What is a dolichosigma

Among the pathology of the large intestine dolichosigma( enlarged sigmoid colon) can be considered as an option of the dolichocolon, accompanied by an increase and expansion of one or all of the departments.

The main manifestation of the disease - severe constipation, with which a person has to fight all his life. Treatment of dolichosigma of the intestine in adults can not do without a strict diet, laxatives and stimulants, massage, exercise therapy. Still, the frequent outcome is a stool and obstruction, so it does not do without surgery.

The essence of the pathology of the intestine

The elongated sigmoid colon forms additional loops, twists, widens considerably. Normally, its task is to accumulate stool, absorb water and prepare to push into the rectal department and further defecation. Average size of sigma in an adult: length 54-55 cm( some authors consider the maximum norm of 46 cm), width up to 4 cm.

lies inside the peritoneal sheet and has its mesentery. Projected to the left iliac region of the abdomen. It differs from other departments with S-shaped direction and the presence of two bends. In some people, moderate lengthening is asymptomatic. It is not considered a pathology of the intestine, but is attributed to physiological abnormalities.

In dolichosigm in adults, the intestine forms one or more additional loops; this disruption of the structure hampers the progress of the stool mass.

. Reasons for

. Why the disease in some people is diagnosed already in early childhood, and in others many years later, remains unclear. Dolihosigma in adults begins to manifest itself by the age of 50, and in children it usually appears at 4 years. Perhaps this is due to the long individual compensatory adaptability of the intestine. Or in childhood there is a congenital disease, and in adults the acquired factors are more important.

Infringement of a structure of a gut in an embryonic period is influenced:

• any infectious diseases of the future mother( bacterial, viral), happened during pregnancy;
• application for the treatment of a woman with drugs with a negative effect on the fetus;
• disorders in the diet of a pregnant woman( lack of fruits and vegetables, meat, the ingestion of preservatives, pesticides, dyes into the blood);
• hereditary predisposition, the presence in the family of a father or mother of similar anomalies;
• stay pregnant in the area of ​​environmental problems;
• transferred stress conditions.

Elongation of the sigmoid colon in an adult person can cause various disturbances in the process of digestion of food, which leads to fermentation and decay of the residues. Are important:

• sedentary lifestyle;Overeating and obesity;
• transferred intestinal infections;
• prolonged excitement, neuroses inhibit peristalsis;
• chronic inflammatory diseases of the upper parts of the digestive tract( esophagitis, gastritis, peptic ulcer, gastroduodenitis, hepatitis, cholecystitis, pancreatitis, chronic colitis) cause a general digestion failure in excess or deficiency of secreted secretion, enzymes, bile acids, as a result, the balance of the intestinal florathe process of digesting food, joins stagnation and fermentation in the large intestine;
• the state of immunodeficiency caused by various diseases, contributes to infection and disruption of intestinal function.

What are the symptoms of dolichosigma?

Symptoms of dolichosigma are caused by congestion of slag substances in the intestine, their fermentation and transformation into toxic poisons, with a gradual poisoning of the body, swelling of the intestine in the sigma zone, development of partial or complete obstruction.

Patients report to the doctor with complaints about the following:

• Constipation - first defecation is delayed for 3-4 days, then this period reaches a month. The symptom is caused not only by the lengthening of the path of passage of fecal masses, but also by careless treatment with addiction to laxative drugs, enemas. The reflex mechanism of bowel cleansing disappears.
• Pain syndrome - caused by a stretched overflowing sigmoid colon, the attachment of inflammation. It is localized in the navel or in the left side of the abdomen. It differs by constancy, sometimes it passes into spasms( with the movement of feces).The stools hardened to the stone-like state damage the intestinal mucosa, "open the gates" for the introduction of pathological flora, inflammation of the intestine( colitis).

A person is worried about constant bloating of the abdomen

In the stool after defecation, an admixture of blood is found, which confirms the wounding of the vessels. Strengthening of symptoms provokes a meal, a walk, exercise. Improvement occurs only after excretion.

What are the complications of dolichosigma?

Stretching of the intestinal wall contributes to its thinning, a rupture is possible with excretion of feces into the abdominal cavity and peritonitis. Then the pain after sharp "dagger" outgrow into permanent, spread throughout the abdomen, the temperature rises, blood pressure drops to shock, intoxication increases.

Dysbacteriosis causes irritable bowel syndrome, beriberi. Anemia( anemia) develops in the absence of synthesis in the intestines of the necessary vitamins. There is a chronic colitis and an acute intestinal obstruction - it is caused by calic stones, kinks, twists of the elongated intestine.

