A diverticulum is a blindly ending protrusion of the wall of a tubular or hollow organ. It is worth noting that this is a very common pathology, because such structures can be found within almost any organ system.
Naturally, patients who encounter a similar problem are interested in any available information. What are diverticulums? Symptoms, treatment, prognosis, preventive measures - these points should be considered in more detail. After all, sometimes the appearance and growth of such neoplasms adversely affects the work of the whole organism.
What is a diverticulum? General information and types of neoplasms
For starters, you should familiarize yourself with the general information. As already mentioned, a diverticulum is a protrusion of the wall of a hollow or tubular organ. Despite the fact that such structures can form everywhere, in most cases digestive tract organs, namely the intestines, suffer from diverticulosis. Much less often, such protruding are formed from the walls of the bladder, urethra, trachea.
It is worth noting that this is a very common phenomenon. Approximately 50% of elderly patients have at least one bowel diverticulum. It is not dangerous in itself. Unfortunately, such protruding tissues are prone to inflammation, which entails a lot of complications.
Similar structures can be:
- Congenital (or true). The outgrowth is formed in the process of fetal development and, as a rule, affects all layers of the intestinal wall);
- False (or acquired). They form with age and, as a rule, in those places where blood vessels enter the intestinal wall.
Most often, in modern medical practice, the diverticulum of the colon, namely the part that is called the sigmoid, is recorded.
The main causes of intestinal pathology
A diverticulum is a protrusion that can be formed both during fetal development and as the body grows older. Unfortunately, it is not always possible to find out the causes of the appearance of congenital diverticulums of the intestine. It is believed that there is a hereditary predisposition (a specific intestinal structure or connective tissue weakness is often transmitted to the child).
If we are talking about acquired abnormal structures and their further inflammation, then several risk factors can be distinguished:
- First of all, it is worth talking about the wrong diet, in particular, fiber deficiency. It is dietary fiber that stimulates intestinal motility. Against the background of insufficient fiber intake, food movement in the intestines slows down. The stool becomes drier and harder, as a result of which the pressure in the lumen of the digestive tract rises. Such processes often lead to the appearance and further inflammation of diverticula.
- Diverticulitis can provoke other inflammatory diseases of the large intestine, including various infections, ulcerative, ischemic and spastic colitis. Even with the right treatment, pathogenic microorganisms can remain in the tissues of the diverticulum, as a result of which an inflammatory process develops.
- Risk factors include age. The fact is that as the body ages, the intestinal mucosa becomes thinner, peristalsis weakens, and chronic constipation develops. That is why intestinal diverticulum is more likely to form in an elderly patient. In this period of life, the risk of inflammation increases.
- The inflammatory process can be triggered by the activity of worms. Against the background of invasion by these parasites, dysbiosis develops. The weakening of the immune system creates excellent conditions for the development of pathogenic bacteria, which most often settle on the surface of the diverticulum.
Intestinal diverticulosis: what are the symptoms?
The diverticulum itself does not cause any serious violations - a person feels quite normal. But, as already mentioned, such protrusions are often inflamed, and this already entails the appearance of very characteristic symptoms:
- The main symptom is pain. Pain is most often localized in the lower left abdomen. Soreness is monotonous and does not disappear within a few days. The patient's condition worsens with tension of the abdominal wall (for example, with coughing, laughing, physical exertion). The pain does not go away even after defecation.
- Diverticulitis is characterized by stool disorders. Against the background of inflammation, a spasm of the intestinal wall is often observed, as a result of which constipation appears. After the wall relaxes and expands, patients are faced with a problem such as diarrhea.
- Inflammation of the diverticulum is often accompanied by damage to blood vessels and the appearance of ulcers. That is why traces of blood often appear in the feces of a sick person. In the most severe cases, the inflamed diverticulum ruptures, which is accompanied by severe pain and bleeding from the intestines.
- Since this is an inflammatory process, one cannot but mention the symptoms of intoxication of the body. Patients complain of fever, decreased appetite, nausea, lethargy, weakness, chills, body aches.
Diagnostic measures
A diverticulum of the sigmoid or colon (as well as any other organ) is rarely accompanied by any specific symptoms, so it can only be detected during a routine examination.
However, with inflammation of this structure, patients complain of abdominal pain and other problems. In such cases, the doctor must collect a complete history, after which he conducts a general examination and palpation. Additionally, analyzes are carried out. For example, during a laboratory blood test, an increase in the number of white blood cells can be detected, which confirms the presence of an inflammatory process.
Instrumental diagnosis for intestinal diverticulitis
Laboratory studies can confirm the presence of an inflammatory process. But a diagnosis such as diverticulitis can be made only after a thorough instrumental diagnosis, which includes the following procedures:
- Perhaps the most informative research method is colonoscopy. During the procedure, the doctor with the help of an endoscope carefully examines the inner surface of the large intestine. The procedure allows you to detect diverticula, determine their exact number and location, carefully examine the condition of the mucous membrane.
- If during the colonoscopy it was not possible to obtain accurate results, the patient is sent for an X-ray contrast study of the intestine. In the picture, the doctor can see a protrusion that goes beyond the contour of the intestine - this is diverticulum.
- Sometimes an additional ultrasound of the abdominal cavity is performed, which also makes it possible to assess the condition of the intestine and detect the presence of protrusions, neoplasms and other pathologies.
