Intestinal dolichosigma is an anomaly that manifests itself in an increase in the length of the sigmoid colon and its mesentery, the organ by which the hollow organs of the abdominal cavity are attached to the posterior wall of the abdomen.
This phenomenon occurs quite often. But for what reasons is the anomaly formed? What symptoms indicate its presence? How is the diagnosis carried out? What is needed for treatment? Now these and many other questions should be answered.
Classification
The first step is to familiarize yourself with the information specified in the ICD-10. According to the international classification of diseases, intestinal dolichosigma belongs to the list of diseases under the code Q43. This class is "Other congenital malformations and malformations."
To be more precise, the code Q43.8 is assigned to this anomaly: “Other specified congenital anomalies”. In addition to this pathology, the list includes diverticulum of the intestine and colon, megaloduodenum, microcolon, cecum syndrome and other malformations.
Causes
Bowel dolichosigma can be either congenital or acquired pathology, characterized by the presence of two to three additional loops.
The etiology of this phenomenon is unclear. To date, the probable provoking factors due to which there is a congenital disorder in the fixation and growth of the sigmoid colon include:
- Heredity.
- Adverse chemical, physical, and environmental factors affecting the fetus during pregnancy.
- Infectious diseases.
- Drug abuse.
Acquired anomaly occurs due to disorders in the digestive tract, which are associated with the processes of decay and fermentation in the intestine. Provoking factors also occur:
- Age over 45-50 years.
- Sedentary lifestyle.
- Sedentary work.
- Abuse of meat and carbohydrates.
- Frequent stresses.
It is worth noting that many experts consider intestinal dolichosigma as a congenital pathology. They say that she simply does not manifest herself in any way until a certain point. Digestion problems cause a manifestation of clinical manifestations with already existing conditions.
Pathology development
It is customary to distinguish three stages of intestinal dolichosigma. By the way, they are also considered as separate forms of the disease.
Stage of compensation. It is characterized by abdominal pain and periodic constipation, which can last up to three days. Emptying can be achieved by following a diet and taking laxatives.
Stage of subcompensation. It is characterized by persistent constipation, persistent abdominal pain and flatulence. Laxatives at this stage are not effective, you have to regularly put cleansing enemas.
Stage of decompensation. This is the most severe form of pathology. Constipation can last for 7 days or more, the discomfort felt in the stomach is painful. The large intestine is swollen due to the accumulation of feces and gases, for the same reason it is enlarged. Symptoms of intoxication are manifested: nausea, lack of appetite, rashes on the skin of a purulent nature. Often there are signs of intestinal obstruction. Empty the intestines only with the help of a siphon enema.
Common symptoms
All manifestations of the anomaly are due to morphofunctional changes occurring in the colon and persistent fecal intoxication.
So, here are the symptoms of intestinal dolichosigma:
- Long constipation. In especially severe cases, bowel movements may be absent up to 1 month.
- Abdominal pain without localization. The longer constipation lasts, the more torment a person experiences with the sensations he experiences.
- Intoxication, accompanied by chills, fever and general deterioration of well-being. This is due to the fact that the accumulated gases and feces provoke the release of toxins that poison the body.
- Decreased appetite.
- Constant bloating accompanied by rumbling.
- Flatulence.
Feces in patients with intestinal dolichosigma are usually large, dense, sometimes resembling a spruce cone, always with a fetid odor. Due to the fact that the passage of solid masses damages the rectal mucosa, bloody impurities appear in the stool.
Effects
As the intestinal dolichosigma develops, other characteristic clinical signs begin to appear. Namely:
- Recurrent pain in the umbilical and left iliac region.
- Flatulence, which intensifies after physical exertion and eating.
- Reflex intestinal cramps.
- The appearance of chronic gastroduodenitis, pancreatitis, biliary dyskinesia, colitis, dysbiosis and diverticular disease.
- Irritable bowel syndrome.
- Varicose disease and hemorrhoids.
- Fecal stones.
- Anemia.
- Fecal autointoxication.
But one of the most dangerous consequences of intestinal dolichosigma is intestinal obstruction, which occurs as a result of intussusception, inversion, kinks and nodulation of the sigmoid colon.
Visit doctor
The considered anomaly causes severe discomfort even at the initial stage. Therefore, you need to contact a gastroenterologist at the first symptoms, possibly indicating the presence of intestinal dolichosigma.
What to do next? Go through diagnostics. First of all, the doctor will interview the patient, find out about his complaints. Then conduct an inspection. Even through palpation of the abdominal cavity, a specialist can determine the overflow of feces of intestinal loops. After this, a digital rectal examination is performed , during which the gastroenterologist discovers an empty rectum.
Diagnostics
After the survey and examination, the patient will need to undergo the following procedures:
- MSCT of the colon. This is a highly informative modern survey method. It allows a detailed study of the location of the colon, its shape, length, contour, lumen width, the presence of additional loops
- Irrigography. This study reveals lengthening of the sigmoid colon and the presence of additional loops.
