Catarrhal sigmoidit – rather easy form of an inflammation of a sigmovidny gut which is proceeding with involvement of blankets of an intestinal wall and not leading to violation of integrity of an epithelium. Symptoms of a catarrhal sigmoidit are pain in the left podvzdoshny area, frustration of a chair and violation of the general condition of the patient. For diagnosis of a disease the general blood test and a calla, endoscopy of a sigmovidny gut with performance of a biopsy, an irrigoskopiya and a survey X-ray analysis of abdominal organs are used. Treatment of a catarrhal sigmoidit provides prescription of antibiotics, eubiotik and performing anti-inflammatory therapy.
Catarrhal sigmoidit represents the isolated superficial inflammation of a sigmovidny gut. Pathological changes affect only an epitelialny layer of a wall of intestines, without involvement of other layers. Sigmoidit can be an independent disease or develop against the background of other diseases of a large intestine. Quite often sigmoidit it is combined with proktity and proceeds in the form of a proktosigmoidit. The first peak of incidence sigmoidity is the share of age of 15-30 years, the second – for 50-55 years. This pathology is registered at any age, both at women, and at men. Treatment of patients with a catarrhal sigmoidit is carried out in office of a proktologiya.
Reasons of a catarrhal sigmoidit
Catarrhal sigmoidit can develop against the background of various pathological states. In some cases the disease arises as a result of intestinal infections (dysentery, an amebiaz, etc.). Besides, chronic catarrhal sigmoidit can be formed at intestinal dysbacteriosis. Sometimes as a cause of illness serves violation of blood circulation in vessels of an abdominal cavity therefore there is ischemic sigmoidit. In a number of situations catarrhal sigmoidit the Krone and nonspecific ulcer colitis is diagnosed against the background of serious nonspecific illnesses of intestines, such as disease. At people who underwent radiation exposure emergence of this disease can be noted too.
Besides factors of the external environment and infectious agents, in development of a disease an essential role is played by hereditary predisposition. Scientists proved that in 17% of cases development of a disease is connected with genetic determinancy. In most cases it is difficult to expert to decide on the reason which caused catarrhal sigmoidit. At the same time, efficiency of therapy depends on the correct establishment of the reason.
Symptoms of a catarrhal sigmoidit
Symptoms of a catarrhal sigmoidit depend on various factors, such as option of a course of a disease (sharp or chronic), a type of violation of motility (hyperkinetic, hypokinetic), existence of complications. Besides, the clinical symptomatology is influenced by the main disease against the background of which developed sigmoidit. At the same time, there are certain symptoms typical for the majority of forms of a catarrhal sigmoidit. This disease, as a rule, is followed by a pain syndrome, frustration of a chair and violation of the general condition of the patient. At a sigmoidita pain is generally localized in the left lower quadrant of a stomach. The pain syndrome rather intensive, irradiates pain in the left leg, can be so sharp that reminds appendicitis of left-side localization. As the sigmovidny gut is very mobile, in rare instances it can be displaced to the right and cause a pain syndrome in the right half of a stomach. Pain at a catarrhal sigmoidit amplifies after depletion of intestines and at the active movements.
The following important symptom of a disease is frustration of a chair which can be shown by ponosa or locks. At the same time patients are disturbed by frequent unpleasant desires on defecation which carry the name of a tenezma. In some cases at tenezma a small amount of slime, pus and even blood can be allocated. A chair at a catarrhal sigmoidit generally liquid, having unpleasant smell. Often excrements have an appearance of meat slops. If the disease proceeds is long, and the patient does not receive adequate treatment, catarrhal sigmoidit can lead to organism exhaustion in general. Emergence of the general symptoms, such as weakness, dizziness and loss of weight, is a sign of a heavy current of a sigmoidit.