Drug treatment
Therapy in this case depends on the condition of the patient, the number of diverticula, the presence of inflammation and ulcers. As a rule, the treatment regimen includes the following medications:
- In the presence of an inflammatory process, doctors, as a rule, prescribe antibiotics of a wide spectrum of effects to patients. Effective in this case are drugs such as Timentin and Cefoxitin. These drugs have a detrimental effect on the walls of bacteria, with the activity of which inflammation of diverticula is associated.
- Anti-inflammatory drugs are also effective, helping to get rid of the main symptoms of inflammation. Drugs such as Salofalk and Mesalazine are often included in the treatment regimen.
- Antihistamines, in particular Tavegil and Suprastin, help reduce the sensitivity of cells to histamine and relieve swelling of the intestinal mucosa.
- Treatment of a sigmoid diverticulum or any other part of the intestine in most cases includes the use of antispasmodic drugs, for example, No-Shpy or Meteospasmil. These funds help relieve spasm from the intestinal wall, relieve pain, alleviate the patient's condition.
- Laxatives for diverticulitis are used with extreme caution. These drugs, of course, thin the feces and facilitate bowel movements. On the other hand, while taking laxatives, the pressure in the intestinal lumen increases, which can provoke a diverticulum rupture.
Proper diverticulitis diet
Treatment of a sigmoid colon diverticulum (or any other part of the digestive tract) must necessarily include an appropriate diet. If we are talking about inflammation, intestinal spasm and inability to eat naturally, then the patient is given a dropper with glucose and a solution of electrolytes.
In the future, it is extremely important to monitor the diet. From the menu, you need to exclude products that promote gas formation in the intestines (legumes, whole milk, grapes). Coarse dietary fiber contained in pineapples, persimmons, radishes and turnips is also contraindicated. Patients are advised to refuse white bread, blueberries, rice, pomegranate, as these products contribute to the development of constipation.
The diet, however, should be rich in fiber. Doctors recommend that patients eat granola, some cereals, oatmeal, peaches, berries, seaweed, avocados, pears. When dealing with constipation, it is important to observe the water balance - drink at least 2 liters of plain, clean water daily.
Diverticulums: operation and indications for its implementation
With the help of correctly selected drugs, you can get rid of inflammation. However, diverticulum removal is sometimes necessary. The operation can be planned (it is carried out 2-4 months after the successful medical treatment of inflammation in order to prevent relapse) and emergency (in the presence of intestinal bleeding, risk of rupture of the diverticulum).
If we talk about emergency surgical intervention, then the indications for it are:
- rupture of the diverticulum and the exit of its contents into the abdominal cavity with the further development of peritonitis;
- acute intestinal obstruction;
- the appearance of infiltrate in the protrusion cavity;
- suppuration of tissues;
- bleeding that cannot be controlled with medication;
- the risk of malignant degeneration of diverticulum cells;
- fistula formation.
Excision of protrusion of the intestinal wall is not carried out for elderly patients, as well as pregnant women. Contraindications include severe pathologies of the cardiovascular system (there is a risk of reaction to anesthesia), chronic diseases during exacerbation, as well as any acute inflammatory or infectious diseases.
Folk remedies
Of course, traditional medicine offers a lot of tools to combat one or another inflammatory bowel disease.
Treatment of sigmoid colon diverticulitis (or any other part of the digestive tract) may include taking a tincture of medicinal smoky. Cooking it is quite simple - you just need to pour two tablespoons of dry raw materials into a thermos and pour all 500 ml of boiling water. The mixture is recommended to leave overnight. Patients take half a glass before meals three times a day.
Oatmeal jelly also has beneficial properties. Some folk healers also recommend that you include flax and plantain seeds in your daily diet, and use olive or flaxseed oil as a salad dressing. For intestinal diseases, peppermint tea and alcohol from tern are effective .
Of course, home remedies can only be used as adjuvants. In no case should you give up drug therapy, especially when it comes to acute inflammation.
Preventive actions
Unfortunately, today many patients are faced with such a problem as intestinal diverticulum. Treatment of pathology in most cases is successful. Nevertheless, even after completion of therapy, patients are advised to adhere to some rules that help prevent the formation of new diverticula:
- Important are regular sports. Physical activity has a positive effect on blood circulation, which in turn normalizes the tone of the smooth muscles of the intestinal wall.
- To support normal peristalsis of the digestive tract, about 25-30 g of fiber is recommended every day. This substance helps to facilitate the passage of food through the intestines, prevent the development of chronic constipation.
- It is necessary to maintain water balance - every day you need to use at least 1.5-2 liters of clean, still water.
- Vegetable oils have a positive effect on health. At least three times a week you need to eat at breakfast a tablespoon of flaxseed or olive oil.
- Of course, it is important to maintain immunity. If you have any health problems, you need to see a doctor on time.
Bladder diverticulosis: symptoms and treatment
According to statistics, in 80% of cases of diverticulum formation occurs precisely in the intestine. However, quite often, in modern medicine, the appearance of such protrusion in the bladder wall is also recorded.
In most cases, the disease develops against the background of such pathologies as urethral stricture, prostate adenoma, and sclerosis of the bladder neck. Due to increased pressure, the wall of the bladder is stretched - this forms a diverticulum. It is worth noting that inside the protrusion, urine often accumulates, which ultimately leads to inflammation.
In no case should you ignore such a problem as diverticula. Surgery is sometimes simply necessary, regardless of whether we are talking about pathologies of the bladder, intestines or other organ.
Nevertheless, the prognosis for patients is favorable - in most cases, correctly selected drug therapy and a surgical procedure help get rid of the problem.