- X-ray of the passage of barium. Helps to assess the motor-evacuation function of the colon. For the same purpose, sphincterometry and electromyography are performed.
In addition to the above, auxiliary methods are often used in diagnostics - survey radiography, ultrasonography, ultrasound.
Laboratory studies are also carried out. Namely - a coprogram, a study of feces for the presence of helminth eggs, hidden blood and the detection of dysbiosis, as well as a biochemical and clinical blood test.
Pain management
After diagnosis, the doctor prescribes treatment for dolichosigma of the intestine. The first category of drugs that the patient will need to take is antispasmodics. The best tools are:
- "Trimedat." This drug regulates gastrointestinal motility by acting on opioid receptors. Quickly and effectively eliminates belching, flatulence and diarrhea.
- "Platifillin." This is an m-cholinergic blocker, which disrupts the transmission of nerve impulses, as a result of which the pain syndrome is eliminated.
- Drotaverinum. An antispasmodic that has a myotropic effect. Helps reduce the tone of smooth muscles of internal organs, produces a vasodilating effect.
- No-Shpa. A well-known drug that has a myotropic, antispasmodic, hypotensive and vasodilating effect.
- Buscopan. It has an antispasmodic effect on the smooth muscles of internal organs. The effect is noticeable 15 minutes after application.
Also, treatment of intestinal dolichosigma is often supplemented by massage of the anterior abdominal wall, taking prozerin (if a person suffers from hypotension), electrical stimulation of the colon, acupuncture and hydrocolonotherapy.
Normalization of peristalsis
In addition to the above funds, you will need to take symptomatic drugs. They will help to normalize intestinal motility and prevent increased gas formation. Usually, the doctor prescribes such drugs:
- "Motonium." Central blocker of dopamine receptors. It significantly increases the duration of peristaltic contractions and accelerates the emptying of the stomach.
- Motilium. Dopamine receptor blocker. It increases the duration of duodenal and antral contractions, and also promotes emptying.
- Dufalac. An effective laxative drug that changes the flora of the colon, which stimulates peristalsis.
- Mukofalk. Another laxative, which is based on hydrophilic fibers from the shell of plantain seeds. They contribute to the retention of fluid in the digestive tract, and this helps soften the stool and facilitate the passage of contents.
- "Duspatalin." This tool has an antispasmodic and myotropic effect. It affects the smooth muscles of the digestive tract and effectively eliminates spasms of the digestive system.
In addition, patients are recommended to take vitamins (E, C, B12 and B6), prebiotics and probiotics.
By the way, you can also try folk remedies for dolichosigma of the intestine. The most effective method is a weak infusion or a decoction of celandine. Drinking a glass every day, it will contribute to the normal functioning of the digestive tract.
Proper nutrition
With dolichosigma of the intestine, a diet must be observed. You will need to switch to fractional nutrition (eat 6 times a day in small portions) and in no case overeat.
You also need to drink more water, since the liquid helps to soften the stool. And you also need to abandon smoked meats, preservatives, crackers and chips, desserts and pastry baking, flour products, store sauces, chocolate, spices and junk food.
It is strongly recommended to diversify the diet with dried fruits, cabbage, low-fat fish, cereals (except semolina and rice), grain and black bread, green tea, herbal infusions and freshly squeezed juices.
Physiotherapy
It is highly recommended that you perform light exercise with intestinal dolichosigma. Ten minutes of morning exercises will bring tangible benefits. Here are some exercises you can do:
- Lie on the floor, put your hands behind your head, bend your legs at the knees and raise at an angle of 90 degrees. Slowly make turns alternately to the left and right. Two approaches of 15 times are enough.
- Sit on the bed, lower your legs, set your shoulders apart. Put your hands on your hips. With your right elbow in this position, reach the left knee. Return to starting position. Then, with your left elbow, reach the right knee. Perform 2 sets of 15 times.
- Lie on the floor, stretch your arms at the seams. Straighten your legs. Raise and lower without bending your knees. You can do it slowly, but the legs should be straight - this is how the press strains to the maximum.
After gymnastics, you can do massage. It's simple - you need to put a palm on your stomach and begin to drive in circular motions around the navel, only slightly pressing on the skin. With a sigh, weaken the movement. When exhaling strengthen. Massage only clockwise.
Surgical treatment
Unfortunately, in some cases, conservative therapy does not help and you have to resort to surgery. Intestinal dolichosigma is eliminated by this method only if the loop of the sigmoid colon cannot be straightened otherwise. This must be done, otherwise intestinal obstruction may occur.
Intervention is aimed at removing excess loops, as well as those in which the innervation and blood supply are disturbed.
After the operation, the patient should observe bed rest for several days. It is allowed to get up on the third day. And walk on the 5th day. After 10 days, the stitches are removed.
Then, for 4-5 months, the patient undergoes rehabilitation, adhering to a diet and the most unstressed schedule. Recovery takes a lot of time, but the operation saves a person from possible intestinal perforation, peritonitis, diverticulitis, acute intestinal obstruction, purulent lesions and the occurrence of fecal stones.