Multiple diverticula of the sigmoid colon treatment. Diverticulitis vs Diverticulosis - What's the difference? Possible complications and comorbidities

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. It's about about a disease such 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 outward 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 precipitating 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 organism.

Another reason contributing to the development of diverticulosis can be considered underdevelopment and weakness. 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:

Asymptomatic
With characteristic, pronounced manifestations
Complicated

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

Characteristic symptoms

Start treatment this disease necessary 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.

Most characteristic symptom 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 bind discomfort with errors in nutrition and medical help are not sought, since the pain usually disappears after a bowel movement.

Often diverticulosis occurs against the background of irritable bowel syndrome and when attached inflammatory process the symptoms of the disease begin to manifest themselves especially strongly. Pain in the left iliac region become persistent and long-lasting, their intensity after stool does not decrease.

The pain syndrome lasts for several days and increases with palpation of the specified area and even while walking. Unstable chair may be associated with nausea and vomiting, abdominal cramps and be accompanied by constant feeling 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 diverticula large sizes the following symptoms are typical:

Drawing pains in the left lower abdomen caused by spasm of the walls of the sigmoid colon
Constipation 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

Possible Complications

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?

Intestinal bleeding. It occurs most often suddenly and is associated with vascular damage as a result of the formation of erosion or ulcers inside an infected diverticulum. The patient notices the appearance of blood in feces, its amount depends on the diameter of the affected vessel. Sometimes the bleeding can be quite heavy. If the bleeding becomes chronic, the patient develops anemia, weakness, shortness of breath, palpitations, dizziness.
The development of diverticulitis (inflammation of diverticula). The complication is caused by bacteria that multiply in the accumulated stool. It is manifested by severe pain in the abdomen, fever and the appearance of mucus in the stool.
Diverticulum perforation, at which the contents of the sigmoid colon exit into the abdominal cavity and the development of peritonitis, a life-threatening patient condition, begins. If the contents of the intestine enter the retroperitoneal tissue, phlegmon is formed ( suppurative lesion tissues).
Abscess in the cavity of the diverticulum. If the abscess breaks into the intestinal cavity, the patient's condition may improve. In the event of an abscess rupture into one of the nearby organs, a internal fistula. With the formation of an enterovaginal fistula, patients develop abundant fetid discharge mixed with feces from the genital tract. Gastro- intestinal fistulas manifest in foul-smelling repeated vomiting, with particles of feces. The intestinal-vesical fistula provokes frequent cystitis, in which particles of feces and pus can be excreted in the urine.
Intestinal obstruction. It develops as a result of long-term diverticulitis and the development adhesive process in the intestine.

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

Diagnostics

When examining a patient, the specialist pays attention to whole line factors: characteristic complaints, age of the patient, lifestyle, diet, 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 research and hardware inspections.

Colonoscopy. A research method that allows you to assess the condition of the intestine 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 the monitor, and the doctor can visually assess the condition of the intestinal walls, the presence of diverticula, and even take a piece of tissue for examination.
Irrigoscopy. During the examination, an x-ray of the intestine is made, pre-filled with a contrast agent. If diverticula are present in the intestine, contrast agent will fill them in, and these saccular protrusions will be clearly visible in the picture.
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, which allows you to examine the surface of the intestine and, under magnification, notice the slightest changes on its walls. If necessary, the doctor may remove an uncomplicated diverticulum. The procedure is performed under general anesthesia.

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.

Treatment of diverticulosis

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

Conservative treatment includes A complex approach, which 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)
Remedies for diarrhea 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
Spend infusion therapy 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,
formation of fistulas of the rectum,
the risk of developing rectal cancer and 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 antibiotics.

timely health care and correctly selected treatment tactics make it possible 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 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 adherence to the principles separate power supply so that food is better absorbed by the body.

The Diverticulosis Diet Includes Flour Bread coarse grinding, 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.

Salads should be eaten daily fresh vegetables with vegetable oil and drink a large number of liquids (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 correct and rational nutrition welcome increase physical activity, long walks and special gymnastics.

Treatment of diverticulosis of the sigmoid colon with folk remedies

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

Treatment with linseed or olive oil. Helps relieve constipation and reduce inflammation. It is recommended to take one tbsp daily. spoon linseed oil before going to bed and during the day, season vegetable salads with olive oil.
Herbal infusion. For its preparation, an equal amount of dry nettle leaves, motherwort, chamomile flowers, rose hips and dill seeds are mixed. Pour a tablespoon of the prepared mixture into a thermos and pour 200 ml. warm water. The thermos is closed and allowed to brew for an hour and a half. The finished infusion is filtered and drunk for four weeks in the morning and in the evening, 100 ml each.
A decoction of elm bark. One teaspoon of crushed slippery elm bark is poured into 200 ml. water and simmer over low heat for 20 minutes. The finished broth is cooled, filtered and taken every day for ½ cup.
A good effect is given by recipes using medicinal herbs and berries. For example, an infusion of elderberry is recommended to drink one glass every day. To prepare it, a tablespoon of berries is brewed with a glass of boiling water and insisted.
It is useful to drink aloe juice, take daily 15-20 pieces of plantain seeds or 30 drops of echinacea tincture. After every meal traditional healers recommend taking a warm infusion of chamomile and mint.

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.

