Sigmoidit – sharp or chronic inflammatory process in the field of a sigmovidny gut. It is shown by pains in the left half of a stomach, swelling, rumbling, increase of a chair, pathological impurity in fecal masses, nausea, vomiting and symptoms of intoxication. At a sharp form of a disease all listed signs are expressed more brightly. At a chronic sigmoidit symptomatology smoothed, some manifestations can be absent. The disease is diagnosed taking into account complaints, data of survey, a rectal research, endoscopy and other techniques. Treatment of a sigmoidit – a diet, symptomatic and etiotropny means of the general and local action.
Sigmoidit – group of inflammatory processes of various etiology with defeat of a sigmovidny gut. Proceeds sharply or chronically, can be isolated or be combined with inflammatory defeat of other sites of a large intestine. Most often the simultaneous inflammation sigmovidny meets and a rectum – rektosigmoidit. Sometimes the symptomatology of a sigmoidit prevails at colitis – a diffusion inflammation of a thick gut. In a sigmovidny gut inflammatory processes develop more often than in other departments of intestines. Sigmoidit strikes persons of both floors, among patients prevalence of women is noted. Adults suffer more often than children. The probability of emergence increases with age. Treatment is carried out by experts in the sphere of gastroenterology and a proktologiya.
Reasons of a sigmoidit
Researchers note what sigmoidit is the most widespread inflammatory disease of intestines and specify that it is explained by a number of anatomic and physiological features of a sigmovidny gut. It settles down between descending obodochny and a rectum and treats the lower departments of a large intestine. Usually the gut is localized at the level of a podvzdoshny crest at the left, but because of the considerable mobility caused by rather long bryzheyka, this department of intestines at some patients can be displaced to the right or under a diaphragm that involves emergence of symptomatology, atypical for a sigmoidit (pains not in the left half, and in okolopupochny area, in the right or top departments of a stomach).
The Sigmovidny gut has the S-shaped form. Its length fluctuates from 15 to 65 cm, diameter – from 4 to 6 cm. The main function of this department of intestines is active absorption of water and formation of fecal masses. Because of the expressed physiological bends and existence rather firm a calla the wall of a sigmovidny gut is more often injured by kalovy masses that creates favorable conditions for development of a sigmoidit. Natural delay of advance of intestinal contents increases even more risk of emergence of a sigmoidit as the harmful substances which are contained in fecal masses long contact to a mucous membrane of intestines.
In a sigmovidny gut the diverticulums promoting stagnation of intestinal contents and which are quite often becoming complicated divertikulity are rather often formed. In development of a sigmoidit pressure of the next bodies, in particular – a pregnant uterus, and also rather widespread local violations of blood circulation connected with features of blood supply of this anatomic zone can play a part.
Intestinal infections, dysbacteriosis, disease Krone, nonspecific ulcer colitis and atherosclerotic changes of the feeding vessels can become immediate causes of development of a sigmoidit. Besides, sigmoidit quite often arises against the background of radiation therapy. At dysbacteriosis intestinal microflora change is observed, it creates favorable conditions for reproduction of various pathogenic and conditionally pathogenic microorganisms and promotes development of an inflammation. At intestinal infections sigmoidit results from defeat of cages mucous the toxins emitted by causative agents of a disease (dysentery, salmonellosis).
Disease the Krone and ulcer colitis are followed by developing of ulcers and erosion on mucous. In the zone damaged mucous easily there are inflammation centers extending to other sites of a sigmovidny gut and becoming the cause of a sigmoidit. At the chronic ischemia of intestines caused by atherosclerosis food of an intestinal wall is broken, there are sites of a necrosis becoming primary centers of an inflammation at a sigmoidita. When performing radiation therapy ionizing radiation destroys a part of cages that also promotes development of an inflammation. Along with the listed reasons, anatomic and physiological factors, in development of a sigmoidit the general infectious diseases and solderings which arose after abdominal organs operations can play a part.
Classification of a sigmoidit
As a current distinguish sharp and chronic sigmoidit. Taking into account character of an inflammation allocate the following types of defeat of a sigmovidny gut:
- Catarrhal sigmoidit. The inflammation mentions only blankets of a mucous membrane. Mucous edematous, hyperemic. Allocation of a large amount of slime is noted, for this reason such sigmoidit sometimes call mucous.
- Erosive sigmoidit. On a mucous membrane there are sites of destruction which are not extending to deep layers of an intestinal wall.
- It is purulent - hemorrhagic (ulcer) sigmoidit. On mucous the ulcers getting into deep layers of an intestinal wall are formed.
- Perisigmoidit. The inflammation extends to a serous cover of intestines. Around a gut infiltrate is formed. The bryzheyka is involved in process. In an abdominal cavity solderings between intestines loops, and also intestines and other bodies and fabrics are formed.
Manifestations of the listed forms of a sigmoidit can be combined among themselves that provides rather various clinical picture and sometimes becomes the reason of difficulties at recognition of a disease and performing differential diagnostics with other pathological states.
