Which doctor treats proctosigmoiditis? What is proctosigmoiditis and how to treat types of the disease

Inflammatory processes of the mucous membrane of the sigmoid and rectum lead to the disease - proctosigmoiditis. It is a common form chronic colitis. Proctosigmoiditis is combined with inflammatory processes (gastroenteritis, enteritis) of the gastrointestinal tract. Distinguish separate variety illnesses - spastic colitis, which occurs more often in women as a result hormonal imbalances. Negative changes can be caused by overwork and prolonged stressful situations.

Proctosigmoiditis. Symptoms

The disease occurs in acute and chronic form. If acute proctosigmoiditis occurs, its symptoms are as follows:

deterioration general condition;

increased body temperature;

Chronic proctosigmoiditis the symptoms are the same as acute. However, they are more weakly expressed. The disease is characterized by aching pain arising after the act of defecation. The pain may spread to the sacrum and coccyx. The disease has complications: hemorrhoids, fissures anus, rectal prolapse. When a doctor makes a diagnosis of proctosigmoiditis, treatment is mandatory.

Causes of proctosigmoiditis

The intestinal mucosa can be damaged due to ingestion of spicy, rough food, alcohol, or as a result of injury. Gastritis with low acidity, liver and gallbladder diseases lead to intestinal pathology. Also persistent infections, dysbacteriosis, allergic reactions, long-term use medicines cause the disease proctosigmoiditis. Symptoms will not take long to appear.

Treatment of the disease

Therapeutic treatment of proctosigmoiditis includes the following steps:

Following a diet that excludes rough, spicy food. The diet should consist of semolina and rice porridges cooked in water, pureed soups without fat, thermally processed vegetables and fruits.
The use of rectal suppositories with medications. Using therapeutic enemas with chamomile decoction. Rosehip oil, sea buckthorn oil, and fish oil are also useful.
The use of drugs that restore intestinal microflora: antibiotics, enzymes. The appointment is made by a specialist, depending on the cause of the disease.
Use of drugs enzyme preparations, reducing the presence of gases in the intestines. For loose stools, enveloping and astringent agents are indicated.
The disease in its acute form requires sanatorium-resort treatment and physiotherapy.

Catarrhal proctosigmoiditis

The symptoms of the disease are the same as those of other forms of the disease. It occurs as a result of damage to the intestine (large) with severe inflammation of the sigmoid colon. The causes of the disease are various. To clarify them, first of all, an examination is carried out for the presence of helminthic infestation, candidiasis, dysbacteriosis. In addition, irrigoscopy is prescribed for the purpose of analysis individual characteristics structure of the large intestine.

Prevention of proctosigmoiditis disease

With the aim of preventive measures it is recommended to quit smoking, alcoholic drinks, too spicy food. It is useful to eat vegetables, apples, yogurts and yogurts with biological additives, cottage cheese. In addition to the above, you need to drink at least two liters of fluid per day, keep healthy image life, make easy physical exercise. If you suspect the development of the disease, immediately contact a specialist.

Description:

Proctosigmoiditis is an inflammation of the mucous membrane of the rectum and sigmoid colon.
Proctosigmoiditis is the most frequent form manifestations. Has a relapsing course and is combined with inflammatory changes in other parts gastrointestinal tract(enteritis, gastroenteritis). Exists separate form proctosigmoiditis - spastic. It occurs more often in women and is caused by hormonal disorders against a background of prolonged stress and overwork.

Symptoms:

There are acute and chronic proctosigmoiditis.

Acute proctosigmoiditis.
Beyond the symptoms general body(fever, deterioration of general condition), intense cutting pains in the stomach, more in the left iliac region. The pain is accompanied by frequent false urge to stool (tenesmus). After the act of defecation, a feeling remains Not complete emptying intestines, feeling foreign body in the rectum. An admixture of mucus, sometimes with blood, is found in the feces. There may be constipation, a stool of the type " sheep feces" Characteristic. It often happens as a result of the absorption of toxic decay products into the blood. At digital examination rectum is determined by spasm of the anal sphincter and severe pain, so this manipulation in acute proctosigmoiditis is performed extremely rarely.

Chronic proctosigmoiditis.
The symptoms are the same as for acute proctosigmoiditis, but less pronounced. The pain is aching in nature and intensifies after defecation. May radiate to the sacrum or coccyx area. The disease occurs with long-term remissions; relapses are provoked by diet violations and alcohol intake.