Stages of the course of the disease, their manifestations

Gastroenterologists distinguish between the forms of the disease or the stage of the flow, as one form / stage can pass into another, more severe. For each symptom of a certain intensity.

Compressed or initial( latent) - usually patients do not know about the existing pathology of the intestine, no unusual manifestations are felt. The only complaint is a tendency to constipation( there is no stool for up to five days).Upon examination, the physician draws attention to the palpable hard bowel in the left ileal region. Switching to a diet and using light laxatives can normalize defecation.

Subcompensated - is expressed in longer constipation, abdominal pain, swelling, lack of laxative effect, mandatory use of cleansing enemas. In patients, there are signs of intoxication( weakness, headaches, irritability, insomnia, nausea).

Decompensated - the condition worsens, periodic vomiting is added to nausea and loss of appetite. Headaches become frequent, weakness is caused by the development of anemia. Append skin manifestations in the form of increased pallor, the spread of pustules. Siphon enemas are used to purify the intestine. On the features of the disease in childhood can be read in this article.

What are the ways to detect bowel disease?

Diagnosis begins with a doctor's examination. The doctor pays attention to the pallor of the skin, nervousness of the patient, bloating. Palpatorically reveals painful compaction in the zone of the sigmoid colon. It can be a fecal obstruction or a tumor.

Rectal examination reveals an empty ampoule of the rectum. Hence, above there are reasons that impede the passage of feces. X-ray examination is carried out by preliminary ingestion of a barium suspension or by direct administration of a contrast medium into the gut with an enema( irrigoscopy).

Upon admission with a drink, the doctor on the first day has an opportunity to examine the esophagus, duodenum and stomach condition. On the second day, the contrast should fill the loops of the large intestine. When fluoroscopy revealed: bowel bowel( colonoptosis), delayed contrast in the zone of descending and sigmoid divisions of the intestine, additional loops and lengthening of the sigma.

The doctor conducts differential diagnosis with another congenital anomaly - megacolon. The disease is accompanied by an increase in the entire large intestine with thickening of individual areas, which causes a narrowing of the passage.

Irrigation of the intestine is performed immediately after the enema

Computed tomography allows you to find out not only the size, patency of the sigmoid colon, but also the state of the mucosa, distinguish dolichosigma from tumors, polyps, often affecting this area. Ultrasound of the intestine reveals dense stool stones, the method is not of great importance, since the picture is smeared due to a significant amount of gases.

For the diagnosis of important blood tests - leukocytosis and ESR indicate inflammation, reduction of red blood cells and hemoglobin - anemia, in the analysis of stool it is important to identify latent bleeding( Gregersen reaction), signs of parasites in the intestines, dysbiosis. Methods for electromyography and sphincterometry are used to determine motor activity and the possibility of intestinal motility.

How to be treated without surgery?

At the stage of compensation and subcompensation therapy costs a strict diet, massage, exercise therapy, the use of popular recommendations.

Diet

Nutrition of the patient with intestinal dolichosigma requires:

• mandatory transition to frequent( fractional) food intake in small portions( 5-6 times a day);
• decreases in the diet of light carbohydrates( sweets, baked goods, wheat bread, pasta);
• increase in the proportion of fiber;
• limited consumption of meat;
• rejection of heavy for digestion in the intestines of cereals from millet, rice;
• daily maintenance of liquid not less than 1,5-2 l, drinking mineral waters containing sulfur, in a warm form;
• cook dishes only boiled or steamed, fried, smoked and spicy food irritates the intestines, inhibits the intestinal peristalsis, is poorly digested.

It is recommended to include in the intestinal diet:

• wholemeal bread, with bran, rye;
• products from sour milk( yogurt, yoghurt, yogurt, cottage cheese);
• of sweets - honey, marmalade( contains pectins useful for the intestines);
• fiber-rich vegetables, fruits, berries, herbs;
• products with a laxative effect( boiled beets, dried apricots, prunes, vegetable oils);
• bran - have not only laxative properties, but also remove toxic substances, waste slag from the body( act as sorbents), they should be added to kefir, porridge.

Olive oil, sunflower oil, linseed oil, and milk thistle oil can be used from vegetable oils. They season salads, recommend drinking a glass of kefir with a tablespoon of oil for the night or taking it on an empty stomach

Using massage

Daily massage of the stomach helps to relax the spasms of the intestine, raise the tone in the absence of peristaltic waves, increase the flow of blood to the stretched muscles. Thus, stagnant phenomena are eliminated, feces are advancing.