Diverticulosis of the sigmoid colon is pathological process that occurs in the large intestine, accompanied by the appearance of many diverticula, which are baggy protrusions (diverticula of the sigmoid colon).

Diverticula occur, as a rule, in the process of strong tension during bowel movement. Often they are localized in the lower part of the sigmoid (large) intestine, and are the size of a pea, rarely much larger. These protrusions are formed as a result of pressure of gas or feces on weak areas of the intestinal wall.

Diverticulosis of the sigmoid colon is a fairly common disease that occurs in 10% of people over the age of 40. Among people over 60, the disease occurs in virtually every second. Symptoms of this pathology are provoked by the age-related processes of the body.

In most cases, diverticular disease is not congenital, and often occurs against the background of adverse factors and non-compliance with the basics of proper nutrition. If numerous diverticula are found in the sigmoid colon, the disease is diagnosed as sigmoid diverticulosis.

Types of disease

Diverticular disease is classified into the following stages.

Asymptomatic diverticulosis. Patients do not have clinical manifestations illness. Diverticula are found in the diagnosis of other pathologies.
Acute diverticulosis. It is characterized by manifestations of spasms of the intestinal wall, a failure of the processes of digestion and the intestinal environment.
Complicated diverticulosis. Requires emergency assistance.

Complicated diverticulosis is classified into the following categories.

Diverticulitis. It develops due to the concentration of feces in diverticula, which contributes to the reproduction of bacteria and infection.
Peri-intestinal infiltrate. Occurs as a result of an inflammatory process in the abdominal cavity, a violation of the integrity of the wall of the diverticulum.
Perforation of the diverticulum. In case of perforation into the abdominal cavity, peritonitis occurs, in the mesentery of the sigmoid colon - retroperitoneal phlegmon.
Intestinal fistula. When an abscess is opened on the skin of the abdominal wall or a neighboring organ, as a result of suppuration, internal and external fistulas occur that require surgical intervention.
Intestinal bleeding. Damage to the mucous membrane with hard stools leads to damage to the vessels and the loss of a lot of blood in the process of defecation and separately.

Diverticular disease is divided into true and false. The true form is congenital and develops as a result of protrusion of all layers of the intestine. The false form of diverticulosis is acquired and develops in the course of life and is characterized by protrusion of the mucosa.

Also separate single and multiple diverticula of the sigmoid colon. The configuration of diverticula is quite diverse: pear-shaped, spherical, oval, etc. They also have different sizes and openings. The smaller the hole width, the more likely formation and accumulation of fecal stones in the diverticulum and the formation of the inflammatory process.

Epidemiology

Among the factors that provoke the development of pathology are age-related changes that cause muscle dystrophy in the intestine and provoke general degenerative changes in the body. Also, one of the reasons is the underdevelopment and weakness of the connective tissue, characterized by congenital or acquired disorders in the synthesis of collagen fibers. Often the disease occurs with violations of intestinal motility.

This is due to the fact that in the process high blood pressure inside the intestines, the fibers in the abdominal wall stretch and form protrusions - diverticula. Diverticula of the sigmoid colon occur in the process of spasms of the muscles of the intestine, which leads to squeezing of blood vessels in the walls of the intestine and impaired blood supply. As a result of the violation, dystrophy and an increase in the space around the vessels occur. This leads to protrusion of the intestinal walls.

The cause of the formation of diverticula may be a genetic predisposition. In this case, the percentage of the disease increases significantly.

Complications

Diverticular

disease of the sigmoid colon

in 20% of cases ends with complications, among which.

Hemorrhages from the rectum. Defeat small vessels chronic nature located near the diverticulum, become a provoking factor in hemorrhage.
Diverticulitis. Inflammation that occurs due to infection in the diverticula. Often, a complication occurs against the background of the concentration of fecal masses in the diverticulum, which leads to the multiplication of microorganisms and the appearance of infections. It is worth distinguishing diverticulitis of the sigmoid colon from diverticulosis.

Clinical picture

The first symptoms of diverticular disease are an important signal for contacting a specialist. However, often sigmoid diverticulosis can be asymptomatic. The vast majority of patients do not experience any manifestations, and the disease is diagnosed absolutely randomly during examination of the intestine from a number of other reasons.

Based on the form of pathology, the symptoms of diverticulosis in patients are very different. With an uncomplicated form of diverticulosis, the disease is accompanied by pain of a different nature and a violation of the stool. Often the pain occurs in the left iliac part and is spastic in nature, increasing as a result of the filling of the colon. After a bowel movement, the pain is relieved.

Some patients complain about aching pain between spasms. When probing the abdomen, it is impossible to determine the localization of pain. This indicates the absence of an organic cause of pain, which is associated with discoordination of intestinal motility. Pain observed from several days and weeks to stable pain over a long period.

As a rule, patients have constipation. Moreover, patients often complain of feeling incomplete emptying and flatulence. Often the disease is accompanied by constipation, alternating with diarrhea.

The symptoms of diverticular disease are not as safe as most gastroenterologists seem to think. Systematic abdominal cramps, urge to defecate, prevent patients from full life and engage in professional activities.

Even if at the initial stage of the development of the disease, the symptoms do not manifest themselves, then in the future the pathology will make itself felt. As mentioned above, stagnant feces lead to a complication of diverticulosis - an inflammatory process of the intestinal walls - diverticulitis. This condition is characterized by regular pain, which is manifested by intoxication of the body with a significant increase in body temperature.