Catarrhal sigmoidit can proceed in the form of an acute and chronic inflammation. In the first case the disease develops quickly, demonstrates emergence of an intensive pain syndrome. In that case sigmoidit demands differential diagnostics with other sharp abdominal pathology, such as appendicitis, renal colic and gynecologic diseases. Except frustration of a chair in the form of a diarrhea, sharp catarrhal sigmoidit is shown by temperature increase of a body, vomiting, nausea and the expressed violation of the general state. The chronic form of a disease proceeds with the periods of an aggravation and remission. The periods of an aggravation are followed by clinical symptomatology, typical for a sigmoidit. They arise at errors in a diet, overcooling and a nerve strain.
At a heavy current catarrhal sigmoidit can be followed by complications, such as erosion, ulcers and bleedings. The heaviest complication is considered perisigmoidit which is characterized by involvement in pathological process of nearby bodies and fabrics with the subsequent development of an adhesive disease.
Diagnostics of a catarrhal sigmoidit
Diagnostics of a catarrhal sigmoidit is a prerogative of such experts as the gastroenterologist, the proctologist and the surgeon. At the same time it is important to carry out differential diagnostics with other inflammatory processes in intestines: nonspecific ulcer colitis, syndrome of irritation of intestines, paraproktity, dysentery, dysbacteriosis. For diagnostics of a catarrhal sigmoidit the analysis of complaints and the anamnesis, survey of a stomach with a palpation of a forward belly wall is used. These simple clinical trials allow to specify localization of process and to suspect sigmoidit. From laboratory methods the general blood test, a koprogramma and the analysis a calla on the hidden blood is carried out. At the expressed inflammatory process in intestines in the general blood test acceleration of SOE and increase in quantity of stab forms of leukocytes is found . The analysis a calla on the hidden blood at a catarrhal sigmoidit usually negative.
From tool methods of a research endoscopy of a large intestine is used. The most available and informative diagnostic methods are the rektosigmoskopiya and a kolonoskopiya. At a catarrhal sigmoidit the endoscopist finds hyperaemia of a mucous membrane of a sigmovidny gut without existence of ulcers and erosion. For an exception of a colon cancer at endoscopy the biopsy is surely carried out. To differentiate catarrhal sigmoidit with intestinal impassability, the patient carry out a survey X-ray analysis of an abdominal cavity and an irrigoskopiya. For differential diagnosis of inflammatory gynecologic diseases performing ultrasonography of bodies of a small pelvis is recommended.
Treatment of a catarrhal sigmoidit
The principles of treatment of a catarrhal sigmoidit depend on what reason is the leader in development of a disease. Antibacterial therapy is applied to treatment of the sigmoidit caused by intestinal infections. The most effective antibiotics for treatment of an inflammation of a sigmovidny gut are ciprofloxacin, ampicillin and . Besides, antibiotic treatment is supplemented with intestinal antiseptics. Antibacterial therapy at treatment of a sigmoidit always has to be followed by purpose of eubiotik and probiotics which will help to restore normal intestinal microflora. If catarrhal sigmoidit developed against the background of a serious nonspecific illness of a large intestine, for its treatment anti-inflammatory medicines are appointed: , Prednisolonum, methylprednisolonum. At a heavy course of disease dezintoksikatsionny infusional therapy which provides intravenous administration of salt solutions and plasma substitutes is applied.
Treatment of an ischemic catarrhal sigmoidit is based on the same principles. At inefficiency of standard therapy by the patient angioplasty of branches of the lower bryzheechny artery, krovosnabzhayushchy intestines is shown. Irrespective of the reason which caused a disease, the dietary table No. 4 which provides an exception of fried and smoked food, and also decrease in amount of fats and salt in a diet is recommended to all patients. For full treatment of a catarrhal sigmoidit in most cases patients need to complete several courses of therapy lasting not less than a month.
At adequate therapy forecast of a catarrhal sigmoidit generally favorable. If the patient does not receive full treatment, the disease can pass to a rectum and other departments of a large intestine. For prevention it is necessary to treat in due time intestinal infections and to eliminate displays of dysbacteriosis which can appear against the background of antibiotic treatment.