Medication sigmoid diverticulosis. Diverticulosis of the sigmoid colon: signs, complications, diagnosis and treatment, diet

In some cases, on the inner walls of the intestine (it may be another part of the digestive system), a kind of "pouches" or diverticula are formed. There are many reasons for these defects. However, there is always a risk of their inflammation and suppuration - this is diverticulitis. The symptoms of the disease can be very different, but most often people complain of pain and indigestion. In any case, the disease requires treatment, since there is a high likelihood of developing an abscess and perforation of the intestinal wall.

Diverticulitis, diverticulosis - what's the difference?

Each of these diseases is associated with changes in the walls of the gastrointestinal tract. For one reason or another, special anatomical structures appear on the inner surface, which in modern medicine are usually called diverticula. They are protrusions of the walls, which in their shape resemble small sacs. It should be noted that diverticula can be either single or multiple. The process of protrusion formation is called diverticulosis. Quite often, in the absence of treatment or under the influence of certain factors, the walls of the diverticula can become inflamed - this is diverticulitis. Symptoms in this case are more pronounced, and if you do not consult a doctor in time, the consequences can be extremely dangerous.

What are diverticula and why do they form?

According to statistics, most often, inflammation of diverticula is diagnosed in people living in developed countries. And in the first place are the USA, Japan and Western Europe. That is why the appearance of protrusions of the intestinal wall is most often associated with dietary habits, in particular, the introduction of a large amount of refined and specially processed foods into the diet.

In addition, the risk factors include muscle tissue weakness, which is often a congenital pathology. There is a theory that explains the protrusion of the walls by impaired vascular circulation. In some cases, diverticulosis is associated with strong mechanical pressure on the intestinal wall, which is observed, for example, with persistent constipation.

Age and aging processes of the body can also be attributed to risk factors. According to statistics, in the middle age group, diverticulosis is diagnosed in 7% of cases, but among people of 70 years of age, the number of patients increases to 60-75%.

Where do diverticula form?

It should be said right away that there are a huge number of varieties of diverticula. For example, they can be congenital (formed during fetal development) or acquired. There are so-called true diverticula (protrusion of the mucous membrane, submucosa and muscle tissues), as well as false ones, which are formed exclusively by the mucous membrane.

Quite often, the disease affects the intestines, therefore, sigmoid diverticulitis is often diagnosed in patients (treatment also depends on the location of the protrusions). On the other hand, wall bulging can occur in almost any part of the digestive tract. For example, patients often suffer from diverticula in the pharynx, esophagus, and stomach. A bulge in the diaphragm can lead to spasms of the heart muscle. In addition, the disease can affect all parts of the small and large intestines.

The main causes of diverticulitis

In fact, inflammation of the walls of diverticula can occur for various reasons. For example, quite often particles of semi-digested food or feces accumulate around the "bags" (depending on the location of the diverticulum). Such an accumulation of organic matter is an excellent substrate for the reproduction and vital activity of pathogenic bacteria - this is how the inflammatory process arises, which, by the way, remains localized in 75% of cases. Of course, the state of the immune system also matters. Inflammation can develop with trauma or damage to the diverticulum.

Diverticulitis: symptoms of the disease

Of course, you should consult a doctor with similar problems. How to recognize diverticulitis? The symptoms are quite common here. Almost every patient with a similar diagnosis complains of abdominal pain, which can be of a different nature (sharp, aching), be constant or occur periodically. If a person has colon diverticulitis, it is likely that soreness will appear in the lower left abdomen.

Along with this, digestive disorders occur. Signs of the disease include nausea, vomiting, loss of appetite up to anorexia. Quite often, the disease is accompanied by constipation or diarrhea. An increase in body temperature is sometimes observed.

Methods for diagnosing the disease

If the patient was previously diagnosed with diverticulosis, then inflammation can be diagnosed based on the clinical picture. Otherwise, some analyzes and research will be needed. A sick person is often prescribed a colonoscopy, as well as CT with the introduction of contrast.

To make an accurate diagnosis, ultrasound methods are also used, in particular, ultrasound of the abdominal cavity and small pelvis, as well as ultrasonography. In rare cases, laparoscopy is performed.

Conservative treatment of diverticulitis

In the initial stages of the disease, if there are no serious complications, conservative therapy helps patients. Some patients may be hospitalized (if there is a high likelihood of an abscess or wall perforation), while others may be able to take medications at home. In any case, patients should be kept to bed and take antibiotics. Antibiotic therapy lasts at least a week. Along with this, a water-saline solution is injected intravenously to a sick person.

This is how diverticulitis is treated. Diet, by the way, is also important for therapy. Fasting is recommended for the first few days. In the future, the specialist draws up a special gentle nutritional regimen.

Surgical treatments for the disease

In some cases, surgery is indispensable - sometimes this is the only way to forget about such an ailment as diverticulitis. Treatment in this case is reduced to resection (excision) of the affected areas of the intestine, followed by reconstruction and restoration of patency.

Similar methods are used for inflammation of the abdominal wall, since these ailments pose a threat to the patient's life. Naturally, along with surgery, antibiotic therapy is also needed.

Why is diverticulitis dangerous?

Such a disease is extremely dangerous, and in the absence of adequate medical care, it can lead to a host of complications. For example, quite often diverticulitis provokes the development of acute intestinal obstruction. In addition, as a result of inflammation, abscesses can form, which can occur both near the diverticulum, and in another part of the intestine, or even in a neighboring organ.