Frequent complications with proctosigmoiditis are fissures anus. When distributed inflammatory process development is possible on pararectal tissue.

Causes:

1. Mechanical irritation of the intestinal mucosa (eating coarse fiber, spicy food, alcohol, mucosal injury from dense feces).

2. A history of gastritis with low acidity and gallbladder. With enzymatic deficiency, incomplete breakdown of food debris occurs, which leads to irritant effect them on the intestinal mucosa.
3. Intestinal dysbiosis.
4. Chronic intoxication as exogenous (long-term uncontrolled use of laxatives, antibiotics, non-steroidal anti-inflammatory drugs, exposure to chemical compounds), and endogenous (gout, ).
5. Allergic reactions.
6. Long lasting infectious process, both bacterial and protozoal etiology.

Currently, the theory of the occurrence of proctosigmoiditis in osteochondrosis is being considered. thoracic spine when there is a violation of the innervation of intestinal tone.

Treatment:

For treatment the following is prescribed:

1. Diet excluding spicy, rough, irritating foods.
The diet includes pureed low-fat soups, water porridge (semolina or rice), pureed cottage cheese, meat and chicken dishes for a couple. Fruits and vegetables must be heat-treated.
2. Local therapy. Therapeutic enemas with a decoction are prescribed medicinal herbs(chamomile), rosehip or sea buckthorn oil, fish oil, collargol. Widely used rectal suppositories with medications.
3. Etiotropic therapy. Includes the administration of eubiotics and bacteriophages to normalize the intestinal microflora. Enzymes, anticholinergics, antibiotics, metronidazole, enteroseptol are prescribed depending on the cause of proctosigmoiditis.
4. Symptomatic therapy. For bloating, medications that reduce gas formation in the intestines are indicated. enzymatic preparations. For diarrhea, astringents and enveloping agents are used.
5. Physiotherapy, Spa treatment, treatment mineral waters when cupping acute symptoms diseases.

Inflammatory processes in the intestines and the digestive system as a whole are extremely unpleasant phenomenon. That is why it is necessary to understand what simple sigmoiditis is, what its types are and methods of treatment. This will help avoid the development of complications and critical consequences in the future.

This disease is an inflammatory process that forms directly in the mucous part of the sigmoid and rectum. Proctosigmoiditis is characterized by a recurrent course associated with inflammatory pathologies. Most often they occur in other departments digestive system– it could be gastroenteritis or enteritis.

In addition, proctosigmoiditis also exists in a separate form, which is spastic colitis. The pathology is most characteristic of female representatives and is formed against the background of hormonal disorders, frequent overwork and prolonged stress.

Proctosigmoiditis is a disease that can be associated with the most different symptoms. The acute form of the disease is associated with:

holistic weakness;
an increase in temperature indicators;
chills, intense spasms in the peritoneum;
attacks of nausea;
flatulence.

The acute form of the disease is also characterized by bloody discharge, the appearance of pus. The patient may show frequent urge to defecation (most often false), and after bowel movement relief does not occur. Additional features There may be diarrhea, occasionally constipation, as well as a sensation of a foreign body in the intestine, while the pain has a specific localization, namely in the left side of the peritoneum.

IN certain situations patients complain of spasms in the sphincter area. As a result, serious painful sensations in the anus itself.

Chronic proctosigmoiditis can be suspected by similar symptoms, but against a background of milder manifestations. For example, painful sensations are more often aching than sharp and are localized in the lumbar region. After defecation, the pain becomes more and more intense, often associated with a burning sensation in the anal area. The reasons for its formation and other features will be discussed further.

Catarrhal

Catarrhal proctosigmoiditis is a specific form of this disease, which is formed as a result of recent and acute lesion large intestine. At the same time, in to a large extent the inflammatory process in the sigmoid colon is expressed. The symptoms of the pathology coincide with the manifestations of the chronic form.

In order to establish the causes of the development of catarrhal proctosigmoiditis, it is necessary to carry out comprehensive examination, which will determine the presence of candidiasis, helminthic infestation or dysbacteriosis. As additional diagnostic measures irrigoscopy is prescribed.

