Intestinal diverticulosis is a very common disease that people experience regardless of gender and age (even in newborns, a congenital form of the disease is sometimes diagnosed). The disease is accompanied by the formation of diverticula - protrusions of the intestinal walls. If untreated, pathology can lead to various complications, including intestinal perforation, the development of peritonitis, and the appearance of massive bleeding.
Of course, many people are looking for additional information about the disease. Why does intestinal diverticulosis develop? Symptoms and treatment, risk factors and possible complications are interesting information that is worth exploring.
General pathology information
As already mentioned, intestinal diverticulosis (ICD-10 assigned the disease code K57) is a pathology that is accompanied by the formation of protrusions of the intestinal wall. Despite the fact that the disease can affect any part of the digestive tube, in most cases diverticula are formed from the tissues of the large intestine (90% of all diverticula are localized precisely in the large intestine).
According to statistics, the likelihood of developing an ailment increases with age. In most cases, people over 40 years old face a similar problem.
Why does the disease develop?
In fact, the reasons for the development of such a pathology can be different. Alas, they are not always able to find out.
If we are talking about a congenital form of the disease, then it may be associated with congenital weakness of the connective tissue. At the same time, diverticula can appear not only in the intestine, but also in the bladder, stomach and other organs. As a rule, at first the protrusion wall consists of the same layers as the intestinal wall. Nevertheless, as the disease progresses, muscle fibers gradually atrophy.
As for the acquired forms of the disease, many factors can provoke their development. For example, malnutrition is potentially dangerous. If a person eats exclusively digestible foods, while refusing foods rich in fiber, then this ultimately leads to the formation of too hard feces that injure the intestinal wall. In addition, fiber deficiency is fraught with a violation of natural peristalsis. Together, these factors lead to the appearance of chronic constipation, and ultimately diverticulums.
There are other risk factors:
- overweight, obesity;
- lack of physical activity;
- sedentary lifestyle;
- violation of motility of the intestinal tract (both congenital, and one that is associated with the development of certain diseases);
- vitamin deficiency;
- constipation.
The formation of a diverticulum leads to a violation of blood circulation in the intestinal tissues, thinning of the walls, and gradual atrophy of the muscle layer.
Forms of diverticulosis
Diverticulosis of the intestine can occur in different ways. That is why there are many classification schemes. Diverticulums can be:
- congenital (formed during fetal development);
- acquired (formed after birth under the influence of certain factors).
Diverticulums can be either single or multiple. In addition, the pathological process can be localized in various parts of the large intestine, for example, the sigmoid, colon or blind (extremely rare) intestine. Diverticula of the walls of the small intestine are formed much less frequently (in no more than 10% of cases).
The disease can be asymptomatic, but often associated with inflammation or complications. Diverticulums can be tractional (formed, for example, by an adhesive process) or false (in the protrusion wall, there are no muscle fibers).
The main symptoms of pathology
It should immediately be noted that sometimes the symptoms of diverticulosis of the large intestine may be completely absent. If there is an uncomplicated form of the disease, then patients for many years may not even suspect the presence of an ailment.
Nevertheless, as the disease progresses, some violations begin to appear:
- Gradually, intestinal motility is impaired, and pressure in its cavity rises, which leads to the appearance of spastic pain. Discomfort is paroxysmal - discomfort then intensifies, then disappears. The pain is dull in nature and, as a rule, is localized in the lower abdomen, more often on the left side.
- Sometimes pain and discomfort appear or intensify immediately after eating.
- In some cases, the pain becomes sharp and resembles an attack of appendicitis. In addition, discomfort can spread to the lower back, sacrum, buttocks, anus, groin and perineum.
- There are also problems with the stool. Protracted constipation is often replaced by diarrhea. In feces, as a rule, there is a large amount of mucus.
- Patients suffer from constant bloating and flatulence. Palpation is accompanied by increased pain, but the tension of the abdominal wall is absent. Gases from the intestines have a very offensive smell.
- Some patients complain of false urges that do not end with bowel movements. Sometimes the patient has a feeling of incomplete bowel movement.
What complications can an ailment cause?
Symptoms of intestinal diverticulosis may be aggravated if certain complications occur. In the absence of timely and proper treatment, an ailment can lead to dangerous, sometimes even fatal consequences. Their list includes:
- inflammation of the tissues of the diverticulum, which is accompanied by an increase in temperature, tissue damage, edema and exacerbation of pain;
- intestinal bleeding (both small and massive);
- perforation of the intestine (perforation of the intestinal wall occurs, which is accompanied by the release of the contents of the digestive tract into the abdominal cavity);
- the formation and accumulation of purulent masses, the formation of an abscess and its further rupture;
- external or internal fistulas (report a certain section of the intestine with nearby organs);
- adhesion formation;
- acute or chronic form of intestinal obstruction (there is a violation or a complete stop of the movement of food and feces along the intestinal tract).
Diagnostic measures
Unfortunately, diverticulosis of the intestine is accompanied by very nonspecific symptoms, which can indicate a variety of diseases. That is why correct diagnosis is so important.
First, a general examination, consultation with a therapist and gastroenterologists is necessary. Doctors should collect as much information as possible for anamnesis, as well as familiarize themselves with the main complaints of the patient.
A blood test is required. An increase in white blood cell count indicates an inflammatory process, and a decrease in the number of red blood cells indicates internal bleeding.
A bacteriological examination of stool samples, a coprogram, as well as an analysis of feces for the presence of occult blood are carried out (again, it helps to detect bleeding in the intestine).
Radiography of the abdominal organs is also necessary.