Another danger associated with the disease is damage or perforation of the intestinal wall. Often, the formation of a rupture leads to the release of intestinal contents (in particular, feces) and its release into the abdominal cavity. In turn, a similar phenomenon is fraught with peritonitis and damage to neighboring organs. For example, perforation is often associated with peritonitis and other, no less dangerous, diseases.

Diverticulosis of the sigmoid colon is a pathological process, the symptoms of which are very diverse, and the treatment depends on the stage and course of the disease. According to statistics, the disease is found in a quarter of the world's population, and is considered one of the most common bowel diseases. According to the International Classification of Diseases, diverticulosis of the sigmoid colon does not have its own code and belongs to the category "". ICD-10 code - K57.3.

Sigmoid diverticulosis (diverticular disease) is a type of colon diverticulosis that occurs in the sigmoid region due to degenerative processes, chronic constipation, and intestinal motility disorders. The sigmoid colon starts from the descending colon in the upper pelvic region, slopes to the left of the peritoneum, and then connects to the rectum.

Diverticulosis is characterized by the appearance of growths on the intestinal walls, the so-called diverticulums. These are peculiar neoplasms (single or multiple) that appear on thinned areas of the mucous membranes and protrude from the walls of the intestine. Diverticula range in size from 2-3 mm. up to 4 cm and more. The larger the diverticula, the more likely complications of the disease are. The shape of the growths is quite varied. Diverticula can be pear-shaped, spherical, or oval.

When multiple diverticula form in the sigmoid colon, it is diverticulosis. Feces accumulate in diverticula over time, which causes their inflammation. In addition, infection can be the cause of the inflammatory process. Bacteria are activated once they enter the diverticulum, and this provokes tissue inflammation. This condition is called diverticulitis and is considered a complication of diverticulosis.

Diverticula are congenital due to an abnormality in the development of the fetus, and acquired. Acquired diverticulosis occurs more often in older people, both in women and in men, equally. To a greater extent, this problem affects people over 50 and is caused by age-related changes in the intestinal walls. At the age of 80 and older, diverticulosis is detected in more than half of patients.

Causes

The reasons that provoke the onset of the disease:

• improper unhealthy diet;
• alcohol and smoking abuse;
• violation of metabolic processes in the body (obesity, diabetes mellitus);
• genetic predisposition. The characteristic features of the intestinal structure and the weak connective tissues of its walls are inherited from parents to children. In this case, the child may be born with diverticula or they develop at an early age;
• mature age. Over the years, the tone of the intestinal walls weakens, peristalsis worsens and frequent constipation appears. The mucous layer of the intestinal walls becomes thin, the immune system weakens. In older people, diverticula appear more often, quickly fill with feces and become inflamed;
• inflammatory or infectious bowel diseases: intestinal infections, infectious enterocolitis, colitis (ulcerative, spastic, ischemic);
• food that does not contain fiber. If less than 30 grams of fiber (dietary fiber) is consumed per day, then the movement of food through the gastrointestinal tract slows down. Intestinal contents become drier and harder, get stuck in the intestines, and constipation develops. Feces squeeze and stretch the walls of the intestine, increase intestinal pressure;
• helminthiasis. Worms in the intestines damage mucous tissues and reduce their protective functions, worsen the microflora. In such an environment, pathogens spread rapidly.

Varieties

Diverticulosis, depending on the clinical picture, is divided into stages:

1. asymptomatic- characterized by the absence of clinical manifestations. Diverticula are found in the diagnosis of other diseases.
2. spicy- manifested by spasms of the intestinal walls, disorders of the digestive processes and the intestinal environment.
3. complicated- requires immediate treatment.

Complicated diverticular disease is classified into the following categories:

• peri-intestinal infiltration, which occurs during an inflammatory process in the intestine and a violation of the integrity of the walls of the diverticulum;
• diverticulitis, which develops from the filling of diverticulums with feces, which leads to the multiplication of pathogenic microorganisms and infection;
• intestinal fistula (internal or external), resulting from suppuration when the abscess is opened on the skin of the peritoneum or an adjacent organ;
• perforation. If perforation has occurred in the abdominal cavity, peritonitis begins. If in the mesentery of the sigmoid colon - retroperitoneal phlegmon;
• intestinal bleeding. Solid feces damage the mucous membranes and blood vessels of the intestine, which leads to the loss of a large amount of blood during bowel movements.

Diverticulosis is true and false. The true form is congenital, in this case, during the formation of a diverticula, all layers of the intestinal wall protrude. False diverticulosis is acquired, appearing in the process of life and characterized by protrusion of only the mucous membrane.

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Symptoms

Single non-inflamed diverticula do not appear for a long time. The formation of diverticulums in the intestine in most cases passes without visible signs. Very often, diverticula are found during examination for other diseases, or when they become inflamed and complications have appeared.

At the early stage of the disease, pain is minor, quickly passing after the passage of gas and bowel movements. Usually localized to the right or left in the lower abdomen.

Typical symptoms of diverticular bowel disease include:

• bleeding - appears at a complicated stage of the disease. Blood is present in the feces, which signals the trauma of the diverticulum;
• chronic pain - pain of a constant nature at a certain point in the abdomen indicates inflammation of the diverticulum. The pain increases sharply on palpation or when walking;
• intoxication - nausea with vomiting, or constipation;
• dizziness;
• pale skin;
• drastic weight loss;
• flatulence, asymmetric bloating with a bias to the left.

