke stretching of the intestinal walls. The disease can be as a complication of colitis, intestinal dysbacteriosis and the development of an inflammatory process caused by contamination with bacterial flora.

Diverticular disease of the sigmoid colon is often asymptomatic, but can manifest itself as symptoms of appendicitis: pain in the left side, nausea and vomiting. With the development of the inflammatory process, it may be accompanied by fever. A neglected disease leads to the development of peritonitis, the formation of fecal stones in diverticula. Bleeding may also occur. In more detail, the symptoms are as follows:

  1. The pain takes on a pronounced form after emptying, as a rule, it is localized in the left side of the abdomen. Pain sensations can be present for a long time, and their source of distribution does not change at all. This process is enhanced if you strongly press on this place or perform physical exercises with increased load.
  2. Chair problems. In most cases, one of the symptoms is constipation, sometimes blood can be seen in the feces - this symptom is noted by 25% of patients.
  3. Increase in body temperature. This symptom is a consequence of a serious inflammatory process, it is associated with excessive accumulation of feces.

The above symptoms may also indicate another disease, but nevertheless, the patient should contact a medical institution. Such manifestations can only indicate a pathological process in the body, the development of which has acquired a rapid pace.

Before treating diverticulosis of the sigmoid colon, it is necessary to undergo a diagnosis of the whole organism in order not only to determine the degree of damage to the body, but also to determine the cause of such a pathological condition. According to the general blood test, an increase in ESR, leukocytosis, and a stab shift to the left are observed. Endoscopic studies such as colonoscopy can differentiate it from intestinal obstruction, colitis, constipation, and cancer. is carried out using a contrast agent that shows the contours of the intestine and with diverticula, protrusions ranging in size from 0.5 to 5 cm are noted, which can be seen on x-rays. According to the results of ultrasound, you can detect, see the thickening of the walls along the intestine.

The method of treatment depends on the form of diverticulitis. Two methods are used - conservative and surgical. The conservative method involves taking antibiotics for two weeks, following a diet, drinking regimen, and taking semi-liquid and liquid foods. The severe form is subject to hospitalization, adherence to dietary nutrition and relief of pain symptoms. The surgical method is used for peritonitis, bleeding, intestinal perforation. In this method, a portion of the intestine is removed as a source of diverticulitis.

You should follow a diet for diverticulosis of the sigmoid colon, which is rich in useful fiber and helps cleanse the intestines. The diet includes whole grain bread, bran, vegetables and fruits. Vegetables that are allowed are cabbage, carrots, and other non-coarse fiber vegetables. Radishes, pineapples, persimmons, legumes, watermelon are contraindicated.

Whole grain bread and bran are good for the digestive tract

Maintaining an active lifestyle, eating foods rich in vegetable fiber and drinking plenty of water, all this helps to reduce the manifestations of diverticulitis and serves as a prevention of its formation.

Treatment at home for diverticulosis of the sigmoid colon can be implemented using conservative methods in combination with folk recipes. This combination increases the effectiveness of conventional therapy, while it should be borne in mind that folk remedies have a minimum of contraindications, and they have also been tested by time and the experience of our ancestors.

However, the use of folk remedies shows good results only with a disease without complications. At the initial stages of development, this method allows you to remove gases from the body, relieve spasms and pain. Bran contains dietary fiber that can normalize stools, which is the main goal in the treatment of diverticulosis, which is asymptomatic. Bran can be mixed with kefir or yogurt, but first they must swell (this will take about 30 minutes). At the beginning of such therapy, the daily dose will be 1 tbsp. spoon, then gradually the volume increases every day by 50 grams.

Olive oil has a positive effect on the intestines

Olive oil has a positive effect on the condition of the intestinal walls. To do this, you can season the vegetable salad with olive oil or flax seeds. The intestinal mucosa must be constantly moistened with olive oil, it can be drunk 1 tablespoon before bedtime. To combat constipation, you need to consume 20 psyllium seeds every day, drink tea with chamomile or mint. A good result shows an infusion of elderberries.

Diverticulosis of the sigmoid colon requires the patient to follow a characteristic diet, it has a number of features and nuances. Many doctors recommend avoiding any food that has the potential to get stuck in the diverticulum. If food enters the diverticulum, it can irritate them, causing pain and an infection known as diverticulitis. Although many patients claim that they experience pain after taking certain small, hard foods, scientific evidence has not been found to support this theory.

