Dolihosigma: what is it, the treatment of dolichosigma in adults and children, surgery, proper nutrition

The intestinal dolichosigma is a disease that develops due to an increase in the length of the sigmoid region of the intestine and the dilatation of its mesentery. Because of the excessive length, the motility of the large intestine and the processes of its emptying are disturbed.

The disease can both be unaffected throughout the life of the patient, and may be indicated by symptoms such as digestive disorders, constipation, flatulence. The most dangerous sign of dolichosigma is the obstruction of the intestine of a chronic type. Read more on intestinal obstruction →

Stages and Species

Dolihosigma is a disease that can be both congenital and acquired throughout life.

Doctors distinguish three main stages of pathology.

1. Compensation stage. The patient's well-being is maintained. The main complaint is constipation lasting up to three days. Normalization of the chair is possible with the help of an elementary diet and receiving laxative agents.
2. Stage of subcompensation. Constipation is regular and prolonged, which significantly affects the quality of life of the patient. For the liberation of the intestine it is necessary to constantly use enemas.
3. Stage of decompensation. The last stage of development of intestinal dolichosigma, accompanied by severe prolonged constipation, severe pain in the abdomen. Often there is an intestinal obstruction. To eliminate symptoms only siphon enemas in a hospital environment help.

The sigmoid colon may be S-shaped, and also have one, two or many loops. About dolichosigma it is usually said if the intestine already has two or more loops that are combined with elongation, high mobility, relatively free movement in the abdominal cavity. The loops should not disappear after the intestine has been emptied.

If not only the lengthening of the length of the sigmoid colon, but also its expansion, thickening of the walls, then this condition is called "megadolioschigma".

Why there are additional sigmoid loops

The development of dolichosigma in children can be both congenital and acquired. In a congenital disease, etiology is not fully established. It is assumed that additional loops appear due to the effects on the fetus of unfavorable environmental conditions, infectious agents, and certain medications taken during pregnancy. Do not rule out the likelihood of a genetic predisposition, but to date it has not been proven.

The acquired intestinal dolichosigma is spoken mostly in adults. At the same time, some doctors believe that the causes of the development of pathology in sedentary lifestyle and malnutrition, while the other part is sure that the dolichosigma was in man since birth, and the way of life only contributed to the appearance of symptoms.

The question of what counts the intestinal dolichosigma: a pathology or a variant of normal intestinal development, has not been resolved between the doctors. This is explained by the fact that 15-17% of people have additional sigmoid ligament loops, which in no way manifest themselves clinically during their entire life, but in some cases a clear clinical picture evidencing pathology arises.

Dolihosigma leads to a disruption of the motor function of the large intestine due to the fact that degenerative changes occur in its walls under the influence of a chronic inflammatory process. Muscle fibers are hypertrophied, sclerotic changes occur in the mesentery, the mucosa is thinned.

Causes of

The exact causes of development of intestinal dolichosigma have not been established.

The following factors are assumed by physicians:

• chronic gastrointestinal diseases;
• decreased physical activity, lack of mobility;
• age changes in the body( with manifestation over the age of 40);
• effects of neuroses and stress;
• use for a long time of some groups of medicines that are capable of provoking changes in the structure and structure of internal organs;
• presence of bad habits in an adult;
• improper nutrition, in which too much carbohydrate enters the body, and other elements - in insufficient quantities.

Development features of

The developmental features of Dolhosigma in adults differ slightly from children. To take into account the features the doctor needs to choose the right therapy depending on the age.

In adults

The presence of intestinal dolichosigma in adults generally has an effect by 40-50 years. In this case, the main causes of the formation of the disease are a sedentary lifestyle and malnutrition. Doctors believe that most adults diagnosed with intestinal dolichosigma always had excess loops in the sigmoid colon, but they only made themselves felt when the general conditions of life worsened. The resolution of the disease without medical intervention is practically not happening.

In children

The presence of intestinal dolichosigma in a child can be diagnosed by the first year of life. The main symptom of the pathology will be permanent constipation.

In children, the dolichosigma can be resolved independently as it grows up. This is due to the fact that the intestine is evenly located in the abdominal cavity and additional loops cease to create difficulties for the passage of stool. Accordingly, the symptoms of dolichosigma of the intestine also stop.

Symptoms of

One of the leading symptoms in dolichosigma in a child or adult is constipation. Feces have a solid consistency and a large diameter. Since the nerve ganglia in the intestine are preserved, constipation can be replaced by periods of normalization of the stool.

In addition, the following will be observed:

• pain attacks in the form of spasmodic pain in the lower abdomen;
• complaints of a feeling of raspiraniya in the abdomen sometimes with the indication of specific localization of the projection of the sigmoid colon;
• enlargement of some areas of the intestine, first of a temporary nature, and then becoming permanent;
• stool is characterized as very offensive, effervescent in large quantities at times of relief of constipation;
• increases gas formation, there are complaints of flatulence.

With prolonged constipation, complaints appear that are characteristic of an intoxication syndrome. The patient speaks of attacks of nausea and vomiting, a decrease in appetite, sometimes a fever is noted. Upon examination, it turns out that the tongue is covered with a white coating, the smell from the mouth is fetid, the turgor of the skin is reduced.

With the progress of dolichosigma, a violation of absorption of nutrients is noted. It is accompanied by brittle hair and nails, loss of body weight, deterioration of the skin.

What diseases accompany dolichosigme

The development of dolichosigma of the intestine usually does not proceed in isolation, causing a number of additional chronic pathologies.

Immunodeficiency comes to the fore often. Its development is facilitated by a violation of absorption of vitamins, micro- and macroelements in the intestine, the presence of a chronic inflammatory process. Tolerance of the organism to infections sharply decreases, frequent catarrhal diseases are noted during the year.