Some of the above symptoms may be signs of other medical conditions, such as appendicitis or colic. These diseases are life-threatening, as are complicated diverticulosis. If these symptoms appear, you should immediately seek medical attention.

Diagnostics

To diagnose diverticulosis of the sigmoid colon, the patient is examined and a set of laboratory and instrumental studies:

• study of patient complaints and collection of a detailed anamnesis;
• palpation of the abdomen to determine typical pain;
• general blood analysis;
• analysis of feces for blood impurities and for the presence of bacteria or helminths;
• - X-ray examination of the large intestine with barium sulfate to detect narrow sections of the intestine and diverticulums on it;
• colonoscopy - an endoscopic examination that assesses the condition of the intestine from the inside and determines the mouth of the diverticulum;
• manometry - performed when there are pronounced disturbances in the motor function of the intestine;
• general X-ray examination of the peritoneal organs;
• CT and MRI;
• laparoscopy is a method of both diagnosis and surgical treatment. The procedure is performed under general anesthesia. During the procedure, the surgeon pierces the peritoneal wall in three places. A miniature camera is introduced through the punctures, with the help of which the intestinal walls and changes in them are examined. If necessary, the doctor may remove the non-inflamed diverticulum.

Treatment

Methods for treating diverticulosis of the sigmoid colon depend on the age, health, lifestyle and nutritional characteristics of the patient, the stage of the disease, and the presence of complications. If the diverticulum is single, not inflamed and does not cause discomfort, therapy may be limited to the prevention of constipation and a therapeutic diet.

Can diverticular disease be cured? Diverticulosis without complications is treated with conservative therapy.

Complex drug treatment consists of:

• antibiotics with a wide spectrum of action on the intestines (penicillins, cephalosporins);
• analgesic and antispasmodic drugs that reduce muscle spasms (No-shpa, Drotaverin);
• prokinetics that stimulate intestinal motor function and have antibacterial, antidiarrheal and antiemetic effects (Motilium, Ganaton);
• laxatives (Microlax, Duphalac);
• enzyme preparations that normalize digestive functions and reduce the load on the intestines (Festal, Mezim);
• preparations for the restoration of intestinal microflora (Bifidumbacterin, Linex);
• medicines for flatulence and diarrhea (Sulgin, Biseptol).

In case of a severe form of the disease, in addition to drug treatment, the following medical procedures are carried out:

1. Gastric lavage.
2. Infusion therapy is performed (crystalloid solutions are injected intravenously).
3. Fresh frozen plasma is used.

Surgical operation is performed in cases where there are serious complications that are life-threatening to the patient.

An indication for surgery is considered:

• profuse bleeding;
• intestinal obstruction;
• peritonitis;
• frequent exacerbation with severe pain;
• rectal fistulas;
• the likelihood of developing rectal cancer and other malignant tumors.

The surgical procedure consists of two stages. First, a resection is performed (the inflamed parts of the intestine are removed), then an anastomosis is formed - the remaining parts of the intestine are connected. In addition, according to indications, drainage of the abdominal cavity is performed, and antibiotics are administered intravenously.

Timely competent treatment relieves the patient of serious complications and allows a favorable prognosis for later life.

Diet

The diet for sigmoid diverticulosis should include foods high in fiber. It is necessary to adhere to fractional meals - eat in small portions 5-7 times a day. It is recommended to include boiled, baked and steamed dishes in the daily menu.

Table of foods that are allowed or prohibited for intestinal diverticulosis:

Folk remedies

It is possible to alleviate the patient's condition by means of traditional medicine. It is necessary to use such funds as an addition to the main treatment and under the supervision of the attending physician.

The most effective and efficient recipes:

1. linseed or olive oil. Relieve constipation and relieve inflammation. Drink 1 tbsp. a spoonful of oil at night. It is recommended to use olive oil for dressing vegetable salads.
2. you will need equal amounts of nettle and motherwort leaves, rose hips, chamomile flowers and dill seeds. Pour 1 tbsp into a thermos. spoon of the mixture, pour 250 ml. boiling water and leave for 2 hours. Drink 100 ml per month. twice a day.
3. One teaspoon of elm bark is poured into a glass of hot water and simmer for 15 minutes. The broth is cooled, filtered and taken half a glass a day.
4. take 150 gr. aloe leaves, grind them and add 300 ml. honey. The mixture is infused during the day, filtered and taken in 1 tbsp. spoon an hour before meals.

You should not independently treat diverticulosis at home using folk remedies, since there are high risks of serious complications of the disease.

A disease that does not spare the elderly is sigmoid diverticulosis. With age, irreversible processes occur in the human body. This is a natural phenomenon. But you can help your body, prevent or stop the disease.

A disease that does not spare the elderly is sigmoid diverticulosis

Diverticulosis: A Memo to Young and Old

Diverticula are a kind of growths similar to hemorrhoids or hernias that form on the walls of the intestine. They can appear in a person throughout his life, without even causing concern. The formation of diverticula is called diverticulosis. In case of inflammation, diverticula provoke a disease that is called diverticulitis in medicine. The disease is most often affected by people of older retirement age. But it happens that this happens before.

Important! Improper diet, an abundance of fatty and fried foods, alcohol can lead to the development of diverticulosis.

This pathology cannot be congenital. Most often this is the influence of negative, annoying factors. The growths are formed not only on the mucous membrane. They can protrude outward, appear on the outer walls. The disease does not pose a great danger. But if patients do not adhere to certain rules, then an exacerbation occurs, which already poses a threat not only to health.