The main thing is to move all movements clockwise. Bowel massage begins with a slight stroking, rubbing to warm up the surface layers of the skin. The belly should blush. Further, the movements become deeper, squeezing, pressing.

Mashing is the main method of deep impact, but it should be used only after preliminary preparation. The fingertips are grasped and kneaded by the muscular layer of the abdominal wall. Movements push the muscles towards the rectum, continue for 15 minutes.

The end of the procedure is reversed( rubbing, stroking).At the very end, you can do an easy tapping, patting. Learn to perform independently better after taking a course from an experienced specialist.

Physiotherapy exercises

For chronic constipation caused by dolichosigma, exercises are carried out with intensive exercise, the number of repetitions is recommended to increase weekly by 10. Jumps in place, alternating with two legs and each. It is useful to use a skipping rope. The rhythm should reach 150 per minute. Squats with pulling the pelvis back and straight back. In the lower position, you must hold the pose for 10 seconds, then go to the minute.

To complicate the exercise, it is recommended to put the feet at a considerable width and dilute the socks as much as possible

Exercises for the intestine are performed lying down. The upper muscles of the press can be made to work, making the ascent without hands. Lower - the most loaded with lifting legs and performing "scissors", "bicycles" at an angle to the floor of 45 degrees.

Folk recommendations

It is better to treat intestines with folk remedies after consulting a doctor and in combination with other methods. Castor oil - recommended to take at night with kefir or warm beer( a tablespoon per cup of drink), in the afternoon you can add it to coffee. You can not use it for pregnant women.

Instead of castor oil for the night, you can drink any vegetable with kefir. Useful properties for the intestine are in cucumber brine without seasonings, it can be drunk in the afternoon. The following parts of plants possess a laxative effect:

• buckthorn bark;
• leaves of Senna;
• seeds of dill.

They should be brewed in a thermos bottle and left overnight. Take the next day for half a cup. You can mix.

Medication treatment

If the above remedies do not help, the pains cause pain, then doctors prescribe medications that stimulate bowel evacuation. Dufalac - an adult can be taken 3-4 times a day.

Mukofalk - a bag of powder is poured into a glass of water and mixed well, no more than four standard sachets can be consumed per day. Duspatalin - in tablets or capsules take 20 minutes before eating, the drug should be washed down with a significant amount of water. Trimedate - is more often prescribed to stimulate intestinal receptors in the postoperative period, it can be administered rectally.

Forlax - mild laxative

Drugs that normalize the intestinal flora( probiotics), are prescribed to fight and prevent the processes of fermentation, putrefaction, candidiasis with dolichosigma. You can choose from the most popular products( Lactobacter, Simbiter, Bifidum), useful yogurts with indication of inclusion of the ferment of bacteria for the intestine.

In connection with the development of vitamin deficiency, combined preparations of vitamins are added to the treatment, C, A, B, PP, D are especially useful. With pronounced intestinal atony, a solution of Prozerin is introduced. The drug should be used carefully for older people.

Cleanses

For the purification and stimulation of defecation, enemas are prescribed. They make them boiled water, saline solutions, vegetable decoctions. It is important not to admit intestinal addiction to this way of outputting the contents. The loss of the reflex leads to complete atony, the disappearance of the urge to defecate, the failure of the sphincters. Another complication is the development of irritable bowel syndrome.

When is surgery indicated?

In the absence of results from conservative treatment of the intestine, in the stage of decompensation, with the onset of atony and obstruction, the only method of treatment is surgery. In the course of surgical intervention, they produce:

• resection( excision) of a part of the long sigmoid colon;
• removal of necrotic walls in torsion and compression;
• rarely have to remove the entire sigmoid colon.

The ends of the intestinal loops are stitched by one of the most suitable methods of

Usually uncomplicated operation lasts 1.5 hours, general anesthesia is mandatory. In the postoperative period on the third day it is allowed to get up and walk a little. Antibacterial therapy, detoxification is mandatory, bleeding is prevented. After 10 days, the patient is discharged.

Patient must follow the diet until the full recovery of peristalsis and further restrict the foods not recommended for the intestine. Such a disease as dolichosigma does not present a difficulty in diagnosis. But further treatment is more difficult the more neglected intestinal pathology. Therefore, doctors do not recommend to suffer constipation. You need to establish the cause and get the best recommendations.

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