Sigmoid bone. Inflamed sigmoid colon: symptoms and treatment. They have an antimicrobial effect

Although the anatomy human body is the same for everyone, some organs may vary in shape and size from person to person. The most common differences occur in digestive system body, namely in the area of the thick and small intestine. In the thick section, it is located on the correct functioning of which the human condition directly depends.

This intestine helps digest food by supplying water to the human body. It is usually located at the level of the iliac crest, but can also reach the hypochondrium. Inflammation of the sigmoid colon is a fairly common phenomenon, which is called sigmoiditis. are expressed quite clearly, they will be discussed in this article. It is important to note that this is a fairly commonly diagnosed disease and affects a large number of people.

Word definition

Before talking about the symptoms and methods of treating the disease, it is necessary to find out the meaning of the concept “sigmoiditis”. What it is?

This disease is an inflammation of the lower part of the intestine, namely the sigmoid colon. Due to the anatomical features of the body structure, this section is considered one of the weakest points in the body. It's like he's attracting infection to himself. By shape sigmoid colon resembles the letter of the Latin alphabet “sigma”. Even despite the individuality of a person, in almost everyone this gut is similar to this letter.

Everything needs to be done on time, especially if it concerns health. Sigmoiditis can develop both independently of other ailments and together with them. So you should be careful in this matter, and at the slightest symptoms, consult a specialist.

Causes of the disease

Why does sigmoiditis occur? The reasons can be very different, but the main one is the structure of the human body. Oddly enough, we cannot influence the anatomy of our intestines and other organs. The large intestine has curves, each person has a different number of them. The more bends in the intestines, the higher the likelihood of inflammation, since it is difficult for the contents to pass freely through the intestines, which leads to stagnation feces.

In pregnant women, inflammation of the sigmoid colon can occur as a result of pressure from the uterus. Also the reason of this disease other ailments may occur gastrointestinal tract, such as dysbiosis or proctitis. Since the sigmoid colon is a poorly protected organ, it is more susceptible to diseases than others. Sigmoiditis is a rather serious illness that can lead to irreversible disruptions in the human digestive tract.

Types of sigmoiditis

The classification of the disease consists of several divisions. According to the degree of activity, acute and chronic sigmoiditis are distinguished. These will be discussed later. We should dwell in more detail on the division according to the changes that occur in the body during inflammation of the sigmoid colon.

Catarrhal sigmoiditis. This is the weakest form of the disease, it is practically not dangerous, the damage does not spread to the entire intestine, but only to the upper layer.
Erosive sigmoiditis. This is the next form of the disease into which catarrhal sigmoiditis can develop if timely treatment is not prescribed. In addition to the signs of the first form, examination can detect erosions (defects in the gastric mucosa).
Ulcerative sigmoiditis. Is very dangerous form The disease is characterized by the fact that inflammation moves from the upper to the lower layers. In some cases, inflammation can spread to the muscles.
Perisigmoiditis. He is the latest and, accordingly, the most severe form. With it, the intestinal wall becomes completely infected, which can lead to irreversible consequences.

U different types sigmoiditis its symptoms and causes. When you consult a doctor, you can find out whether you have this disease, what stage it is at and how to treat it.

Sigmoiditis: symptoms of the disease

As already noted, the degree of activity can distinguish between acute and chronic form diseases. The symptoms will be different in each case. First, let's look at a case where a person has acute sigmoiditis:

pain appears in the left iliac region;
pain is accompanied by spasms and radiates to the lower back;
bloating and regular rumbling of the stomach;
often loose stool with blood;
weakness, pallor, constant nausea.

The chronic form of the disease usually manifests itself together with intestinal dysbiosis. It is characterized by alternating diarrhea and constipation. If a person feels constant fatigue, weakness, and during bowel movements sharp pain, then most likely it is sigmoiditis. Symptoms and treatment for this form of the disease largely depend on the cause.

Digestion of food does not occur properly with this disease. If you do not see a specialist on time, a person can lose a lot of weight, get tired quickly, and feel constant fatigue. It is possible that everything will return to normal for a while, but there is no need to rejoice too early. Sigmoiditis may recede, but if a person has not been treated in any way, then he can be sure that the disease will return again.

Repeated illness can lead to serious infectious diseases, hypothermia and injuries.

Diagnosis of sigmoiditis

Even doctors can make mistakes, and even more so if we are talking about the fact that the sigmoid colon is inflamed. Where is it located and how does it hurt? The fact is that the symptoms of sigmoiditis are very similar to the symptoms acute appendicitis. There are often cases when doctors confuse these two diseases, since diagnosing sigmoiditis is quite difficult.

If a person consults a doctor late with this problem or an incorrect diagnosis is made, then the inflammation can grow to enormous proportions, posing a threat to life and health. In this case, there is a possibility that the sigmoid colon will grow together with other organs that are located nearby. Then the usual medicines and measures for sigmoiditis will not help, surgical intervention will become necessary.

Only an experienced doctor, a professional in his field, can diagnose sigmoiditis. The localization of the patient’s pain and the source of the disease is what the specialist needs to determine first. The patient himself can help the doctor with this, as well as palpating the abdomen. It is mandatory to take a blood and stool test so that the doctor can determine the severity of the disease. Since the correct diagnosis is very important, the specialist may prescribe the patient to undergo an ultrasound abdominal cavity. To diagnose the disease with certainty, the patient can be examined using an endoscope.

Treatment of inflammation of the sigmoid colon

A person’s life practically deteriorates if he is diagnosed with sigmoiditis. Symptoms and treatment of the disease are inextricably linked with each other. Regardless of the stage of the disease, the patient is in constant discomfort and regularly feels weak and tired.

The more severe the symptoms of the disease, the longer and more thorough the treatment will be. Currently, there are good and high-quality medicines for literally all stages of the disease. The main thing is to identify the cause in time and begin an examination.

Depending on what caused the disease, they are prescribed medications. If it enters the body as an infection, doctors recommend using antibiotics in treatment. If the disease occurs due to anatomical structure body, anti-inflammatory drugs are prescribed. Each doctor chooses the dosage and quantity individually for the patient.