This pathology cannot be congenital.

Diverticulosis symptoms

Pathology may not manifest itself for a long time. Under the influence of various provoking factors, diverticula become inflamed, causing discomfort. The most basic symptom is lower abdominal pain. It may be subtle, but uncomfortable. And it can plunge into a real shock. Moreover, after a bowel movement, the pain disappears.

Even a small amount of stool creates pressure in the intestines, which negatively affects the growths. Many are starting to attribute this to malnutrition, constipation, or diarrhea. It is similar to food poisoning when it gets better after going to the toilet.

Important! Any pain in the intestines should force you to see a doctor, especially at an older age.

But pain is not all that accompanies diverticulitis. There are a number of other signs that may resemble those of other diseases. This:

• bleeding similar to hemorrhoids;
• painful fistulas;
• flatulence;
• unreasonable constipation or diarrhea.

Pathology may not manifest itself for a long time.

Unlike hemorrhoidal bleeding, sigmoid diverticulitis does not hurt when bleeding. This should be alarming. Even the attending physician will confirm that a similar symptom is characteristic of this disease. So, there are many growths, and this can cause profuse bleeding, which is already life-threatening.

After the onset of bleeding, the disease is not so asymptomatic. The patient experiences constant abdominal pain, fever, bowel functions are impaired. This suggests that sigmoid diverticulosis has worsened. Symptoms and treatment, characteristic of sigmoid diverticulosis, require immediate treatment.

Causes of the disease

It is clear that the appearance of such a pathology raises the question: why did this happen? The intestinal walls weaken with age. When it is filled with feces, increased intra-intestinal pressure is created. And this provokes stretching of the walls and leads to protrusion of the diverticulum.

They can also bulge with muscle intestinal spasms, leading to a violation of intestinal blood flow. Dystrophy appears, which again stretches the intestinal walls, and growths protrude near the blood vessels. What caused this pathology?

Unhealthy food

Yes, everything is extremely simple. This:

• violation of nutrition or diet;
• alcohol;
• smoking;
• obesity;
• diabetes.

In our regions, such a disease occurs, but not as often as in America. The inhabitants of this country do not care about proper dietary nutrition at all. The states lead the world in the number of obese people. But in Asian countries, this is a rarity, since the diet of the inhabitants of these countries is based on fiber, which is part of the dishes they eat.

Diagnosis of the disease

If sigmoid diverticulosis is suspected, treatment begins only after a thorough diagnosis. The doctor makes an anamnesis, learns about hereditary factors, lifestyle and nutrition. Only after that, the patient needs to undergo laboratory and instrumental examination, which includes:

• X-ray (irrigoscopy) with a contrast agent is carried out using a special probe with a camera;
• colonoscopy to monitor the internal state of the intestine;
• laparoscopy as an additional examination and for the possibility of removal if there are few diverticula and they are simple.

By the decision of the attending physician, additional magnetic resonance imaging and plain radiography are prescribed. Ultrasound is not prescribed for this disease, since the data obtained will not give a clear picture.

Treatment of ailment

In sigmoid diverticulosis, treatment depends on many factors. This:

• the degree of the disease;
• the risk of a possible complication;
• the physical condition of the patient;
• the patient's lifestyle;
• diet;
• the presence of bad habits.

In most cases, the disease is treated with medication on an outpatient basis, after which a diet is prescribed for diverticulitis of the sigmoid colon. In rare cases, conservative intervention may be necessary. With a mild form, the patient is prescribed:

• antibiotics;
• antispasmodics;
• pain relievers;
• prokinetics to improve bowel motility;
• enzymes;
• preparations to improve microflora;
• diarrhea prevention agents.

But this is only in milder forms. If the patient's condition is more severe, then after the infusion therapy, frozen plasma is used. If the condition is even more severe, then surgery is performed.

If the condition is even more severe, then surgery is performed

The surgery is performed in two stages. First, a resection of the affected area is done, after which the remaining areas are connected. The operation is difficult, especially considering the age of the main group of patients, but the prognosis is favorable, which cannot be said about those situations when some patients ignore treatment or self-medicate. It can be intestinal bleeding, abscess, intestinal obstruction. Such situations are already life threatening.

Nutrition for diverticulosis

If the nutrition of the majority of patients were correct, the majority of patients could have avoided such an unpleasant fate. The attending physician prescribes a diet for sigmoid diverticulosis. The basis should be made up of foods rich in fiber:

• nuts, preferably almonds;
• dried mushrooms;
• green pea;
• figs;
• dried apricots;
• mango;
• ginger;
• tomatoes;
• cabbage;
• avocado.

In order to anticipate irritation of the intestines and stomach, all dishes are steamed, boiled or baked in the oven. For such dishes, you can use potatoes, poultry without skin, sea fish and seafood, veal, lean pork. Fermented milk products are recommended to be consumed only by the decision of the attending physician, as they can cause fermentation, gas formation.

Fiber-rich foods must be present in the daily diet.

Food intake should be carried out 5-6 times a day in small portions. In order for food to be better absorbed, many nutritionists recommend using a separate feeding system, drinking water without gas, tea without sugar, rosehip broth. It is generally better to exclude sugar and replace it with honey. To eliminate constipation, you can use prunes.

Physiotherapy

Regular physical education plays an important role even for those patients who had to undergo surgery. Doctors recommend such patients to devote the first days to leisurely walks in the fresh air. A little later, you can slightly increase the load and perform more complex exercises.