If no perforations and other complications were revealed during a radiography, then irrigography with double contrast is performed. In the pictures, the doctor will be able to see the protrusion of the intestinal wall, which communicate with the cavity of the digestive tube.
An abdominal ultrasound is also performed. The diverticuli themselves cannot be seen during the procedure, but some other diseases can be ruled out and the absence of complications confirmed.
Informative are endoscopic examination methods, in particular, colonoscopy. Using special equipment, the doctor can carefully examine the intestinal mucous membranes, determine the presence of adhesions, protrusion and other deformities.
During endoscopy, sometimes a biopsy is also performed - samples of damaged tissues are taken with their further microscopic examination.
Additionally, computed and / or magnetic resonance imaging is performed.
Treatment of intestinal diverticulosis directly depends on the causes of its development and the presence of complications. It is this information that needs to be clarified during the diagnosis.
Medication for intestinal diverticulosis
The appearance of digestive disorders is a good reason to make an appointment with a doctor. Symptoms and treatment of intestinal diverticulosis are interconnected. The methods of therapy will directly depend on the appearance of certain disorders, as well as the intensity of the symptoms.
If intestinal diverticulosis was detected by chance (the disease is at an initial stage, there are no symptoms), then a special diet with a high content of plant fibers is prescribed to patients. In addition, a person needs to undergo regular examinations so that the doctor has the opportunity to monitor the progression of the disease.
Sometimes, enzyme preparations are included in the treatment regimen (provide an improvement in the digestive processes), as well as drugs that reduce the amount of gases formed in the intestines. Probiotics that provide colonization of the digestive system with beneficial bacteria will also be beneficial.
If diverticulosis of the large intestine is accompanied by an inflammatory process, then antibiotics are advisable. As a rule, doctors prescribe a wide range of antibacterial drugs (you can’t take them arbitrarily).
Antispasmodic drugs (Spazmalgon, Spazmol, Drotaverin, No-shpa) help relieve abdominal pain.
Digestive tract stimulants are used. Such drugs as Motilak, Motilium, Domperidon are considered effective.
To combat constipation, some prebiotics are used, in particular, Lactulose Poly, Normase, Portalac, Dufalac.
If improvement does not occur within three days after the start of drug treatment, the patient needs hospitalization. Patients are injected with saline and glucose, which helps maintain water-salt balance and natural metabolism. In such cases, the doctor conducts additional diagnostics and resolves the issue of surgical treatment.
Diet for intestinal diverticulosis
You already know what medicines are used for such a disease. Nevertheless, proper nutrition for intestinal diverticulosis is no less important than the use of drugs.
The rules of the diet are quite simple:
- Wheat bran is useful, as they can reduce pressure inside the intestines, as well as facilitate the formation and movement of feces. Brewed bran can be added to soups, cereals, vegetable dishes, mixed with fermented milk products. Since the abundance of plant fibers can aggravate abdominal pain, it is recommended to start with the minimum daily dose of bran, gradually increasing it.
- The diet should also include kefir, yogurt and other dairy products. Buckwheat and wheat cereals will be useful. Doctors also recommend including a diet of vegetable soups (can be cooked in meat broth), vegetable casseroles.
- It is worth abandoning rice and semolina, pasta, bread and pastries from premium flour. You also need to exclude from the diet cocoa and chocolate, brewed tea, coffee, jelly, red wine. These products slow intestinal motility and have astringent properties.
- It is important to maintain water balance - it is advisable to drink about 2 liters of clean water per day.
When is surgery necessary?
Symptoms and treatment of colon diverticulosis are closely related. And with the appearance of certain complications, surgical intervention is indispensable. The operation is performed if the following indications are available:
- the formation or opening of an existing abscess;
- the presence of fistulas;
- damage to the diverticulum, especially if the process is associated with the development of phlegmon or peritonitis;
- acute intestinal obstruction;
- the presence of severe intestinal bleeding;
- frequent relapses of the disease, lack of effect of drug therapy.
Surgical treatment of diverticulosis of the large intestine is to remove the affected area with further stitching. According to statistics, the procedure is well tolerated by patients and provides a lasting effect. The likelihood of relapse (subject to the appropriate diet and other precautions) is about 2%.
Alternative methods of treatment
Alternative medicine also offers medications that help cope with abdominal pain, constipation and other symptoms of intestinal diverticulosis. Of course, such tools can only be used with the permission of the treating specialist.
Herbal collection will help to cope with digestive disorders. First you need to mix in equal amounts the crushed rose hips, as well as dried chamomile flowers, dill, nettle and motherwort leaves. A tablespoon of the mixture should be filled with a glass of boiling water and insisted (2-3 hours will be enough). Strained infusion is taken half a cup twice a day, preferably with meals. The medicine is used daily for 6 weeks.
Green apples and sprouted wheat grains need to be crushed in a blender (we take equal quantities of components). It is recommended to eat 200-300 g per day. This helps to saturate the body with plant fibers, improve intestinal function. The course lasts a month, after which you need to take a break for 4 - 5 weeks.
- Preventive actions
- We have already studied the symptoms and treatment of intestinal diverticulosis in adults. According to the reviews of doctors and statistical studies, the disease in most cases is well treatable.
- Unfortunately, it is impossible to prevent the development of congenital forms of the disease. As for the acquired diverticulosis, it is possible to prevent its appearance by adhering to the correct diet (you need to include foods rich in plant fibers in the diet). In addition, it is important to maintain physical fitness, strengthen muscles, improve the immune system. Since obesity is considered a risk factor, it is important to control body weight. If alarm signs appear, you should immediately consult a specialist.