If the patient feels very unwell, he will be offered hospitalization. If any similar symptoms begin to appear, you should immediately consult a physician. Self-treatment It is not recommended for sigmoiditis, as it is very dangerous. In this case, it is better to completely trust the attending physician and not take rash or uncoordinated actions.

Treatment with folk remedies

Despite the fact that at home there is a minimal chance of a complete recovery, treatment of sigmoiditis folk remedies occurs. Decoctions from medicinal herbs will be an excellent solution, as they will help improve well-being during intestinal inflammation, and also stop diarrhea and improve the functioning of the gastrointestinal tract.

For this decoction you will need small quantities of plantain and celandine leaves, rose hips and chamomile flowers. Place all the ingredients in a container one teaspoon at a time and pour boiling water over it. After the decoction has infused (6 hours), you can start consuming it. It would be correct to drink it 6 times a day, half a glass before meals. After drinking the decoction for 4 weeks, you need to stop for a week and then resume taking it again. For best results, it is recommended to repeat this cycle three times.

If a person suffers from diarrhea, then juice from plantain leaves will be a good help. To prepare this liquid, you need to grind the leaves and squeeze the juice out of them. One tablespoon of juice is diluted in a glass of boiling water. It is recommended to take half an hour before meals.

However, the treatment of this disease with the help traditional medicine not very effective, it will only help relieve pain temporarily. Seeing a doctor is a must for anyone with ulcerative or non-ulcerative sigmoiditis. Treatment of the second with folk remedies is more appropriate, as it will prevent the disease from growing further.

Proper nutrition when sick

In almost all cases of sigmoiditis, the doctor prescribes a diet. Most often this is diet number 4. Its goal is to eliminate inflammatory and other negative processes in the body, as well as to achieve proper bowel function. The main thing in this diet is to exclude fats and carbohydrates, due to this, a sufficient amount of gastric juice is released.

As already noted, this diet is prescribed to almost everyone who has sigmoiditis. Symptoms in this case are not very important. This diet low-calorie, high in protein, and the amount of fat and carbohydrates is kept to a minimum. The optimal duration of the diet is about 7 days. Since it does not contain enough vitamins, long-term use of it can adversely affect health. You should eat food 5-6 times a day in small portions.

crackers or stale bread;
boiled or steamed;
boiled;
porridge cooked in water;
green tea, coffee without sugar;
sour apples, quinces or pears.

Prohibited products include:

fresh bread, flour products;
meat, lard, sausages;
fatty fish;
spices, sauces, spicy additives;
carbonated drinks, cocoa and coffee with sugar.

As you can see from the products, this is a fairly low-calorie diet, and not everyone will be able to withstand it even for a week. However, it is necessary. Of course, after agreement with the attending physician. Patients often lose several kilograms after completing this course. This will relieve pain and reduce inflammation slightly. After the patient has been on a diet for a week, do not immediately switch to fatty and high-calorie foods, this can only worsen sigmoiditis. Symptoms in women are approximately the same as in men, there are no significant differences. So everyone will have to go on a diet, regardless of gender.

Disease prevention

This disease is very common, and in order to somehow protect yourself from it, you need to know about sigmoiditis. Many people don’t even realize what it is until they discover constant pain in the area of the iliac crest. The famous proverb says: forewarned is forearmed.

Prevention of this disease comes down to timely solving problems with the gastrointestinal tract and preventing extreme forms of illness. Very important point is proper nutrition. If possible, you should minimize your intake of fatty foods and consume more vegetables and fruits. It is advisable not to eat large meals twice a day. It is better to divide these portions into six times; this decision will have a positive effect on digestion. Thus, a person avoids overeating, and, accordingly, bloating.

In this case, all parts of the gastrointestinal tract will function normally. Of course, it is also necessary to seek professional help in a timely manner. At the first sign of any disease, especially those related to the intestines, you must make an appointment.

It is very difficult for people to understand whether their sigmoid colon is inflamed. Where is it located and how does it hurt? You need to know the answers to these questions. At the slightest manifestation of the first symptoms, you need to take action immediately.

Forecast

The future of the patient's disease depends on large quantity factors. Depending on what the symptoms are, the cause of the disease, the degree of sigmoiditis, the form of the disease, what will happen next to the patient depends. In general, it can be noted that sigmoiditis, with timely treatment and maintenance preventive measures almost always has a favorable outcome.

Of course, any disease that is detected late becomes difficult to treat, and in this case, sigmoiditis is no exception. The symptoms and causes of the disease are always different, and a lot depends on it. An unfavorable outcome can only occur if the disease is too advanced. Then surgery remains the only option.

SIGMOID COLON [colon sigmoideum(PNA, BNA); colon sigmoides(JNA); syn.: S-shaped colon, S-romanum, sigma] - part of the large intestine, which is a continuation of the descending colon and passes into the final section of the intestine - the rectum.

Anatomy

Sigmoid colon (sigmoid colon, T.) is located in the left iliac and pubic regions of the abdominal cavity and partially in the pelvis (Fig.). It begins at the level of the iliac crest and in the small pelvis at the level of the third sacral vertebra it passes into the rectum (see). S. is covered on all sides by the peritoneum, has a mesentery (mesocolon sigmoideum) with an average width of 16 cm and is characterized by significant mobility. In front, the S. k. is adjacent to the anterior abdominal wall, behind - to the iliacus and psoas major muscles, iliac vessels and the sacrum, above and to the right there are loops small intestine, below - the bladder (see), in women - the uterus (see).

In adults, S. has a length from 15 to 67 cm (on average 54 cm); the diameter of its lumen is approx. 4 cm, wall thickness - 2-2.5 mm. The length of the intestine depends on individual characteristics and age. In children, it is the longest section of the large intestine. The SK forms two loops: the upper (colon iliacum) - proximal, convex downward, occupying mainly the left iliac fossa, and the lower (colon pelvicum) - distal, convex upward, longer, located in the pelvis. Right-sided localization of loops is often observed.

Blood supply to the blood supply is carried out by 2-5 sigmoid arteries (aa. sigmoideae), which are branches of the lower mesenteric artery(a. mesenterica inf.). The sigmoid arteries divide into branches and anastomose with branches of adjacent arteries, forming arcades. Branches arise from them, forming an artery passing at the mesenteric edge along the intestine. Straight arteries extend from this artery, covering the intestine on both sides and connecting with each other at its free edge. The superior sigmoid artery anastomoses with the left colon artery(a. colica sin.), lower - with the superior rectal artery (a. rectalis sup.).