The famous American doctor Olduri developed a whole program concerning the treatment of diverticulosis without medication. His program is devoted to many issues. Special attention was paid to nutrition and physical activity. Many patients of both sexes took part in his research. This gave a positive result. Therefore, the recommendations presented here are compiled from his teachings.

The doctor argued that most sedentary men are susceptible to this disease in the first place. Exactly how physical culture counteracts the formation of diverticula, there is no exact scientific confirmation yet. But the fact that it gives positive results is certain.

Lower abdominal pain

The contents of the intestine pass faster during exertion, relieving pressure in the sigmoid colon. Blood circulation improves, which strengthens the intestinal walls and prevents the formation of new growths.

1. Walking briskly five times a week, but taking into account age and physical ability. Gradually, walking turns into a slow run.
2. Run. Run not fast, jogging. The load can be gradually increased.
3. Exercises. What kind of exercises to perform does not matter at all. These are complexes designed for the abdominal and pelvic muscles.

Don't try to exercise with zeal. Fatigue may be present, but slight. A person should feel a surge of strength, but not exhaustion. For those in better shape, cycling and swimming in the pools are recommended. Most of the patients are elderly people, so you shouldn't put too much stress on your body.

Healing infusion

The centuries-old recipes of traditional medicine will help to avoid complications, and for some - the disease itself. For this it is recommended to use:

• aloe juice;
• flax seeds;
• plantain seeds;
• herbal preparations;
• echinacea;
• Dill;
• nettle;
• parsley;
• bran;
• linseed oil.

Herbal decoctions. For their preparation, herbs are used that have a laxative, soothing, wound healing effect. To prepare the collection, take chamomile, plantain, yarrow, echinacea, nettle, mint, motherwort, mixed in equal amounts in one container. For one dose, one tablespoon of such a mixture is needed, which is poured with a glass of boiling water, insisted and drunk. For each meal, you need to prepare a new portion.

Rose hip. Rosehip decoctions are able to strengthen the intestinal walls, improve blood circulation. But this is a drink that has a fixing effect. Therefore, doctors do not recommend drinking broths only from rosehips. You can add hawthorn. To prepare such a vitamin drink, you must use a thermos. Two tablespoons of fruits are placed in a liter thermos and poured with boiling water. It is better to cook the broth in the evening. In the morning, you can not filter, but divide the entire volume by day and drink in equal parts with the addition of honey.

Rosehip tea

Bran. People with this diagnosis or those who want to avoid the disease should have bran in their diet at all times. It is the richest source of fiber, which is detrimental to diverticula. The same can be attributed to bran bread.

One tablespoon of bran is poured into a glass of low-fat kefir or milk, stirred and drunk in the morning and evening. This treatment is increasing: daily the dose of bran should be increased by one spoon. Bring consumption to 10 spoons, then take, decreasing. You can not take a break, but continue in the same order.

Oatmeal or linseed jelly. Mucus is very beneficial for the intestines, and there is simply no richer source than oats and flax. These two components can be used separately, or you can mix them. But first they are ground on a coffee grinder, diluted in hot milk or in water.

In order not to provoke diarrhea, it is better to use skim milk and dilute it with boiled water. Add two tablespoons of the dry mixture to a glass of hot liquid. After that, cover, wrap and let it brew for half an hour. You can take. It is advisable to take two glasses of jelly per day, cook one in the morning before breakfast, the other in the evening an hour before bedtime.

Disease prevention

Eat a healthy diet to prevent disease

In most cases, the prognosis after treatment of this disease is favorable. But a relapse is possible. Regular dieting, fiber-rich foods, and physical activity almost completely eliminate this.

But people of older retirement age, due to their physical health, cannot always follow the recommendations given by the doctor. Therefore, they remain at risk, and they may have complications:

• chronic diverticulosis;
• intestinal obstruction;
• ruptured diverticula;
• intestinal bleeding;
• oncological degeneration of diverticula;
• bacterial contamination.

Such complications do occur, but are extremely rare. Therefore, doctors strongly recommend not to forget about diets, about regular check-ups with a coloproctologist. The presence of fiber-rich foods in the diet is imperative. Physical activity is desirable, but whenever possible. If you were not active in your youth, make up for retirement. Be healthy!

Diverticulosis is a health condition in which small pockets, known as diverticula, develop in the colon. Some doctors talk about several foods to avoid for this condition, but research has not proven that they cause problems. Has diverticulosis of the sigmoid colon, symptoms and treatment, the latter can be switched only 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 and acquired. Congenital pathologies are characterized by underdevelopment, or a violation in the development of the yolk 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 a sigmoid diverticulum is. - This is a blind protrusion of the intestinal walls, which are formed with excessive consumption of flour, meat food. Uniformity in diet and food poor in fiber leads to the development of constipation, which provoke stretching of the intestinal walls. The disease can be a complication of colitis, intestinal dysbiosis 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 on the left side of the abdomen. Painful sensations can be present for a long time, and their source of distribution does not change at all. This process is enhanced if you press hard on this place or perform physical exercises with increased stress.
2. Stool problems. In most cases, constipation is one of the symptoms, sometimes blood can be seen in the stool - this symptom is noted by 25% of patients.
3. Increased body temperature. This symptom is a consequence of a serious inflammatory process, it is associated with excessive accumulation of feces.