Chronic

With this type of pathology, long-term remissions may well be observed. They are interrupted by aggravation of the patient’s condition due to a violation of the diet or after drinking alcoholic beverages.

Chronic proctosigmoiditis is usually formed due to:

destabilization of the enzymatic functions of either the stomach or pancreas;
dysbiosis of the gastrointestinal tract, which forms due to prolonged treatment with antibiotics;
initial forms chronic pathologies(let's say Crohn's disease);
hereditary predisposition.

It is recommended to follow a diet and take probiotics and enzyme preparations for preventive purposes to prevent the worsening of the chronic form of the pathology. The features of the treatment will be discussed later in the article.

Erosive

Erosive proctosigmoiditis is a consequence of undertreated catarrhal form proctosigmoiditis. In other words, this is a relapse with a transition to a more complex form, in which extensive ulcerative lesions.

There are many symptoms of this disease, the main one being constant pain during bowel movements and movement. Characteristic feature is the localization on the left side. Gastroenterologists pay attention to the fact that:

Stool becomes irregular. It is often followed by constipation and diarrhea.
Marked false urges to bowel movement. They are characterized by blood discharge mixed with mucous patches.
There is a possibility that stool will be released in small quantities. Most often they have a foul odor and bloody impurities. All this is evidence that intestinal walls there are bleeding ulcers.

Surface

Superficial proctosigmoiditis is the simplest and best treatable form of the disease. In this case, although the inflammatory processes cover the entire mucous surface of the rectum and sigmoid colon, they occur exclusively on the surface, without penetrating into the depths tissue structures.

The course of the pathology is recurrent, combined with inflammatory processes that occur in other parts of the digestive system. The symptoms of the disease are similar to those functional disorder intestines and is not always clearly expressed:

The pain is either aching or spasm-like, localized in the left half of the peritoneum. In some cases, they get a so-called “spill”, spreading character.
Stool disorders. Most often it is diarrhea, but constipation may occur.
Feces are excreted in small quantities and are characterized by a fetid odor. After bowel movement, the feeling of incomplete emptying still persists.

In addition, the superficial form of proctosigmoiditis is characterized by some general physiological signs, namely weakness and malaise with an increase in temperature, frequent nausea, permanent fatigue. When making a diagnosis before starting treatment for proctosigmoiditis, colonoscopy is used. It reveals visual changes that occur on the superficial part of the intestinal mucosa. Most often it is redness and slight swelling.

Treatment of proctosigmoiditis - suppositories and other drugs

On initial stage treatment involves the use of eubiotics and bacteriophages, which help normalize intestinal microflora. If it worsens pain syndrome and the appearance of flatulence, enzymatic names are used.

Speaking directly about tablet forms, attention is paid to the use of antibiotics, antispasmodics and antihistamines. One of the most common therapeutic compounds Mesacol is used for the treatment of catarrhal proctosigmoiditis. It is characterized by antimicrobial and anti-inflammatory effects.

Another feature is the release in six types dosage forms, namely rectal suppositories, suspensions, rectal suspensions, as well as three types of tablets (coated and uncoated, prolonged action). You should also remember that:

the form and amount of Mesacol is prescribed depending on the type and degree of complexity of the pathology;
for extensive forms of the disease, tablets are used, for more local forms - suspensions and suppositories;
local therapy consists of using microenemas with Collargol;
suppositories for proctosigmoiditis are used with Prednisolone, Sulfasalazine and Hydrocortisone.

Experts point out that the drugs listed last are used exclusively for serious forms of pathology.

Briefly about the diet

Diet for any form of proctosigmoiditis is one of the foundations of treatment. Patients are advised to monitor portions and the composition of their own menu as strictly as possible. Not recommended for use heavy, oily or spicy, as well as salty food. Alcoholic and carbonated drinks are strictly prohibited.

If a person has been diagnosed with lactose intolerance, it is recommended to avoid dairy products. It is strongly recommended to completely eliminate strong types of coffee and tea from your diet. Drugs for the treatment of proctosigmoiditis should be taken in certain time, and the diet should be adjusted specifically to this course.

Proctosigmoiditis symptoms treatment, which has its own characteristics, is associated with inflammation of the rectum and sigmoid colon. Most often, the disease affects women and occurs against a background of stress, chronic fatigue or hormonal changes. Can provoke its development enzymatic disorders Gastrointestinal tract resulting from genetic changes or long-term antibiotic therapy.