The veins of the S. to. accompany the arteries. The outflow of venous blood occurs in two directions: through the inferior mesenteric vein (v. mesenterica inf.) into the portal vein (v. portae) and through the veins of the rectal venous plexus (plexus venosus rectalis) into the inferior vena cava (v. cava inf.).

Lymph, vessels S. to. accompany blood vessels and are directed to the sigmoid lymph nodes (nodi lymphatici sigmoidei) and the lower mesenteric lymph nodes (nodi lymphatici mesenterici inf.), lying at the beginning of the inferior mesenteric artery.

Innervation of the S. to. is carried out by the branches of the lower mesenteric plexus (rr. mesentericus inf.).

Comparative anatomy, embryology, histology and physiology- see Intestines.

Examination methods

When interviewing a patient, it is necessary to establish previous diseases, the nature of abdominal pain, their connection with food intake, time of day, frequency of bowel movements, and features of feces. When examining the abdomen (see) in a patient with S.'s pathology, one can see increased intestinal motility (with obstruction), protrusion of the abdominal wall (with large tumors, especially in exhausted patients). When palpating the anterior abdominal wall, a pathologically altered S. can be identified. Of the instrumental methods, endoscopic (see Colonoscopy, Peritoneoscopy, Sigmoidoscopy) and X-ray examination (see Angiography, Irrigoscopy) are used.

Pathology

Patol. processes in S. k., as a rule, are not isolated; they are usually associated with diseases of other parts of the colon. There are malformations of S. to. (see Megacolon, Splanchnomegaly, Splanchnoptosis), damage (see Abdomen), functional diseases (see Intestine), inflammatory diseases(see Colitis, Crohn's disease, Sigmoiditis, Ulcerative colitis), infectious diseases affecting S. k. (see Actinomycosis, Amebiasis, Dysentery, Syphilis, Tuberculosis), neoplasms (see Villous tumor, Polyp, polyposis; Cancer) , diverticulosis, diverticulitis (see Intestines), as well as a number of other diseases - mega dolichosigma, volvulus, intestinal fistulas (see), etc.

Megadolichosigma - lengthening and expansion of the S. k.; can be congenital (see Megacolon) and acquired. Acquired megadolichosigma is a consequence of mechanical obstruction due to congenital and acquired narrowing of the rectum, as well as its damage.

Wedge, manifestations - persistent (up to 2-3 weeks) constipation (see), not amenable to conservative treatment and resolved only after mechanical cleansing of the rectum. The patient's abdomen is large, swollen, and has a round shape. The skin of the anterior abdominal wall is stretched, the venous network on it is expanded, and peristaltic movements of the intestinal loops may be visible. With deep palpation, you can determine the accumulation of feces in the colon. A characteristic symptom of the formation of a pit is that when pressing with a finger through the anterior abdominal wall on the dense fecal masses located in the intestine, as a rule, persistent pressure occurs.

The diagnosis is made on the basis of anamnesis (long-term constipation), wedge, pictures, X-ray results. studies (with the introduction of a contrast agent both through the rectum and through the mouth). Before X-ray research it is necessary to cleanse the colon using siphon enemas (see).

Complications: possible development of obstructive intestinal obstruction (see) and peritonitis (see) due to perforation of the intestinal wall.

Treatment can be conservative (diet, regular use of laxatives, cleansing enemas, mechanical cleaning of the intestine), and if it is ineffective, surgical (resection of S. to.).

The prognosis for regular and thorough bowel movements is favorable.

Volvulus of the sigmoid colon most often occurs due to its obstruction. In the etiology of S.'s volvulus, the condition of its mesentery plays an important role: wrinkling and cicatricial deformation of the mesentery (especially when its length is significant) causes the ends of the S. to come together, which promotes stretching and elongation of the intestine and leads to stagnation of the contents in it. Predisposing factors to volvulus may be an increase in intra-abdominal pressure (large and sudden exercise stress), increased intestinal motility after eating a large amount of food rich in coarse plant fiber, prolonged constipation. Volvulus occurs as a result of the rotation of the S. to. and its mesentery around its axis.

The onset of the disease is acute - sharp cramping pain in the abdomen, cessation of the passage of feces and gases, increasing bloating. Physical examination reveals abdominal asymmetry, stenotic intestinal peristalsis, and splashing noise. Digital examination of the rectum reveals a gap anus, expansion of the ampulla of the rectum (symptom of the Obukhov hospital). With volvulus, the Tsege-Manteuffel symptom is characteristic: with the help of an enema, it is possible to introduce 1-2 glasses of water, the edges quickly flow out, do not contain feces, and there is no discharge of gases. The vomiting that appears initially may then stop and resume again due to the development of peritonitis. General state The patient initially remains satisfactory, but as intestinal obstruction increases and peritonitis develops, it worsens.

The diagnosis is made on the basis of anamnesis, clinical, endoscopic and radiograph. studies (see Intestinal obstruction).

Treatment is initially conservative - novocaine blockade, siphon enema, intubation (see). With absence positive effect In contrast to conservative measures, surgical intervention is indicated, which usually consists of reversing (detorsion) of the colon or, if the intestine is not viable, its resection with the imposition of a temporary or permanent unnatural anus (see Anus praeternaturalis).

Operations on S. to. is carried out under endotracheal anesthesia (see Inhalation anesthesia) with the use of muscle relaxants (see). Preoperative preparation and postoperative management - see Intestines, operations. Access to S. to. is a median laparotomy (see).

Resection of S. k. for cancer, intestinal obstruction under favorable conditions and with full confidence in the viability of intestinal loops, it can end with the imposition intestinal anastomosis end to end (see Intestine, Intestinal suture). If there is uncertainty about the viability of the distal and proximal ends of the intestine after S.'s resection, the imposition of an unnatural anus is indicated. Extirpation of the rectum is also usually completed by applying a sigmostoma (see Sigmostomy). For diverticulitis, nonspecific ulcerative colitis and Crohn's disease with S.'s lesions, hemicolectomy (see) or colectomy (see) can be performed.