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

Before treating diverticulosis of the sigmoid colon, it is necessary to undergo diagnostics 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 analysis of blood, there is an increase in ESR, leukocytosis, stab shift to the left. Endoscopic examinations such as colonoscopy differentiate it from intestinal obstruction, colitis, constipation, and cancer. carried out with the use of a contrast agent that shows the contours of the intestine and with diverticula there are protrusions ranging in size from 0.5 to 5 cm, which can be seen on X-ray images. According to the results of ultrasound, you can find, 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, adhering to a diet, drinking regimen, and taking semi-liquid and liquid food. A severe form is subject to hospitalization, dietary intake and relief of pain symptoms. The surgical method is used for peritonitis, bleeding, intestinal perforation. With this method, a portion of the intestine is removed as a source of diverticulitis formation.

You should follow a diet for sigmoid diverticulosis, which is rich in healthy fiber and helps cleanse the intestines. The diet includes whole grain breads, bran, vegetables and fruits. Vegetables that are allowed are cabbage, carrots, and other vegetables with non-coarse fiber. Radish, pineapple, persimmon, legumes, watermelon are contraindicated.

Whole grain bread and bran are good for the digestive tract

Leading an active lifestyle, eating foods rich in plant fiber and drinking plenty of fluids, all this helps to reduce the manifestations of diverticulitis and prevents its formation.

Home treatment of sigmoid diverticulosis can be carried out 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 are also 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 stool, which is the main goal in the treatment of asymptomatic diverticulosis. The 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, you can drink it 1 tablespoon before bedtime. To combat constipation, you need to consume 20 plantain seeds every day, drink tea with chamomile or mint. A good result is shown by 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 gets into a diverticulum, it can irritate them, causing pain and an infection known as diverticulitis. Although many patients claim they experience pain after eating certain small, harsh foods, no scientific data has been found to support this theory.

Foods that are at a higher risk of entering 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 are safe, especially when thermally cooked. If any of these foods are causing problems, you can grind them in a food processor.

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

Nutrition with 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 be avoided in case of diverticulosis. These types of food take a long time to digest. And it can cause bloating and 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 in diverticulosis are foods with fast-digesting carbohydrates, such as white rice, pasta, and white bread.

Low fiber foods take extra time to go through the digestive process, causing high blood pressure in the same way as 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 in people with diverticulosis, whether they are in food or drug form. Laxatives severely harm the colon and diverticula. But researchers haven’t proven that such food is a big problem, so many doctors recommend keeping a very detailed food diary to determine which foods are safe for each patient. In order to keep a diary, the patient will need to record what he or she eats with each meal, as well as his or her medications and bowel movements (that is, how often the patient goes to the toilet). What foods are causing pain should be observed so that the patient can determine what foods to avoid for diverticulosis.

The preventive diverticulitis diet is very different and is intended to be used when people do not have an active infection. This diet focuses on getting the patient high in 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 low-fat protein foods and can be very nutritious and beneficial.

Diverticulosis is a serious disease of the digestive system that requires the patient to be very patient and take special treatment. The latter mostly consist in proper nutrition and conservative methods, and their effectiveness can be significantly increased by treating sigmoid diverticulosis with folk remedies. It is forbidden to prescribe therapy on your own, therefore it is imperative to go to the hospital, in most cases, hospital treatment will be required so that the specialist can monitor the patient's condition and make the necessary adjustments to his treatment.

Diverticulosis of the sigmoid colon is a disease characterized by chronic lesions of the large intestine, in which protrusions, that is, diverticula, begin to form in a separate part of it. Diverticula are hernial protrusions of the walls from the side of the intestinal lumen outward. Diverticulosis of the sigmoid colon occurs mainly in older people.

In about 10% of cases, diverticula are diagnosed in people under the age of 40. With age, the number of people with diverticulosis increases significantly. According to statistics, more than 50% of people aged 70 have diverticulosis of the rectum and other parts of the intestine. Treatment of pathology, as a rule, is carried out by conservative methods.

Types and stages of the disease

In clinical practice, the following stages of diverticular disease are usually distinguished:

1. Diverticulosis is asymptomatic. In half of the cases, the pathology for a long period does not have pronounced clinical manifestations and is revealed by chance, after contacting a specialist for another reason.
2. Acute diverticulosis. Typical signs are spasms of the walls of the sigmoid colon, a high content of pathogenic microflora in the affected area and nearby parts of the intestine, and disturbances in digestive activity.
3. Complicated diverticulosis. The extreme stage of the disease, which is characterized by critical states of health of the patient. Requires immediate medical attention.

Complicated diverticulosis, in turn, is subdivided into the following categories:

• Diverticulitis of the sigmoid colon. It develops as the diverticula are filled with feces, which creates a fertile ground for the reproduction of pathogenic bacteria, as a result of which the threat of infection increases;

• Peri-intestinal infiltration. It occurs when the abdominal cavity is extensively inflamed and the surface of the diverticulum itself is significantly damaged;

• Intestinal fistula. Characterized by spontaneous opening of the abscess, affecting adjacent tissues and organs, which entails the formation of external and internal fistulas. With this form, urgent surgical intervention is required;

• Intra-intestinal hemorrhage. Occurs due to damage to the intestinal mucosa through exposure to hardened feces. The vessels are damaged, and there is a loss of significant volumes of blood both during the process of defecation and independently of it;

• Perforation of the diverticulum. If perforation affects the peritoneal region, this threatens the onset of peritonitis; if the mesentery of the sigmoid colon is affected, the patient risks getting retroperitoneal phlegmon.