What is proctosigmoiditis (another name for the disease is distal colitis)? This is the name for inflammation that occurs in the mucous membranes of the rectum and sigmoid colon. The disease can recur. Sometimes the cause of its appearance is gastrointestinal diseases, and in some cases vice versa.

Like any other disease associated with the process of inflammation, it occurs in acute or chronic form. In females, it is mainly diagnosed in an acute form.

Exist different types diseases associated with changes that occur in the patient’s body:

Catarrhal proctosigmoiditis is associated with inflammation of the upper intestine.
Erosive proctosigmoiditis leads to damage to the entire surface of the mucous membrane.
Ulcerative proctosigmoiditis occurs when the lower part of the intestine is affected.
Ulcerative-necrotic is associated with tissue death.
Fibrous or atrophic proctosigmoiditis provokes tissue changes or occurs if left untreated.
The hemorrhagic appearance leads to pinpoint bleeding.
Purulent-hemorrhagic is diagnosed based on the presence heavy discharge blood and pus.

Depending on what caused the disease, it is divided into:

The development of the disease can be provoked by incorrect physiology of the rectum, which is under pressure from nearby organs or various diseases(infectious or venereal).

In children, proctosigmoiditis occurs only if there is presence in the body infectious disease and may appear against the background of pathology of the gastrointestinal tract.

Symptoms and treatment of proctosigmoiditis in adults are always interrelated. Therefore, before prescribing a course of therapy, the doctor will ask what is bothering the patient.

During an exacerbation of the disease, the patient complains of:

signs general poisoning body;
high temperatures;
feeling of incomplete bowel movement;
frequent urge to defecate;
feeling of a foreign object in the rectum;
scanty feces with an unpleasant odor;
aches all over the body:
general weakness;
flatulence;
starts to hurt left side belly;
nausea appears;
from time to time the patient suffers from constipation;
you can see mucus and streaks of blood in the stool;
spasms near the anus.

Chronic proctosigmoiditis manifests itself:

aching painful sensations immediately after defecation, which often radiate to the tailbone;
itching in the anal area;
changes in the shade and condition of the skin in the anal area;
mucopurulent discharge;
relapse after a diet disorder or alcohol abuse.

Before prescribing treatment for proctosigmoiditis, the doctor must make sure the correct diagnosis is made.

To do this, he will interview the patient, find out what symptoms of proctosigmoiditis bother him and prescribe additional examination:

sowing feces;
blood analysis;
sigmoidoscopy;
rectoscopy;
cytology of intestinal contents;
biopsy of the intestinal mucosa.

Based on the symptoms, treatment of proctosigmoiditis should be aimed at ridding the patient of the main root causes of the pathology. There is no single treatment method.

Along with therapy, the patient is prescribed a certain diet for proctosigmoiditis. Such nutrition must be gentle and not irritate the intestinal mucosa. At the same time, it is advised to completely exclude from your diet: sour, salty, fatty, spicy foods, fresh vegetables and fruits, alcoholic products and any sweets. In addition, you need to drink about 2 liters daily clean water. The diet should be based on vegetables, lean boiled meat and fish, porridge, vegetable soup, cottage cheese, kefir, yesterday's eggs. White bread, berry jelly.

Drug treatment

The doctor will tell the patient how to treat the pathology after diagnosis.

Using microenemas

Direct and sigmoid colon have their own physiological characteristics structure and location, so inflammation in them can be treated using special therapeutic microenemas. This method can be considered effective regardless of what caused the inflammatory process. This method of therapy acts directly on the affected area and has virtually no side effects.

Proctosigmoiditis can be treated with:

Decoctions of medicinal herbs (chamomile, calendula, St. John's wort), along with starch and tannin. This procedure has an anti-inflammatory and adsorbing effect.
Antiseptic solutions (Sintomycin, Furacilin, etc.).
Collargol anti-inflammatory solution.
Sea buckthorn oil and Solcoseryl. This method is used to relieve superficial irritation of the mucous membrane, heal wounds during an erosive process or if the disease is subatrophic in nature.

The procedure must be carried out in the evening, before bedtime. After administration, the patient must hold the substance inside until the urge to defecate occurs. The number of procedures depends on the recommendations of the attending physician. As a rule, 8-10 microenemas are indicated. No more than 50 ml of the drug should be administered at a time.