Dolichosigma

Dolichosigma is a developmental anomaly of the sigmoid colon, consisting in its elongation with normal lumen width and wall thickness. Dolichosigma is usually observed with megacolon, characterized by changes in the entire colon or most of it and elongation of the sigmoid colon, often accompanied by its expansion (see Intestine).

Examination of a patient with dolichosigma should include a thorough examination of the medical history, general clinical and proctological examinations. Such patients have a history of persistent constipation, flatulence, and abdominal pain. When examining the abdomen of a patient with dolichosigma, increased intestinal motility and protrusion of the anterior abdominal wall may be detected. When palpating the anterior abdominal wall, in some cases you can feel an elongated sigmoid colon filled with feces. During a rectal examination in some patients, despite appropriate preparation, fecal stones can be detected in the rectum. During sigmoidoscopy (see), the smoothness of the folds of the intestinal mucosa, its hyperemia, and sometimes pressure ulcers from fecal stones and the fecal stones themselves are determined. With the help of colonoscopy (see) and irrigoscopy (see) the length of the sigmoid colon and the relief of its mucous membrane are determined. In addition, after taking a barium suspension through the mouth, its passage through the intestines is studied and the functional characteristics of the large intestine are assessed.

The diagnosis is made based on the results of a comprehensive examination of the patient. Differential diagnosis in adults it is carried out with colitis (see), in which there is no elongation of the sigmoid colon during irrigoscopy. Dolichosigma is also differentiated from megacolon (see), in which all parts of the colon are expanded.

Conservative treatment in initial stages the disease is aimed at combating constipation and includes rational diet therapy (consumption of foods rich in plant fiber), physical therapy and various laxatives. If there is no effect from conservative treatment surgical intervention is indicated - resection of the sigmoid colon. The prognosis with timely and adequate treatment is usually favorable.

Bibliography: Baulin A. A. On the peculiarities of blood supply to the wall of the colon and sigmoid colon, Vestn. chir., t. 112, no. 3, p. 128, 1974; Blood supply to organs digestive tract man, ed. K. I. Kulchitsky and I. I. Bobrik, Kyiv, 1970; Malysheva E. P. Lymphatic vessels human sigmoid colon, in the book: General patterns of morphogenesis and regeneration, ed. K.I. Kulchitsky and others, c. 2, p. 128, Kyiv, 1970; Melman E. P. Functional morphology of the innervation of the digestive organs, M., 1970; Romanov P. A. Forms of fixation of the colon in an adult, Surgery, No. 2, p. 59, 1980; Surgical anatomy belly, ed. A. N. Maksimenkova, p. 587, D., 1972; Abdomen, ed. by A. Alvia. P. H. Arger, v. 3, N.Y., 1980; Lawson J. O. Pelvic anatomy, Ann. roy. Coll. Surg. Engl., y. 54, p. 288, 1974; Parrott D. M. The gut as a lymphoid organ, Clin. Gastroent., v. 5, p. 211, 1976; Shackleford R. T. Operative anatomy of abdomen and pelvis, Arch. Surg., v. Ill, p. 834, 1976.

G. A. Pokrovsky; N. V. Krylova (an.).

– an abnormal increase in the length of the sigmoid colon and its mesentery, leading to impaired motility and bowel movement. Dolichosigma is manifested by chronic constipation, flatulence, and recurrent abdominal pain. In the diagnosis of dolichosigma, the main role is played by irrigography and radiography of the passage of barium through the large intestine; auxiliary - rectosigmoidoscopy, colonoscopy, etc. For dolichosigma, diet, massage, exercise therapy, and physiotherapy are prescribed; for prolonged constipation - laxatives and enemas. In case of chronic intestinal obstruction, dolichosigmoid resection is performed.

General information

Dolichosigma is an anomaly in the structure of the sigmoid colon, consisting in its elongation without changing the diameter of the lumen and wall thickness. The elongated sigmoid colon often has increased mobility, which is accompanied by impaired formation and passage of feces. The frequency of dolichosigma in the population reaches 25%, however, it is assumed that due to the blurred clinical manifestations and the complexity of diagnosis, the pathology is not detected in all cases. In pediatrics, dolichosigma is found in 40% of children suffering from constipation.

Normally, in an adult, the length of the sigmoid colon loop is on average 24-46 cm: such a colon is regarded as normosigma. When the length of the sigmoid colon is less than 24 cm, they speak of brachysigma, and when the length is more than 46 cm, they speak of dolichosigma. The combination of elongation of the sigmoid colon with its expansion and thickening of the walls is designated as megadolichosigma.

Causes of dolichosigma

Dolichosigma can be a congenital or acquired condition in which the sigmoid colon has 2-3 additional loops. The etiological cause of dolichosigma is unclear. It is assumed that congenital disorder of growth and fixation of the sigmoid colon may be associated with heredity; exposure to unfavorable environmental, physical, and chemical factors on the fetus; infectious diseases expectant mother, taking certain medications by a pregnant woman.

Acquired dolichosigma occurs as a result of digestive disorders associated with the processes of prolonged fermentation and putrefaction in the intestines. This usually affects people over 45-50 years of age who lead a sedentary lifestyle, are engaged in sedentary work, abuse meat and carbohydrates, and often experience stress. At the same time, some authors believe that dolichosigma is always congenital anomaly, and digestive problems only cause the manifestation of clinical manifestations given the existing anatomical prerequisites.

Due to a long absence of bowel movements, a child with dolichosigma may form fecal stones, develop fecal autointoxication, anemia, and irritable bowel syndrome. One of the serious complications of dolichosigma is intestinal obstruction due to nodulation, volvulus, kinks, and intussusception of the sigmoid colon. In these cases, a picture develops acute abdomen.

Diagnosis of dolichosigma

Examination of a child suffering from dolichosigma reveals underweight, retardation in physical development, pallor skin. Palpation of the abdominal cavity reveals intestinal loops filled with feces. A digital rectal examination reveals an empty rectum, even if the child has not had stool for a long time.

Decisive instrumental method in the diagnosis of dolichosigma is irrigography, during which the elongation of the sigmoid colon is revealed, the presence of additional loops in the form of a “figure eight”, “double-barrel”, “knot”, “snail”, etc. MSCT of the colon allows you to examine in detail its location, shape, contours, length, lumen width, haustration, presence of additional loops.