Often the symptoms of diverticulosis appear as a result of irritable bowel and in the presence of inflammation, clinical picture shows up very strongly. Pain is greatly increased and does not stop after defecation. Unsteady stools are accompanied by nausea and vomiting, abdominal cramps, and discomfort.

Therapy

The method of treatment of diverticulosis of the sigmoid colon depends on many factors, including: the form of pathology, the likelihood of complications, the age and general condition of the patient's body, his lifestyle and nutrition. The initial stage of the disease is conservative treatment. Severe forms of diverticulosis require surgical intervention.

Conservative treatment consists in a complex method, which includes a sparing diet and drug treatment.

The patient is assigned:

broad-spectrum antibiotics;
painkillers and antispasmodic drugs, aimed at reducing muscle spasms;
prokinetics that stimulate intestinal motility;
laxatives, which include lactulose;
enzymes to improve digestion;
means for restoring normal environment in the intestine;
drugs to relieve diarrhea and bloating.

In severe cases of pathology, it is necessary to take the following therapeutic measures:

perform gastric lavage;
unload the intestines through siphon enemas;
perform infusion therapy with crystalloid agents;
apply fresh frozen plasma.

The operation is performed in cases where there are complications that threaten the life of the patient: severe bleeding, peritonitis, intestinal obstruction.

Indications for surgery:

exacerbations with severe spasms;
the formation of fistulas of the rectum;
probability of development malignancy rectum.

The operation is done in two steps. At the first stage, the damaged parts of the sigmoid colon are removed (resection), at the second stage, an anastomosis is formed, connecting the parts of the remaining intestine. Abdominal drainage and further intravenous antibiotic treatment are also done.

Diet

A diet for diverticulosis of the sigmoid colon is prescribed to the patient to alleviate his general condition. The diet of the patient should be dominated by vegetable fiber. Food is created on the basis of such products: fruits and vegetables, rice, cereals and legumes. To avoid irritation of the intestines, all products should be heat-treated. Nutrition consists in fractional meals 5-6 times a day in small portions.

Many nutritionists recommend following the principles of separate nutrition for better absorption of food by the body. It is necessary to eat wholemeal bread, bran, whole grain cereals. It is necessary to exclude from the diet products such as milk, chocolate, carbonated drinks, spirits, coffee, strong tea. Drink plenty of clean water every day fresh juices from fruits and vegetables, broths and soups.

Do not overeat, lead a healthy lifestyle, exclude foods with artificial food additives from the diet. Go in for sports, walk more in the fresh air, do special gymnastics.

Forecast

Timely access to a specialist and a properly selected method of treatment provide a favorable prognosis and save the patient from undesirable consequences.

Note!

The presence of symptoms such as:

smell from the mouth
stomach ache
heartburn
diarrhea
constipation
nausea, vomiting
belching
increased gas formation(flatulence)

If you have at least 2 of these symptoms, then this indicates a developing

gastritis or ulcer.

These diseases are dangerous for the development of serious complications (penetration, gastric bleeding, etc.), many of which can lead to

LETHAL

exodus. Treatment needs to start now.

Read an article about how a woman got rid of these symptoms by defeating their root cause. Read the material ...

The human digestive system and the organs included in it are more often than other systems subject to negative impact various factors under the influence of which numerous pathologies develop. If we talk about the intestine, its structure may change, including all sections, in particular the sigmoid. In older people, diverticula can be observed, which are protrusions of the intestinal wall - mostly thick, much less often thin. Such formations can be congenital or acquired. In this case, they talk about diverticulosis or diverticulitis of the sigmoid colon.

The difference between these diagnoses lies in the fact that with diverticulitis, intestinal contents enter the resulting protrusions. These masses are rich in nutrients, which allows microorganisms to actively multiply, causing the development of inflammatory processes.

Why diverticulosis develops and its types

Basically, diverticulosis is an acquired pathology, accompanied by a protrusion of the intestinal mucosa exclusively. congenital form pathology is observed infrequently, in this case there is a protrusion of all layers of the organ. As for provoking factors, the disease can cause:

Age-related changes, when muscle weakening occurs and as a result internal pressure diverticula are formed. The development of pathology in those whose age exceeds 50 years can be considered a common occurrence.
Heredity plays a significant role, in the presence of such a diagnosis in the family, the risk of the disease increases.
The influencing factor could be Not proper nutrition- studies have shown that if there is a sufficient amount of vegetable fiber in the diet, pathology develops much less frequently.
A problem with protrusion can occur when the functionality of the intestinal vessels is impaired - when they spasm in the large intestine as a result of compression, the blood supply worsens, the tissues of the sigmoid colon next to the vessels are stretched.
The disease can be caused by weakened connective tissue.

In order to be able to realistically assess the conditions observed in a patient, specialists have developed a classification of sigmoid colon disease, which includes three basic forms:

Diverticulosis in the absence of obvious symptoms.
Disease with clinical manifestations.
The advanced stage, which is accompanied by complications.

Most often, diverticulosis is diagnosed randomly when the patient is prescribed examinations for other pathologies.

Occasionally, the victim feels a slight, radiating pain in the abdomen, which is often attributed to problems with food, since the signs of the problem go away with bowel movements or with the release of gas contents. Gradually, the symptoms worsen, if you ignore the treatment, the consequences can be serious - diverticulitis may develop, leading to complications. The strength of the manifestation of symptoms is directly dependent on the formed diverticula (their number), concomitant diseases, and the age group of the patient.