Foods that are at higher risk of diverticulum are nuts, seeds, and popcorn. While some argue that even the small seeds in tomatoes, cucumbers, and strawberries can cause problems, most doctors say they're safe, especially if they're thermally cooked. If any of these foods are causing problems, they can be ground in a food processor.

It is necessary to establish nutrition taking into account all the nuances

Nutrition for diverticulosis of the sigmoid colon has some nuances, first of all, you need to protect yourself from harmful and “heavy” food. Fried and high-fat foods are also considered foods to avoid with diverticulosis. These types of food take a long time to digest. And it can cause bloating and a feeling of pressure in the large intestine, which can cause pain and other complications. Diverticula are weak areas of the colon and therefore anything that causes additional pressure should be avoided. Some other foods to avoid with diverticulosis are foods with fast-digesting carbohydrates, such as white rice, pasta, and white bread.

Foods low in dietary fiber take extra time to go through the digestive process, causing high blood pressure just like fried foods. Patients should instead increase their fiber intake to help the colon digest foods easily.

Colon stimulants, also called laxatives, can also cause problems for people with diverticulosis, whether they're in the form of foods or drugs. Laxatives are very harmful to the colon and diverticula. But researchers haven't proven that these foods cause big problems, which is why many doctors recommend keeping a very detailed food diary to determine which foods are safe for each patient. To keep a diary, the patient will need to record what he or she eats at each meal, as well as taking their medications and bowel movements (that is, how often the patient goes to the toilet). Foods that cause pain should be observed so that the patient can determine which foods to avoid in diverticulosis.

The preventive diverticulitis diet is very different and is meant to be used when people do not have an active infection. This diet focuses on getting the patient a diet high in dietary fiber. Some of the best sources include beans, whole grain rice, and other whole grains such as oats. Green vegetables and many types of fruits are very high in these fibers. Dietary fiber is combined with protein low fat foods and can be very nutritious and beneficial.

Diverticulosis is a serious disease of the digestive system that requires the patient to be especially patient and follow special treatment measures. The latter for the most part consist in proper nutrition and conservative methods, and their effectiveness can be significantly increased by treating diverticulosis of the sigmoid colon with folk remedies. It is forbidden to prescribe therapy on your own, so you must definitely go to the hospital, in most cases you will need treatment in a hospital so that the specialist can monitor the patient's condition and make the necessary adjustments to his treatment.

It can become inflamed due to the significant curvature of this organ. As a result of this, significant pressure is exerted on it, which leads to the formation of diverticulosis of the sigmoid colon. It manifests itself in the form of the formation of protrusions. They are called diverticula.

The concept of "diverticulosis"

Diverticula form on the intestinal walls and resemble small sacs. Pathology can be congenital or acquired.

With congenital diverticulosis of the sigmoid colon, protrusions form in a child in the womb. An acquired disease can occur at any age with an improper lifestyle, primarily nutrition or the presence of a pathology of the digestive system.

Diverticula can be from one to several. About such a disease as diverticulosis of the sigmoid colon, they speak in the latter case.

Diverticulosis of the sigmoid colon according to ICD-10

In our country, the International Classification of Diseases (ICD) was introduced in 1999 to account for the causes of death, the reasons for the appeal of individuals to medical institutions, and the incidence rate. Currently, the ICD 10th revision is in force. A new edition is to be released by WHO in 2018.

According to the ICD, diverticulosis of the sigmoid colon refers to diseases of the large intestine and has the code K57 "Diverticular bowel disease". Upon closer examination of the code, K57.2 and K57.3 can be distinguished, which refer to the large intestine with and without perforation and abscess, respectively.

Etiology

Diverticula in the large intestine are rare in people under 50 years of age (5%), the disease progresses after 50 to 70 years, its incidence increases to 30%, and after 70 to 50%. After 90 years, almost every person has multiple protrusions. They can be located in any part of the large intestine (sometimes they are also found in the small intestine), most often diverticulosis of the sigmoid colon is observed. This is due to its smaller diameter, compacted consistency of the content, multiple bends. Also, the sigmoid colon is characterized by a reservoir function, which increases intraluminal pressure in it. The protrusions have a diameter of 3 mm to 3 cm or more.