To assess the motor-evacuation function of the colon in a patient with dolichosigma, barium passage radiography, electromyography, and sphincterometry are performed. Endoscopy in children (rectosigmoscopy, colonoscopy), ultrasonography of the large intestine, ultrasound of the abdominal cavity, radiography of the abdominal cavity are of auxiliary importance in the diagnosis of dolichosigma. From laboratory methods a coprogram is used; stool analysis for dysbiosis, occult blood, helminth eggs; clinical and biochemical blood tests.

For spastic pain, antispasmodics (drotaverine, platyphylline) are prescribed; for intestinal hypotension - prozerin, massage of the anterior abdominal wall, exercise therapy, electrical stimulation of the colon, colon hydrotherapy, acupuncture. Patients with dolichosigma benefit from courses of vitamin therapy (B6, B12, C, E), bacterial preparations (probiotics and prebiotics), and treatment in sanatoriums in Zheleznovodsk and Truskavets.

Indications for surgical treatment of dolichosigma in children are extremely rare. Surgical treatment is indicated for intestinal obstruction, failure of conservative therapy, persistent constipation, progressive fecal intoxication, the presence of unstraightened loops and kinks of the intestine. With dolichosigma, resection of the sigmoid colon is performed. In the case of predominant damage to the distal sigmoid colon, the operation of choice is proctosigmoidectomy.

Forecast

Usually, if all medical recommendations are followed, it is possible to achieve regular independent bowel movements and an acceptable quality of life. As the child grows, many disorders can be compensated; in some cases, the problem of dolichosigma worries patients even in adulthood. In the latter case, lifelong adherence to the diet and quality of nutrition is necessary, to exclude the development of nutritional, psychogenic and other types of constipation. Children with dolichosigmoid need observation by a pediatrician, pediatric gastroenterologist, periodic courses of conservative therapy, and examination of the condition of the large intestine.

In many countries of the world, malignant diseases take 3-4 place among all cancer diseases. The number of cases of colon cancer is steadily increasing.

The distal colon includes the sigmoid colon, which is a continuation of the descending colon and precedes the rectum. Sigma gets its name from its curved S-shaped convolution.

The organ is located in the left iliac region and often serves as the site of localization of a malignant formation - about 50% of all cases occur in the distal colon.

The pathology most often occurs in individuals with predisposing factors:

Age.

After fifty years of age, the risk of developing this cancer increases sharply.

Features of the diet.

Increases the chance of getting sick by eating large amounts of meat products (beef, pork), refined foods and reducing the content of fiber and plant fibers in the menu.

The alkaline environment resulting from a large number of meat products contributes to an increase in the growth of bacteria, decomposing bile acids can have a carcinogenic effect on the mucous membrane of the digestive tract.

Precancerous intestinal diseases.

Pathologies such as UC, adenomatous polyps, diffuse polyposis increase the risk of cancer and should be of concern increased attention doctors, causing cancer alert.

Family history.

Cases of diagnosed cancer among close relatives or existing familial polyposis of the colon greatly increase the likelihood of developing this cancer.

Physical inactivity and excess body weight.

The relationship between low level physical activity and overweight: Obese people are more likely to develop colon cancer.

Abnormal stool.

The tendency to constipation contributes to the retention of feces and the accumulation of toxic substances, which increase the amount of carcinogens in the intestinal lumen.

Also, with excessive straining, the inner wall of the organ is mechanically injured, causing inflammation. If a patient has at least one of the above risk factors, he should be attentive to his health and be wary of cancer pathology.

Classification of the disease

The disease arises from the epithelium of the inner wall of the organ. There are several classifications that reflect the direction of tumor growth, its origin and structure, and the extent of the process.

Histological classification

Examines the structure and origin of formation at the microscopic level. The following varieties are distinguished:

Adenocarcinoma.
Squamous cell carcinoma.
Signet ring cell.
Mucous (mucinous).
Undifferentiated.

An important point from a histological point of view is determining the degree of maturity of tumor cells. They can be highly, moderately, and poorly differentiated.

The worst prognosis is for cancer with low-grade cells. This tumor progresses much faster and has an unfavorable course.

Macroscopic classification

When examining the intestinal walls visually using an endoscope, the doctor makes an assumption about the macroscopic nature of the tumor, taking into account the shape and direction of growth of the formation.

There are 2 types of tumors:

Exophytic - growth occurs in the lumen of the intestinal tube. Externally, cancer looks like protruding nodes various shapes and pedunculated sizes into the intestinal lumen.
Endophytic - growth occurs deep into the wall of the organ. Such formations are more typical of the sigmoid colon.

TNM classification

Reflects the prevalence of damage at three levels:

T – local.
N – reflects involvement in pathological process regional lymphatic system (whether there are metastases to nearby lymph nodes).
M—indicates whether distant hematogenous metastases are present.

Taking into account the above data, the stage of the tumor is formed, which reflects its prevalence, as well as an approximate prognosis for cancer.

The first symptoms and signs of sigmoid colon cancer

The insidiousness of this pathology lies in the fact that for a long time it may not manifest itself in any way, and the first clinical manifestations often arise already advanced stages diseases.

Clinical signs at first may be so scanty and unremarkable that patients may attribute them to an intestinal disorder or temporary malaise.

However, you should be wary if the following symptoms appear:

Blood and mucus in stool.
Impurities of pus in stool.
Intestinal dysfunction: changes in the rhythm of bowel movements, frequent alternation of constipation and diarrhea.
False urge to defecate – tenesmus.

Patients may experience nonspecific symptoms of general intoxication:

Sudden, unmotivated weight loss.
Increased fatigue.
Weakness.
Pale or yellowish skin.
Loss of appetite.
Increased body temperature.

If more than two symptoms are detected, you should immediately consult a doctor! There is no need to “delay until the last minute” or underestimate the signs of illness. It is better to undergo an examination of the body and know everything about your health condition than to consult a doctor at the stage when the disease has become advanced.

Symptoms of sigmoid colon cancer in women and men

The first signs of oncology of this colon are not very specific and are often not given due attention by either doctors or patients.

But as the cancer progresses, the clinical picture becomes more pronounced. The oncopathology clinic depends on the size of the tumor, the presence/absence of metastases.