Symptoms and traditional treatment of pathology

Let us consider in more detail the diverticulosis of the sigmoid colon, the symptoms and treatment of the disease. As already mentioned, at the initial stage of the development of pathology, there are no symptoms, slight pain passes quickly and usually goes unnoticed. In this case, there is no need for specific therapy, often it is enough to adjust the diet, enter some dietary dishes on the menu, use traditional medicine recipes against the background of the diet. If necessary, the attending physician may prescribe the use of antibiotic drugs.

However, in the acute stage, in the presence of an inflammatory process or perforation, a significant threat to the patient's life appears, in which case urgent surgical intervention may be required to remove the diverticula and part of the sigma. A number of symptoms indicate the onset of inflammatory processes:

Pain in the form of colic, not passing for a long period, localized in a certain place - the lower abdomen on the left side. When you press on the painful point, the discomfort increases.
There is an increase in temperature.
If inflammatory processes, in addition to the intestine, affect nearby organs, a neoplasm can be felt in the abdominal space - a peri-intestinal painful infiltrate.
There are attacks of nausea, which can flow into vomiting.

Therapeutic methods include taking antimicrobials and antispasmodics that relieve pain manifestations pathologies, laxatives and prokinetics that improve digestive processes, enzymatic substances. A special diet is prescribed to improve the general condition of the victim.

The menu should include dishes from vegetable fiber, it is based on legumes and cereal crops, rice, vegetable dishes, fruits.

To prevent intestinal irritation when eating fiber, the products must be thermally processed. Nutrition should be fractional, with a decrease in the volume of portions, their number is increased - food should be consumed up to 6 times a day. It is necessary to remove dairy products, chocolate, soda, alcohol-containing and coffee drinks, strong teas from the diet. The drinking regimen is important, observing which you should consume at least 2 liters daily. still water. The diet includes freshly squeezed fruit, vegetable juices, soups, broths, natural laxatives, these include prunes and dried apricots, infusions from medicinal herbs and dairy products. To normalize the intestinal microflora, it is recommended to use garlic.

Treatment of pathology with traditional medicine recipes

With diverticulosis of the sigmoid colon, treatment may become more effective if, against the background of pharmaceuticals apply traditional medicine recipes. The best medicines for diverticulosis are oil-based formulations that help normalize the microflora and the functioning of the digestive tract organs, while at the same time having enveloping properties:

Carrot powder is prepared from carrot seeds in the amount of 5 large spoons, finely grinding them. Take the remedy should be a small spoonful three times a day, drinking each dose with a large volume of liquid. The course of treatment is 14 days, after which they take a seven-day break and resume treatment.
It helps to take linseed or olive oil, you need to use a large spoonful of the remedy every day on an empty stomach.
Aloe tincture is prepared - about 300 grams of honey is added to 200 grams of ground leaves of the plant, this mixture is infused for 24 hours, after which they use a large spoonful of the product 60 minutes before each meal. The course of treatment is about 14 days.
You can use elderberry infusion, for which they take a large spoonful of the fruits of the plant and pour 200 ml of boiling water. The infusion is taken in a glass daily.
They drink aloe juice (a teaspoon three times a day), eat plantain seeds 20 pieces a day, take 30 drops of echinacea tincture. After meals, you need to drink mint or chamomile tea in a warm form.

Treatment with herbal medicines

In addition to simple medicines, complex fees can be used. Consider how to treat the disease with herbal infusions and decoctions:

Mixed in equal proportions nettle leaves, flowers chamomile, motherwort, rose hips, dill seeds. A large spoonful of the collection is placed in a thermos, 200 ml of boiled water is poured and the medicinal composition is infused for 90 minutes. Then the infusion is filtered, drunk in the morning and evening time. The volume of one dose is 100 ml. The course of therapy is 4 weeks.
For treatment, a decoction of slippery elm is used - they take 250 ml of boiled water and add half a small spoon of powdered plant bark and a small spoon of ordinary elm bark to it. Then the mixture is put on a small fire and boiled for 20 minutes, after which it is filtered and drunk up to 3 glasses of the product per day.
For diverticulosis great attention they devote to cleansing the intestines, for which they prepare the following composition - they take green apples and sprouted wheat grains in equal quantities. The components are crushed and ground with a blender. The resulting composition in the amount of 300 grams is taken instead of breakfast. The course of treatment is 30 days, then a break of the same length follows, and the therapy is resumed.
Apply bran, while observing some rules. Therapy begins with the intake of small portions, the volume of each does not exceed a large spoon per day. Bran is poured with milk or kefir, you can use yogurt. Gradually, the amount of bran per serving is adjusted to 50 grams daily.
A very effective remedy for the treatment of diverticulosis is oatmeal jelly. To prepare it, take a container, pour 2.5 liters into it boiled water pre-chilled to 50 degrees. Add to the liquid 150 ml of kefir, 500 grams oatmeal"Hercules". All ingredients are mixed, the container is tightly closed, placed in heat for 2 or 3 days - until signs of fermentation appear. After that, the product is filtered, the mixture remaining in the colander is washed, pouring one and a half liters of water onto it, which cannot be poured out.
The liquids remaining after the first filtration and subsequent washing are mixed, poured into a glass container, and sealed tightly. The remedy should be infused for 20 hours. Next, the liquid is divided into layers. The bottom is carefully poured into a clean tank, sent to the refrigerator. This composition is a concentrate necessary for the manufacture of oatmeal jelly. They take 3 glasses of water, add 10 large spoons of concentrate to the liquid, set the composition on a small fire, bring to a boil and cook until the volume is reduced, after which cream, buckwheat, linseed or olive oil, salt according to preference. oatmeal jelly allowed to eat bread.
For inflammation, a diverticulum is used next collection- in equal doses (100 grams each), nettle leaves, peony roots, mistletoe are mixed. Pour 2 large spoons of the collection with a liter cold water, set the container on fire, heat it almost to a boil, but do not boil the composition. Then it is cooled and filtered. Drink a remedy of 200 ml in the morning and evening hours 60 minutes after eating. The same decoction can be used as a remedy for enemas, they are put for constipation, the course of treatment is up to 2 weeks.