Causes of the disease

Diverticulosis of the sigmoid and descending colon is mainly caused by dystrophic changes in the intestinal walls, vascular dynamics and weakening of the connective tissue.

In addition, the reasons may be:

  • age;
  • chronic pathologies.

The appearance of diverticula is strongly influenced by malnutrition. A rational menu should include food with a small amount of carbohydrates and a large amount of fiber. Otherwise, constipation occurs. Hard feces begin to stretch the walls of the intestine. However, the exact picture of what is happening has not yet been clarified.

In addition, the development of diverticulosis is affected by low physical activity and overweight. In this case, there is a prolapse of hemorrhoids during the formation of hemorrhoids, the development of constipation, which leads to the occurrence of the disease in question.

It is 10 times less common among residents of African and Asian countries compared to Europeans and Americans.

Symptoms

In the presence of single protrusions, they do not manifest themselves for a long period of time. After the onset of the inflammatory process, the following symptoms of sigmoid diverticulosis appear:

  • there are signs of severe intoxication;
  • there are painful syndromes that are chronic;
  • bleeding occurs;
  • discomfort develops in the abdomen.

The first painful syndromes begin to appear even before the onset of the inflammatory process. They are irregular in nature, so they are mostly ignored by patients.

After the act of defecation and discharge of gases, they pass.

At the beginning of the development of complications, blood appears in the feces, which indicates injury to the diverticulum. As the size of the protrusion increases, painful sensations appear that do not stop. During the implementation of palpation of the abdomen, they become more pronounced.

Symptoms of intoxication appear with a long stay of feces in the sac and the beginning of the development of the inflammatory process.

The following symptoms appear:

  • nausea;
  • vomit;
  • diarrhea;
  • increase in body temperature.

Depending on the degree of the disease, various symptoms of diverticulosis of the sigmoid colon are observed. Treatment should be aimed at eliminating the cause of the disease. One person may have several symptoms at the same time. They can develop as a result of the development of other pathologies that require an immediate emergency call to the house.

Complications

The main ones are the following:

  • obstruction in the intestines due to the formation of adhesions that impede the exit from the body of feces;
  • perforation of the diverticulum, in which there is a rupture of the walls of the intestine, due to which the feces enter the abdominal cavity, causing intoxication of the body, while acute pains appear in the abdomen, the rupture leads to relief of suffering, but requires immediate hospitalization;
  • fistula formation - inflammatory processes can be purulent, which turn into fistulas if left untreated, which are difficult to eliminate without surgery;
  • severe bleeding - it is possible immediately after the onset of the inflammatory process, after the formation of ulcers on the diverticulum.

If the patient has severe abdominal pain, you should immediately visit a doctor or call an ambulance.

Diagnosis

The doctor collects an anamnesis, listening to the patient's complaints and performing palpation in the abdomen. After that, an additional examination is assigned, including:

  • analysis of blood and feces;
  • colonoscopy;
  • x-ray examination;
  • Ultrasound of the abdominal organs.

Diverticulitis is characterized by an increase in ESR and a shift of the leukocyte formula to the left. In the presence of bleeding, iron deficiency anemia is observed.

In addition to the diagnostic methods listed above, an endoscopic examination may be prescribed. But in this case, the affected segment can be viewed. This is due to the fact that the mouths of the protrusions are found if they are open. They can also be skipped if the line of their location is in the blind zone.

Colonoscopy with a pronounced inflammatory process is contraindicated.

In the acute stage of the disease, CT may be used.

After that, the doctor decides how to treat sigmoid diverticulosis.

Healing

If the pathology is in the initial stage of development without symptoms, then preventive measures and a diet are prescribed to prevent constipation. Treatment of diverticulosis of the sigmoid colon in this case also includes a set of exercises to eliminate the stagnation of stool.

For more serious inflammatory processes, the following agents are prescribed:


With the development of serious complications, the patient is sent for hospitalization. With it, antibiotics are administered intravenously, which stops the development of inflammation.