Symptoms of a sigmoidit
At a sharp current catarrhal is usually observed sigmoidit. Patients complain of severe skhvatkoobrazny pains in the left half of a stomach, is frequent – with irradiation in the left leg and a waist. Patients sigmoidity have a nausea, vomiting, rumbling, an abdominal distension and frustration of a chair in combination with frequent false desires. The chair becomes fetid, in it there are impurity of slime and streaks of blood. At a combination of a proktit and a sigmoidit perhaps otkhozhdeny slime and blood without impurity a calla.
Symptoms of intoxication come to light: weakness, weakness, hyperthermia, headache. At a palpation of a stomach of the patient with sigmoidity morbidity in a projection of a sigmovidny gut is defined. At a rectal research the thickening of the struck department of intestines is found. On the clinical manifestations sharp sigmoidit reminds appendicitis or peritiflit, but pains are localized not in right, and in the left podvzdoshny area. At an atypical arrangement of a sigmovidny gut localization of pains can change that sometimes becomes the reason of diagnostic difficulties.
Severe forms of an ulcer sigmoidit are inclined to a subsharp or chronic current. Violation of the general state, weakness, intoxication, intestinal discomfort, frustration of a chair and false desires are noted. Persistent diarrhea is characteristic. A chair of patients sigmoidity liquid, badly smelling, on color reminding meat slops. At severe forms of a disease distribution of inflammatory process with development of a perisigmoidit is often observed.
The clinical picture of a perisigmoidit does not differ from manifestations of a usual sigmoidit. As a result of inflammatory defeat of a peritoneum in an abdominal cavity solderings are gradually formed. The adhesive disease at a sigmoidita usually proceeds favorably. The nagging pains amplifying after physical activities, an abdominal distension, feeling of a raspiraniye in a stomach and tendency to locks are noted. In some cases at the sigmoidit complicated by an adhesive disease the phenomena of intestinal impassability can be observed: the accruing pains, vomiting, lack of a chair, a hyperthermia and .
The aggravation of a chronic sigmoidit usually arises against the background of violations of a diet, the use of alcoholic beverages, sharp infections (flu, a SARS), the general physical or mental overfatigue. Expressiveness of symptomatology can significantly vary – from small morbidity and insignificant increase of a chair before the developed manifestations reminding sharp sigmoidit. Diarrhea is quite often combined with locks. Patients show complaints to feeling of a raspiraniye in a stomach and the pains giving to a leg, a crotch and a waist. At a long current of a sigmoidit the sleep disorders, fatigue and the increased irritability caused by constant discomfort in a stomach are possible.
Diagnostics of a sigmoidit
The disease is diagnosed by the proctologist on the basis of clinical symptomatology, data of fizikalny survey, a rectal research, endoscopy and laboratory analyses. At a palpation of a stomach of the patient sigmoidity reveal morbidity in the left podvzdoshny area. At a rectal research find the filled edematous lower part of a sigmovidny gut. At a combination of a proktit and a sigmoidit puffiness is noted not only in sigmovidny, but also in a rectum. After extraction of a finger from a rectum on a glove traces of blood and slime are visible.
The most informative method of diagnostics of a sigmoidit is the rektoromanoskopiya allowing to estimate expressiveness and prevalence of changes of a mucous membrane of a gut. The general blood test demonstrates existence of a leykotsitoz. Koprogramma of patients sigmoidity and the analysis a calla on give the chance to confirm an inflammation in a large intestine and to define the activator at infectious defeats of a gut. In hard cases (at atypical localization of pains) for a differentiation of a sigmoidit with an acute appendicitis and peritiflity carry out a laparoscopy.
Treatment of a sigmoidit
Treatment is conservative, depending on expressiveness of clinical manifestations it is performed on an outpatient basis or in the conditions of a hospital. To the patients suffering sigmoidity recommend to refuse reception of fried, fat, spicy, spicy, rough, too cold and too hot food. Advise to use the boiled or steamed warm fast dishes wiped. At the sigmoidit which is followed by the expressed diarrhea the diet No. 4 promoting elimination of processes of an inflammation, rotting and fermentation in intestines is shown. Because of insufficient caloric content this diet is usually appointed term no more than to 7 days. In hard cases sigmoidity within 1-2 days recommend to patients hunger and plentiful drink.
Carry out etiotropny and symptomatic therapy. At a beam sigmoidit stop radiation therapy or correct a radiation dose. For destruction of pathogenic microorganisms appoint antibacterial means. For restoration of normal intestinal microflora at a sigmoidita use a probiotics. Apply spazmolitik to elimination of spasms. At the heavy sigmoidita which are followed by the expressed diarrhea apply infusional therapy to compensation of losses of liquid and fight against intoxication. Appoint special medicines for restoration mucous intestines.
At a timely initiation of treatment and observance of recommendations of the doctor forecast usually rather favorable. The phenomena of a sharp sigmoidit manage to be stopped within several weeks, many patients with an outcome have an absolute recovery. At a chronic sigmoidit perhaps long bezretsidivny current. In the presence of the chronic diseases provoking and supporting an inflammation in a sigmovidny gut (at ulcer colitis, a disease Krone), the forecast is defined by the course of the main pathology.