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Diverticulosis of the sigmoid colon

The content of the article:

Diverticulosis of the sigmoid colon is a pathology in which protrusions appear on the surface of this section of the intestine, resembling pockets - diverticula. To date, this disease is most common in gastroenterology. Diverticulosis sigma affects persons of any gender, and the main risk criterion is the age of the patient: in persons younger than 30 years, diverticula are not diagnosed.

Patients turn to a specialist in case of complications, when the first complaints appear; before this, the pathological process may be asymptomatic.

Often, patients with pain in the left side of the abdomen, dyspepsia, unstable stools, after consulting a therapist, ask: “Which doctor treats diverticulosis of the sigmoid colon?” The specialist is called a "gastroenterologist", but in emergency situations, hospitalization in the department of abdominal surgery is possible.

Treatment involves proper nutrition and intake medications, but there are life-threatening complications that may require surgery. Diverticula in the sigmoid colon different sizes, but more often small ones are detected, with a diameter of up to 1 cm. Almost a third of the population aged 40-50 years is faced with intestinal diverticulosis, and only 10% have clinical manifestations.

The intensity of this disease increases in proportion to age. This is due to the following factors:

Loss of elasticity of the intestinal wall;
chronic constipation against the background of loss of peristalsis and the associated increase in intracavitary pressure in the intestine;
a tendency to flatulence.

In addition, there is evidence that predisposing factors include heredity, eating habits, and certain diseases of the gastrointestinal tract, for example, megadolichosigma, in which overstretched atonic walls contribute to the appearance of protrusions.

The incidence of diverticulosis depends on the diet, in those regions where food rich in fiber is preferred, diverticulosis is less common. Fiber helps to optimize the digestive process.

Depending on the severity of the pathological process, therapy is prescribed. In some cases, diverticulosis of the sigmoid colon is complicated by conditions that threaten life:

intestinal bleeding;
perforation of the diverticulum;
acute intestinal obstruction;
inflammation of the peritoneum.

These complications require urgent surgical intervention.

Sometimes a localized abscess develops in the cavity of the diverticulum, which is manifested by pronounced changes in tissue morphology. If the abscess breaks into the intestinal cavity, recovery will occur, if pus enters the abdominal cavity, there is a risk of peritonitis. Involvement in the pathological process nearby organs and tissues can be complicated by the formation of a fistulous canal.

Sigmoid colon

The sigmoid colon owes its name to the curves that resemble the Greek letter "sigma".
This intestine is a section of the large intestine, S-shaped, starting from the descending part of the colon in upper divisions pelvis and goes to left half abdomen and then into the rectum. Its length is more than half a meter, its diameter is about 4 cm.

The role of sigma in the digestive process is the absorption of liquid from the food gruel. The blood supply and innervation of the sigmoid colon is provided by the mesentery, which consists of a large number of nerve and vascular structures.

Symptoms of diverticulosis of the sigmoid colon

ICD-10 code: K57

Depending on the diagnostic results, complaints, age of the patient, concomitant pathology, a treatment regimen is selected.

If the disease does not impair the quality of life and is in an asymptomatic or uncomplicated phase, then it is recommended to pay attention to the following aspects:

1. Diet optimization: increased amount fiber (eat more vegetables and fruits), drink enough fluids so that the feces are soft and do not stretch or injure the intestinal walls. During an exacerbation, only liquid food can be taken for 3 days, this helps to restore the intestinal mucosa and reduce the inflammatory process.

2. Rejection bad habits.

3. Therapeutic exercise.

With complaints and the addition of inflammation, conservative therapy is carried out.

Prevention

Every patient needs to know what preventive measures will be effective in preventing complications of diverticulosis. Gastroenterologists advise to adhere to the following rules:

1. First of all, it is necessary to normalize the chair.

2. Increase the amount of fluid consumed.

3. Introduce food containing a large amount of fiber into the diet: fruits, vegetables, bran.

4. Sports activities: exercises aimed at strengthening the muscles of the anterior abdominal wall and the press are especially useful.

5. Try to avoid stressful situations, with excessive anxiety after consultation with a neurologist, it is possible to take mild sedatives.