With diverticulitis of the sigmoid colon, perforation of the protrusion, the presence of multiple diverticula or peritonitis, surgery is performed, which consists in removing the affected area. After a long recovery period, the patient is prescribed antispasmodics, painkillers and laxatives.

Bleeding in many cases is stopped during the diagnosis with angiography by intra-arterial administration of "Vasopressin". Sometimes it is stopped by surgery. At the same time, angiographic embolization can lead to intestinal infarction in every fifth patient, so its implementation is not recommended. In most cases (in three quarters of patients), the bleeding caused by the disease stops spontaneously.

Folk methods

Treatment of diverticulosis of the sigmoid colon involves taking one spoonful in the morning after sleep of olive or flaxseed oil, which helps to thin the feces, saturate the body with minerals and vitamins, and relieve the inflammatory process in the intestines.

Also, to provide a carminative, anti-inflammatory and soothing effect, take decoctions from the following plants:

  • nettles;
  • wild rose;
  • motherwort;
  • chamomile;
  • dill.

A decoction of elderberries is also useful. They are poured with boiling water and infused for several hours, after which they are taken 100 ml 3 times a day.

Diet for diverticulosis of the sigmoid colon

It is prescribed after the normalization of the stool. The intestines should periodically relax, so the following dishes and foods are included in the diet:

  • cereals from oatmeal, buckwheat, brown rice;
  • nuts and dried fruits - pumpkin seeds, walnuts, dried apricots, prunes;
  • fruit and vegetable dishes: baked apricots, plums, pears, apples, boiled carrots, beets;
  • plentiful drink. You need to drink at least 2 liters of liquid per day - rosehip infusion, green tea, tea drinks, mineral and filtered water.

Eating should be fractional, uniform. The number of doses per day should be 5-6 times.

Prohibited Products

Nutrition for diverticulosis of the sigmoid colon does not include the following foods in the diet:

  • alcohol;
  • carbonated drinks;
  • Black tea;
  • coffee - the products listed above are not included for two to three months;
  • fatty, fried foods;
  • flour and sweet;
  • delicatessen goods;
  • sausages.

The latter worsen the digestive process and provoke chronic constipation. Meat dishes and seasonings lead to an increase in the load on the intestines, which leads to disruption of its work and irritates the mucous membrane.

Forecast

In the case of the development of diverticular bowel disease, in most cases it is favorable. But in some cases, life-threatening severe complications may develop. This is mainly characteristic of older people who have a weakened immune system and have many concomitant diseases.

In the diet you need to introduce foods rich in dietary fiber (fiber). In 5-10% of cases, this reduces the incidence of complications and improves the course of the disease.

A third of patients have relapses of the inflammatory process. A fifth of those who have had bleeding problems see them return after a few months or years.

Acute diverticulitis may occur in up to a quarter of patients with diverticular disease. Conservative therapy in the first episode is effective in 70% of cases, in the third - in 6%.

Prevention

It is necessary to carry out the following activities:

  • saturate the diet with dietary fiber;
  • perform a massage;
  • attend physical therapy classes.

Finally

Thus, diverticulosis of the sigmoid colon occurs everywhere after a person reaches 90 years of age. Up to 50 years, its prevalence is quite rare. Less often cases are noted in Asian and African countries. Often it is asymptomatic, detected randomly when diagnosing concomitant diseases. In the absence of pain syndromes, no treatment is required. At the same time, foods rich in fiber should be included in the diet. If pain syndromes are present, as well as bleeding, it is necessary to carry out medical intervention, which can be therapeutic or surgical. In complex treatment, folk remedies in the form of decoctions of various herbs can be used.

With the formation of abnormal protrusions in the large intestine against the background of activation of degenerative processes, diverticulosis of the sigmoid colon is diagnosed. The disease proceeds hidden, but as it progresses, it manifests itself as abdominal pain, constipation / diarrhea, flatulence, bleeding. Pathology is diagnosed during colonoscopy and irrigoscopy procedures. Auxiliary methods are analyzes and manometry. Treatment is traditional. The operation is not indicated, but is possible with the development of complications.