Causes of sigmoid diverticulosis

Diverticulosis develops as a result of a combination of factors that occur in older people. Over time, certain areas of the walls of the sigmoid colon begin to weaken, as a result of which, at first, minor protrusions are formed, and then full-fledged diverticula. The main reason for the appearance of areas of weakening of the intestine is a violation of innervation.

The aging process predisposes to the appearance of diverticulums. With aging, dystrophic changes are observed in the tissues of all organs, including the muscles of the intestine. Among other things, elderly people experience a decrease in the level of nutrients in the body, which predisposes to bulging in the intestines.

Another common cause of diverticulum is weakness and underdevelopment of the connective tissue. It should be noted that such developmental disorders, as a rule, do not lead to the appearance of diverticulums at a young age, but almost always provoke protrusion of the sigmoid colon in the elderly. Underdevelopment and weakness of connective tissue is a congenital defect characterized by a failure in the synthesis of collagen fibers.

In addition, an increased risk of diverticulum development occurs in older people with signs of bowel motility discoordination. The fact is that chronically increased intraintestinal pressure causes stretching of the muscle fibers of the walls of the sigmoid colon and eventually leads to the appearance of a full-fledged diverticulum.

In some cases, severe spasms of the intestinal walls can provoke the appearance of a diverticulum of the sigmoid colon. During a spasm, intramural blood vessels are compressed, which leads to a violation of blood microcirculation. Disruption of tissue nutrition irreversibly leads to the appearance of areas of muscle tissue dystrophy and stretching of the perivascular spaces.

Malnutrition also contributes to the development of sigmoid diverticulosis. Diverticular disease of the colon almost never occurs in people who eat fiber-rich plant foods. At the same time, people living in developed countries who prefer to eat soft foods rich in animal fats have an extremely high incidence rate.

Hereditary predisposition also plays a role in the process of damage to the sigmoid colon by diverticula. Currently, there are no known genes that can be transmitted and lead to a weakening of the muscles of the intestinal walls, but, according to statistics, people who have relatives suffering from diverticulosis in old age often experience the appearance of a similar disease.

Symptoms of sigmoid diverticulosis

In most patients, diverticula of the sigmoid colon do not manifest themselves in any way. A person may not know about his problem for years until a complication arises, or he does not turn to a proctologist in connection with another pathology. One fifth of patients complain of recurrent abdominal pains like colic. The pain is blurred or localized in the left iliac region; on palpation, the abdominal wall is not tense. Pain syndrome can go away on its own, sometimes relief comes after bowel movement. In addition, there is bloating, constant constipation, which periodically give way to diarrhea. All these symptoms fit into the clinical picture of irritable bowel syndrome, which greatly complicates the diagnosis.

Symptoms change and become brighter when complications arise. The most common of these is diverticulitis, or inflammation of the diverticula of the sigmoid colon. It occurs due to stagnation of feces in the intestinal lumen and in the diverticulum itself, the action of intestinal flora and increased permeability of the weakened walls of the sigmoid colon. The pain in the abdomen increases, its localization is often uncertain. On palpation, there is some tension in the anterior abdominal wall, increased pain in the left iliac region. The patient's temperature rises, symptoms of intoxication appear.

The further course of the disease can lead to the formation of an infiltrate. The inflammation spreads to the mesentery, omentum, and surrounding tissue. On palpation in the left lower abdomen, a painful lump with limited mobility is palpable. An abscess may form at the site of the infiltration. The patient's condition deteriorates sharply, the temperature rises to high numbers, the fever is hectic in nature with large daily fluctuations. On palpation, there is a strong local tension of the abdominal wall, sharp pain.

Perforation, or perforation of the diverticula of the sigmoid colon is the most severe complication. The process may develop with or without diverculitis. Patients complain of sharp pain, weakness, fever. Perforation always results in peritonitis or retroperitoneal phlegmon (if perforation of the sigmoid diverticulum has occurred in its mesentery). At the same time, the patient's condition is severe, there is weakness, fever, symptoms of an acute abdomen are observed. If the perforation opens into a hollow organ or onto the surface of the abdominal skin, a fistula will form. Most often, fistulas open into the lumen of the small intestine, bladder, less often into the lumen of the vagina.

Violation of the integrity of the vessels of the intestinal wall leads to open bleeding. It can be the first and only symptom of sigmoid diverticulum. Blood appears in the feces, it almost does not mix with feces, does not change its color. Bleeding is rarely profuse, but it can be repeated, as lumps of feces constantly injure the intestinal wall. Frequent bleeding ultimately leads to anemia.

Complications of sigmoid diverticulosis

In the absence of appropriate treatment, developing diverticula in the sigmoid colon can lead to the following complications:

• Bleeding from the rectum. It occurs due to damage to the vessels surrounding the diverticulum, characterized by blood impurities in the stool after the act of defecation. The severity of bleeding varies depending on the caliber of the damaged vessels;
• Diverticulitis is an inflammation of the diverticula of the sigmoid colon. The reason is bacteria, which, together with feces, are retained in diverticula. P is manifested by abdominal pain, mucus impurities in the stool, an increase in body temperature;
• Perforation (breakthrough) of the diverticulum, with the release of the contents of the sigmoid colon into the peritoneal cavity and the development of peritonitis (inflammation of the peritoneum).