Additionally, microenemas with herbal decoctions (sage, oak bark and marshmallow root) can be used. They have anti-inflammatory, antiseptic and enveloping effects.

The amount of such decoction should be no more than 400 ml. To obtain the desired effect, at least 30 such procedures should be performed.

ethnoscience

Treatment with folk remedies can give a good effect. But they can only be used at the initial stage of the disease. In case of atrophy of intestinal tissues, with purulent, necrotic or fibrous form proctosigmoiditis, the use of such methods can be not only ineffective, but also dangerous for the patient.

Traditional medicine offers the following treatment methods:

Warm enema sea buckthorn oil, which in minimum quantity is inserted into the rectum. In this case, the first urge to defecate should be restrained. It is allowed to empty the intestines only 1 hour after the administration of the oil.
2 tablespoons of 4% tannin solution diluted in 2 liters warm water. Make an enema from the resulting solution. This remedy is administered once and helps eliminate pain and inflammation. Further treatment must be carried out using enemas with decoctions of herbs that have an anti-inflammatory effect.
10 g pork fat mix with dried yarrow herb and calendula flowers, of which you need to take 3 tablespoons. Let the mixture sit for several hours. After this, heat the product, strain out the herbs and pour into small molds shaped like suppositories, leaving them in the refrigerator until completely hardened. In the evening, after bowel movements, you need to put 1 such suppository for 7 days.
Sitz baths with potassium permanganate. To do this, take a few grains of potassium permanganate per 1 liter of warm water and dissolve it well. The duration of the procedure is 15 minutes. The course of treatment is 2 weeks.

If you consult a doctor in a timely manner, proctosigmoiditis can be cured. In this case, the prognosis for the patient is favorable.

If the disease is not treated, then various complications arise over time:

haemorrhoids;
rectal prolapse;
perforation of the ulcer with further bleeding;
paraproctitis;
anal fissures.

To prevent the development of the disease, doctors recommend adhering to the following preventive rules:

Stop practicing anal sex.
Eat properly.
Keep your anus clean.
Avoid excessive loads and lifting weights.
Treat any diseases in a timely manner, especially those that develop in the coccygeal region.

Having noticed any signs of proctosigmoiditis, the patient should consult a doctor who will prescribe qualified treatment.

Self-medication in this case can be very dangerous, as it often leads to a worsening of the patient’s condition.

Inflammation in two areas of one system at once - common occurrence. If one area is not treated, then it affects the neighboring ones. Sometimes inflammation begins in two areas at once. One such disease will be discussed in the article.

What is proctosigmoiditis?

What is proctosigmoiditis? This is an inflammation of the mucous membranes of the sigmoid (colon) and rectum. It has a recurrent nature. It can either occur against the background of gastrointestinal diseases or provoke them (,). It often manifests itself in acute form, especially in women.

Like many others inflammatory diseases, proctosigmoiditis has two forms:

Spicy;
Chronic.

Based on the changes observed during the disease, they are divided into types:

Atrophic;
Hypertrophic;
Catarrhal;
Purulent;
Ulcerative;
Ulcerative-necrotic;
Fibrinous;
Erosive;
Hemorrhagic.

For reasons of occurrence, which will be discussed further, they are divided into types:

For motor dysfunction:

Spastic;
Paralytic.

According to the complications that arise, they are divided into:

Early;
Remote.

Causes

Based on the classification of proctosigmoiditis, we can conclude that there are many reasons for its occurrence. Thus, alimentary proctosigmoiditis occurs due to poor nutrition: a person constantly consumes too many fried, fatty or salty foods. With congestive proctosigmoiditis, congestive factors are observed: constipation, congestion venous blood, mucosal injuries due to the hardness of stool. Ischemic proctosigmoiditis often develops according to age reason in atherosclerosis, when there are various disorders in the nutrition of the rectum.

Separate attention should be paid to infectious proctosigmoiditis, which develops after infection enters the rectum. How does she get there?

Through the mouth, for example, cholera or dysentery, which often affects the large intestine.
Through anal intercourse or masturbation, for example, infection with syphilis or gonorrhea.
Through blood ( hematogenous route), in which other diseases develop, for example, paraproctitis, cystitis, vaginitis, hemorrhoids, prostatitis, polyps, rectal cancer, etc.