6. A rational approach to the daily routine: avoid overwork, it is recommended to sleep for at least 8 hours.

Diverticulosis Diet: Do's and Don'ts

Note that the main point in the treatment of sigma diverticulosis is a diet that helps to reduce muscle contractions and reduce pressure on weakened areas of the intestine.
Some experts consider the statement about the dangers of seeds and tiny particles to inflammation in diverticula to be unproven, however, it is better to avoid vegetables and fruits that contain seeds, especially if complaints appear after consumption. List of products that can aggravate the course of the pathological process:

Kiwi;
tomatoes;
grape;
zucchini;
zucchini;
cucumber;
blackberry;
raspberries;
strawberry;
eggplant;
pepper.

Avoid cruciferous vegetables such as Brussels sprouts and cauliflower.
Seeds and nuts with diverticulosis can provoke pain.

Avoid baked goods that contain peanuts, pistachios, cashews, and almonds, as well as sunflower, pumpkin, cumin, and sesame seeds.

Unprocessed dried fruits are difficult to digest in the gastrointestinal tract, so it is preferable to introduce either steamed prunes and dried apricots into the diet, or cook dried fruit compote.

Grains can linger in the gastrointestinal tract, especially if there are "pockets" in the form of diverticula. Stuck grains undergo processes of putrefactive fermentation and provoke an inflammatory process. In addition, the accompanying increased flatulence will contribute to pain and the appearance of new diverticula.

It is allowed to use refined bread and cereals, preferably from oatmeal.
Pasta, white rice, semolina, premium flour products are not recommended for nutrition with diverticulosis.

Nutritionists recommend including low-fat foods in your diet dairy products(kefir, fermented baked milk, matsoni, curdled milk), some patients digest whole milk well, but it is better to consult with your doctor about this.

In any case, products containing palm oil, margarine, cooking oil, mayonnaise are not useful.

Natural cheeses and cottage cheese in small quantities can be eaten with intestinal diverticulosis.

Other Foods to Avoid for Diverticulosis and Intestinal Diverticulitis

Red meat must be excluded or limited, the main diet for diverticulosis of the sigmoid colon is low-fat chicken, white varieties of fish, broths.

Avoid carbonated drinks and sweets, as they can cause increased gas formation, which will aggravate the clinical manifestations.

Do not eat a lot of acidic foods, there is evidence that with problems in the gastrointestinal tract, the risk of accession increases allergic dermatitis. Also, do not excessively consume oranges, lemons, grapefruit.

Avoid refined high-carb foods: limit cakes, ice cream, pizza, puffs, pretzels, biscuits, donuts, canned juices, chocolate, muffins, white sugar, cream, pies, etc.

Read the inscriptions on the packages: preservatives, sweeteners, dyes, etc. advances in chemistry will not add health.

Eliminate fatty and fried foods, fast food, french fries, convenience foods.

Instead, food cooked with the most gentle heat treatment is preferable: baked, boiled, steamed.

Alcohol and smoking always irritate the colon and stomach, so it is better to get rid of bad habits.

Home treatment for intestinal diverticulosis is possible if not serious complications: eat right, perform special exercises for diverticulosis, take prescribed drugs at home.

Some Recipes Helpful for Diverticulosis

1 tablespoon of bran is added to 200 ml of kefir or yogurt (any fermented milk product will do), left for 30 minutes to swell. Kefir with bran can be used instead of breakfast.

Gradually, the amount of bran is brought to 3 tablespoons, while paying attention to well-being: replacing constipation with frequent liquid stool- not the best result.
The target stool is soft, shaped, which helps prevent intestinal trauma, relieve inflammation and flatulence.

A decoction of mint, chamomile and psyllium seeds has good anti-inflammatory properties.

For cooking, you need to take vegetable raw materials in equal proportions (1 teaspoon each), add 250 ml of boiling water, insist for 1.5 hours. Take 1/2 cup 3 times a day on an empty stomach, 30 minutes before meals, the course of treatment is 10 days.

Get rid of constipation will help 1 tablespoon of olive, flaxseed or vegetable oil, stirred in a glass of kefir, take the resulting product shortly before bedtime. This recipe can be used for a long time.

A decoction of flax seeds also has a laxative effect.

Drugs for intestinal diverticulosis

Treatment with antibiotics and anti-inflammatory drugs is justified in diverticulitis.
Conservative treatment for diverticulosis of the sigmoid colon, in addition to antibacterial agents, with associated inflammation, includes the following:

Drugs to improve intestinal motility;
antispasmodics;
laxatives;
vitamin complexes;
drugs to increase hemoglobin.

With complications in the hospital, antibiotics are prescribed intravenously, which increases the effectiveness of treatment. Nutrition is carried out parenterally, which makes it possible to "rest" the gastrointestinal tract.

Surgery for diverticulosis of the sigmoid colon

In some cases, only surgical treatment can save a life: minimally invasive laparoscopic surgery - resection of the sigmoid colon, or open surgery. The operation is resorted to with frequent recurrences of the inflammatory process against the background of diverticulosis. The essence of the operation is the removal of the pathological site and the stitching (anastomosis) of the ends of the intestine.

What drugs are used for diverticulosis and treatment regimens

According to the indications (inflammatory process), it is possible to use Rifaximin 400 mg 2 times a day. every week of the month for a year. This increases the effectiveness of therapy by 2 times.
Symptoms are also eliminated by Mesalazine at a dosage of 400 mg 2 times a day, 10 days of each month for a year.

If necessary, laxatives and drugs are prescribed to normalize the composition of the intestinal microflora.