Blood in stool

Up to 75% of patients with an established diagnosis report this symptom. Somewhat less common are mucus and pus in the stool, found after defecation.

Bleeding may be hidden and not visually apparent. Its presence is established using diagnostic tests, as well as on the basis of clinical and laboratory confirmed anemic syndrome.

Bowel dysfunction

At first, unstable stool may be observed in the form of alternating diarrhea and constipation; as the disease progresses, patients show a clear tendency towards increased constipation, changes in the color and shape of stool.

A false urge to defecate – tenesmus – causes a lot of inconvenience to patients. They can occur up to 20-40 times a day. There is a feeling that you need to go “big”, but when you visit the restroom, emptying does not occur.

Gas, mucus, and a small amount of blood or pus may be released. Tenesmus occurs due to irritation of intestinal receptors by a growing tumor.

Intestinal obstruction

The sigmoid section of the large intestine is located in the left iliac region, the diameter of the hollow organ on the left is less than the diameter of the intestinal loops on the right.

Therefore, often one of the symptoms of cancer of the distal gastrointestinal tract is obstruction due to blockage of the organ lumen with feces and tumor tissue.

Stomach ache

Pain in the left half of the abdomen at the level of the navel or below can be moderate, tolerable, and inconsistent.

And they can be cramping, unbearable in nature when developing. Pain syndrome may be accompanied by nausea, vomiting, increased gas formation, and increased body temperature.

In this connection, the patient mistakenly assumes that he is poisoned or has developed intestinal infection. Prefers to be treated at home and postpones visiting a doctor. This is not worth doing.

Any of the above symptoms require a visit medical institution or calling a doctor at home.

Violation of general condition

As the disease progresses and spreads, nonspecific symptoms of intoxication are observed: weight loss to the point of exhaustion, cachexia, pale skin with a yellow-gray tint.

And general weakness, decreased performance, increased fatigue, fever.

Stages of sigmoid colon cancer

Depending on the prevalence of the oncological process, four stages of the disease are distinguished:

Stage 1 – the tumor is located locally, in the mucous and submucosal layer. There are no regional or distant metastases.
Stage 2 - the pathological process occupies no more than half the diameter of the sigma, does not invade the entire intestinal wall of the organ, but single metastases appear in nearby lymph nodes.
Stage 3 - the tumor grows to more than half the diameter of the intestinal tube with exophytic growth, or with endophytic spread it grows into the entire wall of the organ. There are metastases, both regional and distant.
Stage 4 – characterized by many metastases in distant organs, as well as in regional lymph nodes. The oncological process extends beyond the distal parts of the gastrointestinal tract and can spread to nearby tissues and organs.

When cancer is diagnosed at stage 1 and treated in a timely manner, the survival rate is about 90%, at stage 2 with successful surgery – 50-60%.

Stage 3 cancer

If a patient sees a doctor and is diagnosed with stage 3 cancer, this means that the patient sought help late: the tumor has spread in the body and given both regional and distant metastases.

If the tumor is diagnosed at stage 3, the survival rate is much lower than in the first two: less than 40%. The prognosis for patient survival worsens as the stage of the cancer process increases.

Stage 4 cancer: life prognosis

Stage 4 is characterized by the neglect of the process and the inability to carry out surgical intervention. Diagnosis of the disease at stage 4 has an extremely unfavorable prognosis for life, 20-30% of patients live for several years.

At this stage of the disease, only supportive, palliative treatment is indicated. Due to multiple distant metastases surgical operations are not produced.

The goal of maintenance therapy is to reduce pain, clinical symptoms illness, improving the quality of life, as far as possible with this pathology.

Cancer of the distal sigmoid colon

With this localization, the tumor is located near the rectum, on the border of the sigmoid and rectum. The most common manifestations of the pathology are: impaired passage of feces, a tendency to constipation, blood in the stool, and false urges.

The tumor is often located in the transitional rectosigmoid junction and spreads to the lower rectum.
You should be careful about such " alarm bells" How:

The appearance of constipation.
Streaks of blood in the stool.
The appearance of mucus in the stool.
The presence of frequent false urge to defecate.

If they appear, you should immediately consult a doctor and undergo the necessary diagnostic examinations to exclude distal cancer.

Stenosing sigmoid colon cancer

This is a type of exophytic cancer growth, when the tumor grows into the lumen of the intestinal tube, closing it and interfering with the passage of feces. Stenosis develops, the manifestations of which are:

Pain, bloating of intestinal loops.
Changes in peristalsis waves.
Impaired passage of gases and feces.
Development of intestinal obstruction.

Complete stenosis of the organ threatens acute obstruction, which is an acute surgical pathology and requires immediate surgical intervention.

Metastasis in cancer

The following types of metastases characteristic of this pathology are distinguished:

Lymphogenic ( cancer cells spread along lymphogenous pathways): to the lymph nodes located next to the pathological focus.
Hematogenous (migration occurs through the blood): distant metastases to the liver, lungs, spine.
Peritoneal (spread occurs by contact through the peritoneum): to the ovaries - Krukenberg metastases, Schnitzler metastases (in the lowest place in the abdominal cavity).

The spread of the malignant process causes pain syndrome and clinical manifestations in the organ where the metastases are localized.

Pain in the spine, heaviness in the liver area, bitterness in the mouth, progressive coughing and increasing shortness of breath may occur.

When an oncological process is detected, it is imperative full examination organism in order to identify or exclude metastatic foci.

Treatment of the disease

Sigma is used in cancer therapy surgery(is the main one in operable stages of cancer), radiation and chemotherapy. Often several methods are used - combined treatment.

The principle of surgical intervention is to remove the tumor with the maximum reserve of a visually healthy organ.

In order to eliminate possible metastatic foci in regional lymph nodes, remove lymph nodes mesentery. Surgical intervention should be performed by oncologist surgeons with special training and high degree qualifications.

All patients undergoing surgery should be informed about the upcoming course of the operation and possible complications.

Radiation and chemotherapy treatment are most often used in conjunction with surgery, preceding it or complementing it. Or as monotherapy as palliative methods in patients with stage 4 cancer.

