Ulcerative sigmoid - causes, symptoms, diagnosis and treatment
Ulcerative sigmoid - Inflammation of the sigmoid colon, accompanied by the formation of deep mucosal defects. Manifested by pain, stool disorders, flatulence, intestinal discomfort and pathological admixtures in stool. Maybe polyetiological disease or development of ulcerative colitis. These two forms of ulcer sigmoidita different with the current, forecast and possible complications. The disease is diagnosed based on symptoms, examination data, barium enema, endoscopy and other studies. Treatment - diet, causal and symptomatic drug therapy, in some cases - surgery.
sigmoid - type of segmental colitis in which defects are formed deep in the mucosa of the sigmoid colon. In view of the etiopathogenic factors and the characteristics of the course is divided into two forms: acute (can occur when intestinal infections, constipation, ischemic sigmoid colon, etc) And chronic (present in many patients with ulcerative colitis). The first type of ulcerative sigmoidita may be complicated by intestinal perforation, subsequently, the formation of scar deformities intestine. The second type occurs with periods of exacerbations and remissions, the ulcer surface, perforations and gross strictures are observed. Ulcerative sigmoid often combined with ulcerative proctitis. Treatment of this disease is carried out by experts in the field of proctology.
sigmoidita acute and usually occurs at a combination of several factors contributing to each other mutually. Among the factors that can trigger the development of ulcerative sigmoidita, include acute intestinal infection, helminth infections, disorders of the local blood circulation, mechanical trauma to the walls of the intestine too hard fecal constipation, irritation of the wall of the intestine compounds formed during excessive use of certain kinds of food and alcoholic beverages, and too high doses of ionizing radiation.
The likelihood of developing ulcerative sigmoidita increased in the presence of dysbiosis, as a violation of normal intestinal microflora creating favorable conditions for the breeding of aggressive pathogens. Ulceration is preceded by the appearance of erosions. In the absence of adequate therapy and /or continuation of the impact of adverse factors are deepening erosion, erosive ulcerous sigmoid enters.
acute appendicitis, which can become the reason of diagnostic difficulties when moving mobile sigmoid colon to the right or left-hand atypical location of the appendix (observed in transposition of the intestine). Often, patients with ulcerative sigmoiditom mark irradiation of pain in the lower back, perineum and the left lower limb. Pain may be exacerbated when trying to lift the left leg.
Violations of the chair is usually manifested in the form of diarrhea. Constipation in ulcerative sigmoid are relatively rare. Feces becomes liquid, smelly, it takes the form of meat slops due to blood impurities. Normal bowel movements interspersed with frequent tenesmus, during which small amounts can deviate mucus, blood or pus. Ulcerative sigmoid observed more abundant bleeding, than other (non-ulcerative) forms of the disease. The destruction of the deeper layers of the intestinal wall during recess ulcers can cause perforation of the colon with the development of fecal peritonitis.
patient stool tests with suspected ulcerative sigmoid confirm the presence of blood, pus, mucus and desquamated epithelium. During the special tests may be identified helminths and causative agents of intestinal infections. In the initial stages of the examination of the anus indicates the absence of pathological changes. With the combination of ulcerative proctitis sigmoidita and initially there is an increase sphincter tone, and then - hiatus sphincter, fecal traces, blood, mucus and pus and lots of maceration on the skin of the perianal area.
According to the barium enema in patients with ulcerative sigmoiditom detected changes of the mucous relief. With the threat of toxic dilatation and suspected perforation of the gut, this technique is contraindicated: in such cases irrigoscopy replaced by plain radiography. The most informative diagnostic methods for ulcerative sigmoid are sigmoidoscopy and colonoscopy, allowing visually assess the prevalence of the inflammatory process, the number, size and depth of ulcers. The study proctologist performs a biopsy.
smoking, diet and characteristics of oral contraceptives. A significant role in the pathogenesis of the disease have autoserotherapy and immune disorders.
The leading role in the clinical symptoms of ulcerative sigmoidita play at UC diarrhea and intestinal bleeding. The number of bowel movements can be increased to 20 or more times a day, daily blood loss may reach 100-300 ml or more. The pain in this form of the disease cramping, less intense than in ulcerative sigmoid not associated with UC. There have been a weakness, sleep disturbances, appetite disturbances, irritability and emotional instability. In long-term course of possible exhaustion.
In some patients with ulcerative sigmoiditom detected extra-intestinal manifestations, caused by an autoimmune skin lesions (erythema nodosum, pyoderma), joints (arthralgia), eye (uveitis, episcleritis), liver and biliary tract (fatty degeneration, sclerosing cholangitis). Rarely observed kidney disease, thyroid and hematopoietic system. Usually it celebrated chronic ulcerative sigmoidita with exacerbations of varying severity and remissions lasting up to several months. Despite the presence of a large number of large defects, rough stricture and perforation of the intestine for this type of ulcer sigmoidita uncommon as superficial ulcers and usually does not affect the muscular layer.
diagnostic scheme corresponds to a diagnostic finding in ulcerative sigmoid not associated with ulcerative colitis. Treatment - diet, anti-inflammatory therapy with salazopiridazina, Salofalk, sulfasalazine and its analogues, infusion solutions of electrolytes, glucose, and amino acids. With the ineffectiveness of non-hormonal anti-inflammatory therapy, and severe forms of ulcerative sigmoidita prescribed glucocorticoids (prednisone, dexamethasone). In anemia arising from repetitive bleeding, use of iron preparations, in severe cases transfused packed red blood cells. After normalization of the patient's use of probiotics.