Sigmoiditis

The reasons

Kinds

Symptoms of sigmoiditis

Diagnostics

Sigmoiditis treatment

Prognosis and complications

Sigmoiditis is an isolated inflammation of the sigmoid colon (the penultimate part of the large intestine), which can be either an independent process or a manifestation of other diseases.   

The reasons

Most of the reasons for the development of sigmoiditis as an independent disease are embedded in the anatomical and physiological features of the sigmoid colon.

First, the main function of the sigmoid colon is the final formation of fecal masses, which can irritate the intestinal mucosa, contributing to the development of microdamages, and therefore creating the prerequisites for the occurrence of inflammation.

Secondly, unlike other parts of the large intestine, the sigmoid colon has a curved shape, which delays the passage through it of the intestinal contents. This feature of the structure increases the duration of irritation of the mucous membranes, which increases the likelihood of inflammation.   

In addition, the reasons also include:

  • intestinal infections like dysentery and amebiasis. The bacteria that cause these infections produce toxins that destroy intestinal cells, forming erosions or ulcers. Due to the characteristics of the sigmoid colon, with such lesions, it is most vulnerable to the inflammatory process.
  • intestinal dysbiosis. In addition, the microflora in the intestinal lumen performs a protective function. In dysbacteriosis, the natural microbial environment is disturbed, which creates conditions for the reproduction of aggressive bacteria, and, consequently, for the development of inflammation.   
  • non-specific ulcerative diseases of the intestines, for example, Crohn’s disease or ulcerative colitis. These diseases are caused by allergic factors, and can cause ulceration, similar to that of intestinal infections.
  • circulatory disorders of the intestine (intestinal ischemia). The most common cause of such damage is atherosclerosis . With atherosclerosis, plaques form in the lumen of the vessels, reducing the amount of blood that is passed, thereby interfering with the feeding of organs and tissues. In the intestine, under the influence of ischemia, necrosis (necrosis) areas appear, which become the primary foci of inflammation.
  • exposure to ionizing radiation – radiation sickness. Under the influence of radiation, some cell structures are destroyed, and free radicals appear – toxic compounds that can damage healthy cells of the body.

Kinds

Like most inflammatory diseases, sigmoiditis can be acute or chronic. In addition, there are the following types of it, which differ in the nature of damage to the intestine:

  • Catarrhal sigmoiditis. The mildest form in which only the upper layer of the intestinal epithelium is damaged.
  • Erosive sigmoiditis. It is a continuation of untreated catarrhal and is characterized by destruction of the intestinal epithelium with the formation of erosions on it – open unprotected sections of the mucous membrane.
  • Ulcerative sigmoiditis. This form appears, with prolonged irritation of erosions on the intestinal surface, as a result of which they turn into ulcers – deeper defects of the mucous membrane.
  • Perisigmoiditis. It is the most severe form of the disease. Through the ulcer surface, inflammation penetrates into the deep sections of the intestinal wall, reduces its mobility, and the adhesions begin in the abdominal cavity (the process of connecting the intestinal loops together).

Symptoms of sigmoiditis

Due to the variety of forms and causes of sigmoiditis, symptoms can vary greatly, but there are three main manifestations characteristic of any type of disease:

Pain in the left iliac region (lower left corner of the abdomen). The pain is intense in nature, can often give up the leg or lower back. It should be remembered that the sigmoid colon initially has a high mobility, resulting in a change in the localization of pain closer to the center line of the abdomen, or higher, towards the diaphragm.

Change the frequency and nature of the chair. Most often there is diarrhea, constipation occurs somewhat less frequently. For sigmoiditis is characterized by an increase in the frequency of desire to defecate, which is explained by irritation of the intestine. Fecal masses most often liquid, have a sharp, unpleasant smell, you can see blood, mucus or pus in them.

Deterioration of the patient’s general condition. Since during a long-term course of the disease, the human body is depleted, it is possible the loss of body weight, reduced efficiency and general well-being, various sleep disorders .

Diagnostics

Diagnostics and treatment of sigmoiditis can be done by a general practitioner, a gastroenterologist, an infectious diseases specialist, a surgeon.

The main task in making a diagnosis is to conduct a differential diagnosis with other inflammatory diseases of the intestines and abdominal organs, such as paraproctitis, ulcerative colitis, as well as infectious diseases, for example dysentery, cholera, intestinal dysbiosis.

For diagnosis, the results of the following studies are used:

  • Survey and examination of the patient, palpation of the abdominal organs. Conducting these studies, the doctor will be able to establish the exact localization of the lesion, and to conclude which part of the intestine is involved in the inflammatory process.
  • General analysis of blood and feces. These studies will help to accurately determine the severity and nature of the inflammatory process.
  • Rectoromanoscopy conducted for the direct study of the mucous membrane of the large intestine. Based on the results of the study, we can conclude about the form of the disease and the area of ​​the lesion, as well as to exclude cancer.
  • Radiography is carried out in order to differentiate sigmoiditis with impaired intestinal patency.
  • In women, data from a gynecological examination, in order to exclude gynecological pathologies, such as endometriosis, adnexitis, tubal pregnancy and some others capable of giving a similar clinical picture.

After collecting all the information, the doctor establishes the final diagnosis and prescribes treatment.

Sigmoiditis treatment

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Treatment is prescribed depending on the cause of the sigmoiditis.

1. For the treatment of sigmoiditis caused by intestinal infections, antibiotic therapy is prescribed (Biseptol, Tetracycline, Ampicillin, Cefran), covered with bacterial preparations, to protect against dysbiosis (Lactobacterin, Bifidobak and others).

Also, in the chronic course, intestinal antiseptics are prescribed, such as Intetrix or Smecta.

2. For the treatment of sigmoiditis caused by nonspecific inflammatory bowel diseases, anti-inflammatory drugs are used that eliminate the underlying disease: Salazoperidazin, Prednisolone, Sulfasalazin.

To combat general intoxication processes, infusion therapy is used with solutions of glucose, blood plasma and iron preparations (for the treatment of anemia ). Also, bacterial preparations are prescribed to normalize the intestinal microflora.

3. For the treatment of ischemic sigmoiditis, the same regimens are used as in the treatment of sigmoiditis caused by non-specific diseases. In some cases, in case of failure of such therapy, an operation on plastic surgery of vessels supplying the intestines may be indicated.

In addition, as with any diseases of the gastrointestinal tract, a special diet number 4 is appointed, which involves the elimination of spicy, fried, smoked food, alcohol, and the maximum reduction in the diet of fats, carbohydrates and salt, as well as showing the preliminary grinding of food before by use.  

The treatment of sigmoiditis is long, in most cases it is necessary to conduct 1-2 courses of therapy for recovery, the duration is from 1 to 3 months.  

Prognosis and complications

With the proper treatment of sigmoiditis, in most cases, it is possible to achieve complete recovery, but it should be understood that the treatment process is long and is accompanied by a lot of restrictions on the part of the diet.

In the absence of treatment, it is possible to spread inflammation to adjacent segments of the intestine, most often to the rectum (proctitis).

Also, with the progression of inflammation, the tightness of the intestine may be disturbed, resulting in peritonitis – inflammation of the abdominal cavity, requiring extensive surgical intervention.

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