Sigmoid colon surgery for cancer

Surgical interventions involve removing part of the intestine affected by the tumor, as well as its visually healthy area. Such interventions are called radical.

Left-sided hemicolectomy and tumor resection are common operations for cancer localized in the sigmoid colon.

After removing part of the organ, doctors must perform an anastomosis - connecting the remaining intestinal loops so as to restore the integrity of the gastrointestinal tract.

Moreover, variations in anastomosis and the extent of surgical intervention also depend on which part of the sigmoid colon the cancer is localized in.

If the tumor is located in the proximal (initial) part of the sigmoid, doctors perform a left-sided hemicolectomy with an anastomosis between the transverse colon and rectum.

If the cancer focus is located in the middle section, it is necessary complete removal organ. If the pathological process has affected the distal (final) section of the sigmoid, then, if possible, surgeons preserve its initial section and connect it to the rectum.

Chemotherapy for cancer after surgery

After surgery, doctors often recommend drug cytostatic therapy to prevent relapse of the disease.

Today there are many effective and modern antitumor drugs, which in combination with surgical treatment give a good effect.

The following drugs are used:

Oxaliplatin.
Irinotecan.
Fluoropyrimidines.
Fluorouracil.
Calcium folinate.
Cetuximab.
Bevacizumab.

The selection of drugs and treatment regimens is carried out individually by specialists.

The optimal course of chemotherapy drugs and the treatment regimen used allows in many cases to achieve long-term and stable remission, which is an unconditional success in the fight against cancer.

Nutrition and diet for sigmoid colon cancer

Nutrition should be balanced and contain sufficient amounts of protein and vitamins. Food should be easily digestible, not injure the mucous wall of the organ, and not irritate the gastrointestinal tract either mechanically or chemically.

All hot, spicy, salty, peppery dishes are contraindicated, as are alcohol and carbonated drinks. You should limit your consumption of meat, especially pork and beef, refined foods, chocolate, strong coffee and tea.

It is necessary to saturate your diet with fiber, plant foods, fruits and vegetables, both fresh and boiled. Porridge, vegetable soups, stewed or baked vegetables, dairy products normalize intestinal motility and relieve constipation.

You should eat food in small portions, but often, 5-6 times a day. Too cold or too hot dishes are contraindicated; dishes should be eaten at room temperature.

Diet after cancer surgery:

In the early postoperative period, for the first 5-6 days after the intervention, the patient is prohibited from eating food by mouth, only drinking.
The patient should receive nutrition parenterally, through intravenous administration amino acid and vitamin mixtures, glucose. It is possible to drink liquid, warm, non-rich broth.
1-1.5 weeks after the operation, the diet gradually expands: vegetable and fruit purees can be eaten, slimy homogeneous porridges, low-fat yoghurts and kefir. This diet should be followed for at least a month, after which more coarse foods should be gradually introduced: fruits, vegetables, cereals, freshly squeezed juices, boiled fish, eggs, lean meat.
You should eat small meals, but often, every 2 hours. Food should be boiled or baked. All fried foods have a harmful effect on intestinal function.
Also, patients should forever forget about fatty foods, pork, beef, processed foods, refined foods, pickles and spices. Avoid coffee, soda, milk, strong tea and alcohol. Herbal teas, fruit drinks from berries, drinking water without gas should form the basis of the drinking regime.

Tumor markers

Testing blood for tumor markers of cancer allows in many cases to prevent the disease (the analysis is used as a screening diagnosis) and take measures for its early detection.

And also monitor the postoperative period, the stage of remission of an existing disease. The most well-known markers for tumors of the sigmoid colon: CEA (cancer embryonic antigen) and CA 19-9.

Often, as cancer pathology progresses, the level of markers in the blood increases. However, this does not always happen; in 40% of patients, the level of these proteins remains unchanged, despite the detection of a tumor.

That's why this study cannot reliably assess the patient's condition; it is used in conjunction with other diagnostic methods– endoscopy, ultrasound, CT, MRI, laboratory and clinical indicators.

How to prepare for an ultrasound

In the diagnosis of tumors, the most important role is played by both endoscopic examinations - colonoscopy, sigmoidoscopy, and ultrasound.

IN Lately Ultrasound of the large intestine, abdominal cavity and pelvis has become increasingly popular in order to assess the local prevalence of the tumor process and the presence of distant metastases.

Under ultrasound control, it is possible to perform puncture of suspicious areas followed by histological examination. In order for an intestinal ultrasound to be informative, special preparation is required before this study:

3 days before the procedure, you should exclude from your diet all foods that increase the formation of gases: legumes, mushrooms, milk, sweets, fresh juices, raw vegetables and fruits.
Espumisan or its analogues should be taken for 3 days to reduce gas formation.
On the eve of the study, the last meal should be taken no later than 18.00; you should not eat in the morning before the study.
In the evening, you should perform a bowel cleansing procedure with an enema or a special drug “Fortrans”.
A few hours before the test you should drink Activated carbon at the rate of 1 tablet per 10 kilograms of weight.
Immediately before the ultrasound, you should drink at least 500 ml of still water to fill the bladder.

It should be remembered that without appropriate preparation the procedure will not be informative. Therefore, the activities described above should be approached with all responsibility.

Although the intestine is a hollow organ, ultrasonography it is possible by filling it with a special liquid, which serves as a kind of contrast during the study. The fluid is injected through a small catheter through the anus.

Ultrasound is a painless, safe manipulation and quite informative. It can serve as both an auxiliary and a primary method for diagnosing sigmoid colon cancer.

Ultrasound of the intestine is especially indicated for elderly, weakened patients, children and all those for whom endoscopic diagnostic procedures are not indicated.

Often a person has serious difficulties associated with bowel movements. The sigmoid colon may be involved, symptoms of dysfunction of which indicate a serious problem in the digestive system. The sigmoid colon receives almost completely processed food. In this segment of the intestine, residues are absorbed into the walls of the sigmoid colon. nutrients, water and vitamins. At this stage, the formation of feces ends. After the sigmoid colon, feces enter the rectum, from where it is excreted. As a result of inflammation of the mucous membrane of the rectum and sigmoid colon, proctosigmoiditis occurs. This disease is extremely unpleasant and can have serious consequences and complications. Treatment of this disease is complex and lengthy. As a rule, middle-aged people suffer from this disease. The majority of patients are women. This is directly related to their physiology.