Description of pathology

Diverticula of the sigmoid colon are formed with morphological and functional changes in the intestinal tissues. The protrusions consist of the mucosal and submucosal layer of the sigma and descending colon, which do not withstand the pressure exerted on them by fecal masses. There is a strong stretching of the walls against the background of weakening of the intestinal muscles. The diverticulum itself looks like a hernia protruding outward. It consists of a neck with a width of 3-5 mm, a body with a diameter of up to 20 mm, a clear shape along the contour.

Prolonged fecal stagnation is dangerous pathological complications.

As stool accumulates, the sac increases in volume, the wall becomes thinner and can break through. Fecal stasis provokes the appearance of ulcers and erosions with inflammation, complicated by bleeding. Most pathological areas appear during a person's life if he does not follow the basic rules of nutrition. Congenital diverticulosis of the sigmoid colon is rare. According to the terminology, a complicated form of pathology is called "diverticular disease".

Prevalence

Most often, diverticula form in the sigmoid colon. The number of recorded cases increases in proportion to the age of the person. Consequently, the disease occurs more often in the elderly, which is explained by age-related changes in the intestinal walls and changes in the functionality of the organ. Therefore, it is not common in young people. 30% of cases are recorded in patients 40-50 years old, 50% - in people over 60; up to 80% - in the elderly. The disease affects regardless of gender. The population of Africa and Asia does not suffer from diverticulitis, since plant foods predominate in their menu. The disease is common in the West, where there is not enough fiber in the daily diet.

Types of illness

Diverticulitis of the sigmoid colon can be congenital or acquired. The second form is almost always found. Depending on the characteristics of the development of the disease, there are:

  • asymptomatic form;
  • expressed;
  • complicated.

Causes of diverticulosis of the sigmoid colon

Diverticula of the sigmoid colon cause the following pathological conditions and changes in the human body:

Symptoms of pathology

The onset of the disease has no pronounced symptoms.

A feature of diverticulosis is the absence of symptoms for a long time. If the diverticula are large or multiple, the patient feels pulling pains in the area of ​​the projection of the descending intestine or in the left lower abdomen. Discomfort appears as a result of spasm of the intestinal walls. Other symptoms of diverticular disease are:

  • instability of the stool with a tendency to prolonged constipation;
  • flatulence and swelling on the left;
  • sensation of fullness and heaviness on the left side, easing after a bowel movement.

As the diverticular pathology develops, it begins to manifest itself, which is typical when inflammation of the formed sacs joins against the background of a constant accumulation of feces in them.

Symptoms of a protracted pathology with inflammation:

  • chronic pain radiating to the buttocks, groin, back, anus;
  • fever, fever;
  • symptoms of poisoning of the body;
  • blood impurities in the stool.

Carrying out diagnostics

Instrumental research methods will help determine the exact diagnosis.

Detection of diverticular disease often occurs by chance during examination due to suspicion of another pathology. To make an accurate diagnosis and prescribe treatment, it is recommended:

  • X-ray of the large intestine using barium contrast (detection of the localization and contour of the protrusion);
  • irigoscopy (endoscopic technique for examining the condition of the mucous sigma);
  • colonoscopy (endoscopy to examine the lining of the colon).

Treatment

When choosing the correct and correct treatment, one should be guided by the following factors:

  • patient's age;
  • features of diverticular disease;
  • predictions of complications;
  • general condition of the patient;
  • character and lifestyle, features of the daily menu.

Medications

The approach to treating symptoms and eliminating the causes of the disease is complex and complex. For this, the following types of medications are prescribed:

Alternative medicine

Treatment with folk remedies is used as an auxiliary measure. Common recipes are:

  • A mixture of oils - linseed and olive. Drink 1 large spoon before bedtime, that is, one time. Folk remedy relieves inflammation, stabilizes bowel movements with constipation. A mixture of oils is recommended for use as a dressing for salads.
  • Decoction with elm bark. To prepare the folk composition, you need to pour a small spoonful of chopped bark with 400 ml of boiling water and warm it over low heat for 20 minutes. After cooling naturally, the decoction is filtered and taken instead of tea.
  • Infusion from the collection of herbs. For cooking, you will need equal amounts of motherwort, nettle, dill grains, rose hips, chamomile flowers. A large spoonful of the mixture is poured into a thermos with slightly warmed water. After settling for one and a half hours and straining, drink twice a day, 100 ml per month.