Recurrence of diverticulitis, especially with an episode of perforation, implies surgery in the amount of resection of the sigmoid colon due to high risk development of life-threatening conditions.

Note that suppositories for diverticulosis of the sigmoid colon do not exist, another thing is that there are suppositories that help fight constipation.

Important! With intestinal bleeding and suspected acute pathology (appendicitis, intestinal obstruction, peritonitis, etc.), suppositories cannot be used.

In intestinal diverticulosis, it is preferable to use osmotic drugs, which do not increase peristaltic movements, but have a laxative effect. These include:

Lactulose;
Macrogol 4000;
Sorbitol;
Sodium sulfate.

Sorbitol in diverticulosis of the sigmoid colon promotes reparative processes in the mucous membrane, which prevents diverticulitis. Exceeding the recommended dose of osmotic laxatives can increase the processes of gas formation.

Laxatives with dietary fiber:

Mukofalk;
Fiberlex;
Naturolax;
Fibercon.

Candles for diverticulosis should be used with caution, since long-term use, for example, Bisacodyl-based suppositories, may be complicated by intestinal atony.

Safe means, with minimal side effects, candles with glycerin are considered.
Before use, consult your doctor.

With the help of statistical data, it can be argued that every fourth person in the world suffers from the disease diverticulosis of the sigmoid colon. Usually this disease is observed in people in old age, since it is precisely the age-related change in the organisms that provokes it.

Diverticlesis occurs during a bowel movement due to strong tension. The usual location is the lower part of the sigmoid colon, about the size of a pea, sometimes a little more.

Doctors say that diverticulosis of the sigmoid colon is a very common disease, which is treated by 10% of people who have already reached 40 years of age. After 60 years, this disease can be found in every third.

What are diverticula?

Diverticulosis of the sigmoid colon is a disease in which a protrusion forms in the mucous membrane of the sigmoid colon. Due to its unusual curved structure, diverticula appear in the large intestine.

All urgent questions and your confusions that are associated with diverticulosis of the sigmoid colon will be easily answered by a proctologist. Diverticulosis cannot be determined without special diagnostics and testing.

Video:

One of the main causes of constipation and diarrhea is use various medicines . To improve bowel function after taking the drugs, you need every day drink a simple remedy ...

Causes

What are the factors that provoke changes in the body? The very first is the so-called age-related changes, which lead to changes in the muscles of the intestinal walls, and also cause degenerative changes.

Natural oils are useful for the whole organism, they saturate with vitamins and microelements, prevent constipation and relieve inflammation in the intestines.

What do Israeli proctologists say about constipation?

Constipation is very dangerous and very often the first symptom of hemorrhoids! Few people know, but getting rid of it is very simple. Just 3 cups of this tea a day will relieve you of constipation, flatulence and other problems with the gastrointestinal tract...

Dill;
Rosehip fruit;
nettle;
Chamomile flowers;
Motherwort.

It is necessary to prepare decoctions from mixtures of herbs and drink it throughout the day. The herb has the ability to soothe, has anti-inflammatory and carminative effects.

Very useful for the intestines is an infusion of elderberries. The recipe is very simple:

It is necessary to pour an armful of berries with one glass of boiling water;
Leave to infuse for a few minutes, until cool;
Drink a glass a day in small portions.

Remember that any remedy from traditional medicine will be effective only if adhered to proper diet as well as medical treatment.

Diverticulosis of the sigmoid colon is a protrusion of the organ wall as a result of degenerative processes, frequent constipation or dysmotility. The disease is quite common and is diagnosed in every tenth person, as a rule, old age. In most cases, it is asymptomatic, which complicates the diagnosis. Treatment includes following a special diet and taking medications.

Causes

Among the causes of diverticulosis of the sigmoid colon are a violation of intestinal motility, degenerative-dystrophic changes in the organ or vascular pathologies. Sometimes the provoking factor is the stagnation of feces (with constipation), which increases the pressure inside the intestine. As a rule, a combination of all negative factors leads to the disease.

Tissue dystrophy occurs in old age as a result of insufficient collagen synthesis. Dystrophic processes affect the muscular apparatus, the mucous and submucosal layers of the intestine.

The cause of pathology in middle-aged people is a violation of peristalsis due to malnutrition (insufficient intake of fiber). At the same time, the work of smooth muscles in the intestinal walls is disrupted, which provokes stagnation of feces and an increase in pressure.

A constant spasm of the muscles disrupts blood circulation in the intestine. This causes stagnation of blood in the capillaries and veins. Sometimes there is atherosclerosis in the arteries. Together with other unfavorable factors, degenerative-dystrophic processes develop, which lead to diverticulosis of the sigmoid colon.

Predisposing factors for the development of pathology include the following.

hereditary tendency to disease. If there are patients with diverticulosis in the family history, then the probability of pathology in the heirs is 65%. People at risk should Special attention focus on disease prevention.
Improper nutrition, adherence to a strict diet and insufficient intake of fiber.
Weakness of the connective tissue, which may be congenital or acquired.

Symptoms

Diverticulosis of the sigmoid colon in most cases is asymptomatic. A person may be unaware of the presence of pathology for several years, until complications appear (fistula, bleeding, peritonitis, diverticulitis, etc.). The disease is often discovered incidentally during preventive examination at the proctologist.