The presence of dolichosigma contributes to the development of diseases such as gastritis, gastroduodenitis, esophagitis. The development of these pathologies is due to an imbalance in the functioning of the digestive tract, instability of excretion of digestive products from the body.

Chronic stress is another concomitant disease, characteristic of people suffering from dolichosigma. It develops in response to the presence of constant discomfort, pain and can in turn lead to ulcers and gastritis.

Which doctor treats dolichosigma

The treatment of dolichosigma is performed by a gastroenterologist. Depending on the concomitant diseases, the proctologist, neurologist, nutritionist, endocrinologist and other doctors may be involved in the process. If a decision is made on an operative intervention, a surgeon's consultation will be required.

Diagnosis

During the diagnostic search, patient complaints, a history of the disease and a family history are taken into account. The data of laboratory analyzes are mostly non-specific. The basis of the diagnosis is a visual examination of the patient and instrumental methods.

During visual inspection, there is a decrease in body weight, insufficient physical development, pale skin. At palpation it is possible to reveal an accumulation of solid fecal masses in the region of the projection of the sigmoid colon. Finger rectal examination will help to establish that the rectum is empty, even if the stool is absent for a long time.

From instrumental methods apply:

• on ultrasound you can see additional loops of the intestine;
• on the roentgenogram defines the expansion of the intestinal loops( not used to diagnose the disease in infants, since the difference between the norm and the pathology is insignificant);
• Irrigography( chest radiograph with contrast) will allow to clearly determine the presence of extensions of the intestine and their severity;
• Colonoscopy with dolichosigma( examination of the intestine with an endoscope through the anus) allows you to see an empty rectum and a cluster of stools or fecal stones in the sigmoid colon;
• a sigmoidoscopy allows to estimate a degree of changes in a mucosa of a rectum. More details about what is best - a colonoscopy or sigmoidoscopy →

Treatment of

Treatment of dolichosigma begins with conservative therapy.

The patient is recommended:

• compliance with the diet;
• vitamin therapy;
• massage of the abdomen for improving peristalsis and activating the process of stool departure;
• for pain due to sphythmic dolichosigma spasmolytics are prescribed( Palthifillin, Drotaverin);
• if hypotension develops, Prozerin is prescribed;
• is prescribed acupuncture, exercise therapy, electrostimulation.

For the evacuation of the intestine, an individually selected laxative is used in combination with enemas.

Treating folk remedies with dolichosigma allows the use of small white bran. They use the course for 6-8 months, individually picking the optimal dose to achieve maximum effect.

When operation

is required. Operations with a dolichosigma are rarely required.

Indications are:

• no effect of conservative therapy;
• is a progressive intoxication;
• persistent constipation and increasing intestinal obstruction;
• detection of loops that can not be straightened or strong bowel movements.

In general, resection of the sigmoid colon( total removal within the anatomical boundaries) is performed. Proctosigmoidectomy can also be performed if the distal intestine is affected.

Postoperative period

After surgery for dolichosigma, the patient is placed in the intensive care unit until complete stabilization. Showing bed rest for the first 3-4 days, after which it will be allowed to move. It is possible to walk full after removal of drains( usually on 4-5 days).

Drug therapy includes antimicrobial, antiulcer, haemostatic drugs. If necessary, infusion therapy is performed.

Sutures are removed by 7-10 days, and the work capacity is restored within 4-6 weeks. After surgery for dolichosigma 4-6 months, it is necessary to limit physical activity( lifting weights) and maintain a diet.

Nutrition

Nutrition for dolichosigma is used to reduce the likelihood of constipation and reduce the time of food in the intestinal cavity. Food should not be too dry, it is not consumed in large pieces( everything is finely chopped or tindered).

In the case of dolichosigma, the following menu is preferred:

• raw vegetables and fruits in large quantities( they are washed, but not cleaned from the skin if possible, so as not to lose the fiber necessary for normal digestion);
• recommended cereals from whole grains, prepared with the addition of olive oil and a small amount of dried fruits for taste( semolina or rice under prohibition);
• with dolichosigma recommended soups with the addition of low-fat meat;
• can be eaten in cottage cheese and dairy products with a low fat content, low-fat fish;
• in the diet must necessarily include bran and pumpkin seeds to strengthen peristaltic activity of the intestine.

The diet with dolichosigme also imposes a restriction on drinking. Preference should be given to simple water, a weak coffee with milk, green tea with the addition of milk or prunes. Too much too hot or too cold drinks categorically it is impossible.

Forecast

With the observance of medical recommendations, the prognosis is favorable for dolichosigma. In most cases, it is possible to achieve complete remission of the disease and normalize the quality of life, regardless of age. If dolichosigma of the intestine has developed in childhood and the child neglects the diet and treatment recommendations, the process can be chronically and decompensated in adulthood.

Prevention

Since the etiology of dolichosigma has not yet been established accurately, specific prevention methods do not exist.

Doctors give only general recommendations aimed at preventing complications:

• adherence to recommendations regarding diet and lifestyle;
• use of cellulose preparations to prevent the development of constipation;
• regular vitamin therapy( preference is given to vitamins of group B);
• massage and exercise therapy to improve peristalsis and fecal matter.

The intestinal dolichosigma is a disease that can not be ignored. If it is started, it can seriously damage health, provoking the development of a mass of concomitant diseases that will adversely affect the quality of life of the patient.

The first symptoms of dolichosigma require a doctor's consultation. If the patient receives timely professional help, you can achieve complete regression of the disease and avoid serious complications.

Author: Arina Volkova, MD,
specially for Moizhivot.ru

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