Toxic or radiation proctosigmoiditis develops due to abuse medicinal products. Long-term use of antibiotics and other medications can disrupt the microflora in the rectum. Radiation therapy for oncology can exceed the norm, which will affect health in other areas.

Additional factors provoking the disease may be:

The special structure of the rectum;
Pressure on the intestine by other organs;
Sexually transmitted and infectious diseases other organs.

Symptoms and signs of proctosigmoiditis of the sigmoid and rectal mucosa

We will consider the symptoms and signs of proctosigmoiditis of the mucous membrane of the sigmoid and rectum according to the forms of the disease:

Acute is characterized by the following symptoms:

Manifestation of general intoxication;
Increase in temperature;
Frequent urge to defecate;
Deterioration in health, body aches;
A feeling that there is something foreign in the rectum;
A feeling that an incomplete bowel movement has occurred;
Flatulence;
Feces are scanty and foul-smelling;
Attacks of pain in the left side of the abdomen;
Presence of blood or mucus in the stool;
Nausea;
Periodic constipation;
When pain occurs, muscle spasms occur in the anal area.

Chronic manifests itself in the following symptoms:

Symptoms are similar to acute form, but less pronounced;
Aching pain after defecation, radiating to the sacrum or tailbone;
Itching in the anus;
Mucopurulent discharge from the anal passage;
Changes in the color and structure of the skin of the anus;
Relapses are triggered by alcohol intake and dietary irregularities.

The symptoms are largely reminiscent of proctitis, rectal cancer and ulcerative colitis, which is excluded as the disease is diagnosed.

Proctosigmoiditis in children

Proctosigmoiditis in children can develop only by infectious causes, which are carried through the blood from other organs. It can develop against the background of gastrointestinal diseases.

Proctosigmoiditis in adults

In adults, proctosigmoiditis is often observed in old age or due to anal sex. It can occur in both women and men. In women it often occurs due to hormonal imbalance or constant stress.

Diagnostics

Diagnosis of inflammation of the mucous membrane of the sigmoid and rectum is carried out general inspection, after collecting complaints. To clarify the diagnosis, additional tests are prescribed:

Rectoscopy.
Stool culture.
Cytological examination of intestinal contents.
Sigmoidoscopy.
Biopsy of the intestinal mucosa.
Blood analysis.

Treatment

Treatment of proctosigmoiditis begins with eliminating the cause of the disease: other diseases are eliminated, radiation therapy, medications, etc. Further prescribed special diet, which will not irritate the inflamed mucous membrane of the sigmoid and rectum:

Avoid spicy, fatty, salty, sour dishes, raw fruits and vegetables, sweets, chocolate, alcohol.
Liquids up to 2 liters are recommended, semolina, rice porrige, boiled meat and fish, vegetable or meat soup, cutlets, cottage cheese, stale white bread, cranberry jelly, eggs, kefir, carrots, plums, cabbage, potatoes, apples, strawberries.

How to treat proctosigmoiditis? Taking medications, decoctions and enemas:

Sulfonamides: sulfosalazine, salofalk;
Medicinal enemas with chamomile;
Drugs that correct intestinal microflora;
Ointments to relieve itching in the anus;
Hormonal drugs for ulcerative form;
Antibiotics for infectious diseases;
Held symptomatic therapy: antispasmodics, gas-reducing agents, astringents and coating medications etc.;
Antiseptics;
Bacteriophages, eubiotics.

Physiotherapeutic procedures include the following activities:

Physiotherapy.
Massage.
Microclysters and suppositories.

Surgical intervention is practically not performed unless complications occur or there is no effect of treatment.

Treatment at home is only possible with the use of medicines. From folk remedies It is permissible to use enemas with a solution of chamomile or oils (corn, olive, etc.).

Life forecast

The prognosis for life with proctosigmoiditis is favorable with timely and proper treatment. How long do they live without treatment? It all depends on the complications and their course:

Rectal prolapse.
Cracks in the anus.
Haemorrhoids.
Perforation of the ulcer, ulceration of the wall, bleeding.

It is necessary to carry out prevention that will help avoid proctosigmoiditis:

Balanced and proper nutrition.
Keeping the anus clean.
Refusal of anal sex.