Diagnostics of the sigmoid colon diverticulosis

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

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

1. Colonoscopy. A research method that allows you to assess the state of the intestines from the inside. The procedure is carried out using a special flexible probe with a video camera at the end, which is inserted into the intestine through the anus. The image from the camera is displayed on a monitor, and the doctor can visually assess the condition of the intestinal walls, the presence of diverticulums, and even take a piece of tissue for examination.
2. Irrigoscopy. During the examination, an X-ray of the intestine is made, which is pre-filled with a contrast agent. If there are diverticula in the intestine, the contrast agent will fill them, and these saccular protrusions will be clearly visible on the image.
3. Laparoscopy. It is both a method of diagnosis and treatment. During the examination, the surgeon makes three punctures in the abdominal wall, through which a miniature camera is inserted, allowing you to examine the surface of the intestine and, under magnification, notice the slightest changes on its walls. If necessary, the doctor can remove the uncomplicated diverticulum. The procedure is performed under general anesthesia.

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

Treatment of sigmoid diverticulosis

The choice of methods for treating sigmoid diverticulosis is influenced by a number of factors, which must be taken into account by the physician performing the therapy. The most important among them are age, the form of the disease, the general state of health of the patient, a tendency to various kinds of complications, lifestyle and nutrition. The early stage of the disease can be treated with conservative methods and means. Surgery is indicated for patients with complicated and extremely severe forms of this intestinal pathology.

Conservative treatment is carried out in a complex manner, while the patient is shown:

• agents that restore a healthy environment in the intestines;
• special laxatives containing lactulose;
• antibiotics with a wide range of effects;
• prokinetics that activate intestinal muscle motility;
• antispasmodics, pain relievers and relieves intestinal muscle spasms;
• drugs that eliminate diarrhea and bloating;
• some enzymes aimed at improving the quality of digestive activity.

If diverticular disease has an extremely advanced form, treatment consists of the following therapeutic measures:

• the intestines are unloaded using a siphon enema;
• gastric lavage is performed;
• inflammation is eliminated using fresh frozen plasma;
• infusion therapy with the use of crystalloid agents is carried out.

Surgical intervention should be used in the following cases:

• the formation of fistulas in the rectum;
• extreme exacerbation with incessant spasms;
• high likelihood of the formation of a malignant tumor of the rectum.

The surgery is carried out in two stages. On the first of them, a resection is performed, i.e., the affected tissues of the sigmoid colon are removed. At the second stage, an anastomosis is formed, in which parts of the remaining intestinal tissue are held together. In addition, the abdominal region is drained, after which the treatment process is completed with antibiotics used intravenously.

Traditional medicine recipes for the treatment of sigmoid diverticulosis

Often, for the treatment of diverticulosis, they resort to folk methods, of which the following are the most common and effective:

1. Linseed or olive oil. The oil should be taken 1 tablespoon once a day before bedtime. Helps relieve inflammation and normalize stool for constipation. During the day, you can season various salads with this oil.
2. Broth of rusty elm bark. A teaspoon of dry crushed bark is poured with two glasses of boiling water and heated for 20 minutes over low heat. Then the broth must be cooled, filtered and taken cold.
3. Infusion from a mixture of herbs. Take in equal proportions motherwort grass, dioecious nettle, dill and rose hips, chamomile flowers. A tablespoon of such a mixture should be placed in a thermos, pour a glass of warm (not hot!) Water and leave for 1.5 hours. Then the infusion should be filtered and drunk in the morning and evening for 0.5 cups. The course of treatment is a month.

Diet for sigmoid diverticulosis

For this, the patient undergoes a series of special examinations. Based on the research data, the specialist makes the final decision.

The selected diet should fall under certain rules:

• You need to eat often, but in small portions;

• All food must be well chopped. This is necessary so that all food is well enveloped with digestive enzymes, without raising the indicator of intestinal pressure;

• The basis of the diet should consist of soups - mashed potatoes or milk porridge;

• The diet must include a large number of foods, which include a large amount of fiber (fruits, bran, berries, vegetables, etc.);

• Between food openings, the patient must take in a large amount of liquid. Ideally, it should be herbal decoctions, jelly, compotes;

• If the patient often has constipation, it is better not to abuse laxatives, but to drink laxative herbal decoctions: rose hips, prunes, etc.;

• Eliminate alcoholic beverages, cigarettes, spicy and smoked, sour and salty, as well as products containing caffeine from the diet;

• It is better to replace bakery products made from white bread with those that contain bran;

• Give up sweets, and replace them with berries or bananas;

• Instead of apple juice, it is better to eat a raw apple with the skin;

• Eat as many baked vegetables and fruits as possible without peeling them;

• Eat bran with kefir or milk;

• Eat once a day vegetarian soups - mashed potatoes, which include barley grits;

• It is better to replace beef with beans.

Specialists nutritionists and gastroenterologists recommend that when choosing a diet for patients who have developed diverticula of the sigmoid colon, treatment and diet should not include foods (berries, fruits) that contain seeds. You should never eat strawberries or grapes, nuts or raspberries.

Prevention of sigmoid diverticulosis

The most important condition for the prevention of this disease is normal intestinal motility, that is, the absence of constipation.

To maintain regular bowel movements you need to:

• do physical exercises aimed at the abdominal muscles;

• eat enough fiber. The recommended norm by American nutritionists is 20-35 g of fiber. This is exactly how much each person should strive to use. Fiber-rich foods include whole grain breads, berries, vegetables, fruits, brown rice, bran, beans, and peas. Thanks to such food, you can prevent constipation and improve health, lower blood pressure, reduce blood cholesterol and the likelihood of developing certain types of intestinal disorders;

• drink enough fluids. If there are no contraindications, the daily rate is at least 8 glasses of water;

• fully rest and sleep.