Sigmoid diverticulosis may be present in some patients periodic pain in the abdomen without a clear localization and colic. The pain goes away on its own, usually after a bowel movement.

Signs of pathology can be stool disorders (constipation alternating with severe diarrhea) and bloating, which causes discomfort. With the development of complications (for example, diverticulitis), the temperature rises, there is a sharp pain in the lower abdomen. Most patients attribute such symptoms to malnutrition or poisoning, since all symptoms disappear after a bowel movement and may not appear for a long time.

Diagnostics

A consultation with a proctologist is required to make a diagnosis. Diagnosis consists in carrying out instrumental methods research.

Irrigoscopy - X-ray of the large intestine, performed after a barium enema. Such a study allows you to identify protrusions of the intestinal wall, assess the size of the diverticulum, as well as the tone of the walls, the mobility of the intestine and the size of the lumen.

Colonoscopy is performed after barium enema and makes it possible to accurately determine the size of the protrusion, identify foci of bleeding and assess the condition of diverticula and intestinal walls. If indicated, a biopsy, MRI and CT of the abdominal cavity are performed.

Laparoscopy is both a method of diagnosis and treatment. Through the punctures of the abdominal cavity, a mini-camera is inserted into the abdomen, which allows you to detect the slightest changes in the intestine. During surgery, the doctor may remove the inflamed diverticulum.

With the development of complications, laboratory tests. So, with diverticulitis, the level of leukocytes increases with a shift leukocyte formula to the left. ABOUT frequent bleeding testifies low level hemoglobin and erythrocytes. To check for bleeding, a fecal occult blood test is performed.

Treatment

Normalization of the stool and restoration of intestinal activity are two goals pursued by the treatment of diverticulosis of the sigmoid colon. First assigned special diet. The patient is recommended to introduce foods rich in fiber into the diet: fruits, vegetables, cereals and dried fruits (prunes and dried apricots). Useful dairy products herbal decoctions(dill, chamomile, rose hips or motherwort) and natural oil (olive or corn). Patients should eat often (up to 6 times a day) in small portions. It is also important to maintain fluid balance by drinking at least 1.5–2 liters of water daily.

It is necessary to exclude from the menu fatty, smoked, spicy dishes and seasonings. They increase the load on the intestines, disrupt its work and cause irritation of the mucosa. It is also worth limiting the consumption of alcohol, sweets, flour products, chocolate and fast food products.

If there is no result after adjusting the nutrition, it is assigned drug treatment diverticulosis of the sigmoid colon. Specific methods of therapy depend on the age of the patient, his general condition and the presence of complications.

Drug treatment includes the following groups of drugs.

Antispasmodics for relief pain syndrome(No-shpa, Papaverine or Spazmalgon).
Antibacterial therapy is used in the presence of a purulent and inflammatory process. Amoxiclav, Sumamed, Ecomed or Azithromycin is prescribed. After antibiotic therapy be sure to take medications that restore the intestinal microflora (Linex, Bifidumbacterin and Acepol).
Prokinetics are prescribed to normalize intestinal motility. For this purpose, Motilak, Ganaton, Motilium, etc. are used. Additionally, prokinetics have antiemetic and antidiarrheal effects.
Laxatives help to avoid constipation and stagnation of feces. Means based on lactulose (Duphalac and Normaze) or fiber (Fitomycil) are used. Such drugs are safe, do not have a traumatic effect, on the contrary, they normalize the microflora.
Enzymes that improve digestion and intestinal motility (Mezim, Pancreatin or Creon).
Medicines for flatulence - Smecta or Espumizan.
To combat bleeding, drugs that increase blood clotting (for example, vitamin K) are prescribed.

In particularly difficult cases, apply radical measures. The patient undergoes a gastric lavage, and the intestines are unloaded using a siphon enema. At big blood loss infuse fresh frozen plasma.

If there are complications, it is possible surgical intervention. Indications for him - severe pain in the abdomen, the formation of a fistula or abscess, intestinal obstruction, peritonitis or profuse bleeding. Surgery is also performed when there is a risk of developing cancer. During the operation, a resection of the damaged part of the organ is performed.

Possible Complications

As the disease progresses, a number of complications arise. The most common diagnosis is diverticulitis - inflammation of the diverticula of the sigmoid colon. Pathology develops as a result of stagnation of feces, activation of the intestinal microflora and increased permeability of the intestinal walls. The patient suffers from severe abdominal pain and heat. Appear common signs intoxication. On palpation, the anterior abdominal wall tense.

When an infiltrate is formed, inflammation spreads to the omentum, mesentery, and nearby tissues. Palpable in the left lower abdomen painful induration with limited mobility. The patient's condition worsens, fever appears. The danger of such a condition is the formation of an abscess, which can open up and affect neighboring tissues and organs.

A serious complication of diverticulosis is intestinal perforation. The patient suffers from severe pain, weakness and high fever. The result of this pathology is peritonitis or fistula.

Often found intestinal bleeding that occur as a result of vascular damage or the formation of ulcers and erosions. At the same time, blood impurities are found in the feces. Chronic bleeding can lead to the development of anemia, which is manifested by weakness, dizziness and shortness of breath.

You can prevent the development of diverticulosis of the sigmoid colon by eating right and eating foods rich in fiber. It is necessary to avoid high physical activity and timely treat constipation.

Attention!

This article is posted for educational purposes only and does not constitute scientific material or professional medical advice.