In the normal state, a person has an act of bowel movement once a day. When the rectum is full, receptors in its mucous membrane signal this to the brain. There is a waste of feces. The inflamed mucous membrane cannot cope with this task, giving false signals that cause a lot of trouble.

Proctosigmoiditis can occur for the following reasons:

Numerous signs may indicate the presence of the disease. If you pay attention to them and immediately get medical help, then the treatment will pass more quickly and painlessly.

Signs of the disease

Proctosigmoiditis is quite difficult to diagnose, since its symptoms affect almost all human organs.

With inflammation of the sigmoid and rectum, the symptoms of this disease are as follows:

deterioration of health;
general weakness;
increased body temperature;
nausea and vomiting;
the appearance of allergies;
nervousness;
depression;
pain in the lower abdomen, which intensifies during bowel movements;
dysfunction of bowel movements (constant diarrhea or constipation);
the appearance of false urges to defecate;
discharge of pus, mucus and blood clots from the anus;
unusual type of stool - it is too hard or liquid, has an excessively pungent and unpleasant odor.

Proctosigmoiditis, in the absence of proper medical care, can cause quite serious complications. Inflamed bowel disease can cause a variety of consequences.

What can happen if treatment is not started immediately:

internal hemorrhoids;
the occurrence of cracks in the sphincter;
complete prolapse of the rectum;
rectal ulcer;
the appearance of bleeding;
formation of malignant tumors.

To assign correct treatment, the patient is prescribed comprehensive examination to determine an accurate diagnosis.

Diagnostics is carried out using the following methods:

Personal examination by a specialist. During the conversation, the time of onset of the disease, its symptoms and possible reasons. The examination helps to obtain big picture diseases.
Blood and stool analysis. The results will allow you to learn about the processes occurring in the body.
Carrying out a tissue biopsy of the sigmoid part of the intestine.
Colonoscopy. Visual examination of the damaged organ using a probe gives a fairly accurate idea of the nature of the disease.

To obtain an accurate picture of the disease, sigmoidoscopy or magnetic resonance imaging can be used.

Based on the results obtained, the patient is diagnosed. Proctosigmoiditis can be classified as acute or chronic.

Inflammation of the sigmoid colon is divided into ulcerative, catarrhal or erosive. Complications of the disease can be early or late. After summarizing all the data obtained, the patient is prescribed treatment.

Treatment of inflammation of the sigmoid intestine

Depending on the severity of the disease, inpatient or outpatient treatment is prescribed.

It is aimed at relieving the causes of the disease. According to the method of influencing the source of inflammation, treatment can be conservative and surgical.

Conservative treatment

At this method an integrated approach is used. In this case, a positive result will be achieved within a few days.

Proctosigmoiditis is a rather insidious disease that can lead to numerous complications. An important contribution to the treatment of this disease is made by exposure to various medical devices. As a rule, electrotherapy is prescribed for 7-10 days. During its implementation, devices operating on various principles are used.

So, the lesion can be affected in this way:

Warming up. Heat ensures blood flow to the site of inflammation. This improves metabolism and strengthens intestinal tissue.
Vibration. Vibrators, which are inserted into the anus, relieve congestion and improve blood supply to damaged tissues.
Electric fields of various amplitudes. Under the influence of electrical or magnetic field damaged cells restore their natural structure. Mutation and cell degeneration are stopped.

Therapeutic diet for proctosigmoiditis

If a patient is diagnosed with proctosigmoiditis, then the first thing to do is go on a strict diet. You must adhere to it until complete recovery.

The patient's diet should include the following dishes:

porridges made from oats, semolina and rice cooked in water;
low-fat soups from poultry and fish, pureed through a sieve;
low-fat fermented milk products;
steamed ground meat;
boiled or baked vegetables and fruits;
omelette cooked in vegetable oil;
herbal teas and infusions.

You need to avoid the following products:

bakery products of any kind;
fatty meat, lard, sausages;
pasta;
fatty soups and borscht with chopped vegetables;
canned meat, fish and vegetables;
animal fat and butter;
fresh herbs, berries, vegetables and fruits;
milk and fat cottage cheese;
peas, beans and other legumes;
carbonated drinks;
coffee and strong tea;
hot seasonings, spices, sauces and spices;
sweets, cakes, chocolate;
alcoholic drinks of any kind.

For intestinal inflammation, special treatment tables are prescribed, which provide split meals within a strict menu. Compliance with the diet helps rid the intestines of inflammation, putrefactive processes and fermentation. By excluding fatty foods from the menu, the quality of its digestion improves and the speed of absorption and processing increases. Food should be taken warm (not hot), chewing thoroughly. If the disease worsens, it is recommended to stop eating for 1-2 days. At this time, you need to drink herbal decoctions or weak tea without sugar.

Surgery is performed only in emergency cases.

The reasons for surgery may be the following factors:

fusion of the intestine with neighboring organs;
pathological tissue damage that is incurable by conservative methods;
the appearance of neoplasms.

After remission occurs, the patient must undergo a long course of rehabilitation. It is not recommended to switch to your usual diet immediately after relief. A relapse may occur.

Prevention of intestinal diseases

Proctosigmoiditis is chronic disease. Its aggravation may occur at any moment.

In order to prevent relapse, the patient must adhere to the following rules of prevention:

Be examined by a specialist at least 2 times a year. Consultation with an oncologist after a prolonged exacerbation is mandatory.
Visit sanatoriums annually to undergo mud therapy and electrotherapy.
News healthy image life. This implies giving up bad habits and regular walks in the fresh air.
Organize balanced diet, which should combine sufficient calorie content and digestion-friendly qualities.
Avoid hypothermia of the body. This can contribute to the exacerbation of a chronic illness.
In case of infectious disease it is necessary to complete his treatment. Residual effects may cause relapse of intestinal inflammation.
Use regularly prophylactic drugs to prevent inflammatory processes. Their list should be determined by the attending physician.

Compliance with the rules of personal hygiene is of no small importance for the prevention of inflammation in the anus. The sphincter must be kept perfectly clean. The anus should be washed with soap after each bowel movement. Water procedures should be done in extreme heat or after heavy physical work.