Diseases of the sigmoid colon: symptoms and treatment, diagnosis

The sigmoid colon is a part of the large intestine located under the left ileum and surrounded on all sides by the tissues of the peritoneum. The sigmoid colon is a segment of the colon - the part of the digestive tract located behind the blind intestine - and passes into the rectum, along which the formed fecal lump moves to the anus. On the front projection of the sigmoid colon, there are loops of the small intestine, as well as the organs of the genitourinary and reproductive systems (in women, this is the uterus, in men, the ureters and bladder).

Diseases of the sigmoid colon have uncharacteristic signs and symptoms, so it is not always possible to recognize them at an early stage. In order for the doctor to be able to make the correct diagnosis, the patient must tell in detail about all the existing complaints and their connection with the influence of external factors: food intake, smoking, alcohol consumption, stress or physical activity.

Diagnostics of the pathology of the sigmoid and colon includes biochemical examination of feces (coprogram), instrumental and hardware methods (irrigoscopy, colonoscopy, sigmoidoscopy). The sigmoid colon is part of the large intestine, therefore, for examination and treatment, it is necessary to contact a coloproctologist (in the absence of this specialist, to a therapist).

Inflammatory processes

The most common disease of the sigmoid colon, with a prevalence of 63.8%, is inflammation of the mucous membranes with the involvement of the submucous layer in the process, which is called sigmoiditis. There are a lot of factors that can provoke the inflammatory process. First of all, this is an unhealthy diet with a high content of spicy and fatty foods, smoking, abuse alcohol (the relative norm is the use of 120 ml of ethyl alcohol per week), strong emotional experiences.

Sigmoiditis can also develop against the background of an ascending infection with diseases of the rectum, for example, infectious proctitis, or with insufficient hygiene of the anorectal zone. In women, the incidence of sigmoiditis at a young age is almost three times higher than in men - they have the main risk group is considered to be patients over 40 years old suffering from chronic tobacco or alcohol addiction.

Symptoms of pathology depend on the form of the disease. Acute (catarrhal) sigmoiditis is manifested by severe stabbing pains in the lower left abdomen. At the same time, the patient tries to take a pose in which the intensity of pain sensations dulls a little - usually this is a bent position with the torso tilted forward. Other signs of acute inflammation can include:

• rumbling and bloating;
• profuse diarrhea against the background of constant urge to empty the intestines;
• impurities of mucus and blood in the stool;
• an increase in temperature (a non-permanent sign);
• pungent, offensive odor from feces.

Chronic inflammation has blurred symptoms and can be manifested by a feeling of heaviness, pressure and distention in the abdominal cavity, cramping pains with subsequent urge to defecate. In some cases, sigmoiditis pain may persist for several hours after bowel movement.

Note! If not only the sigmoid, but also the rectum is involved in the inflammatory process, the symptoms will be slightly different. This condition is called "proctosigmoiditis" and is characterized by intestinal cramps and prolonged absence of stool. The release of dense mucous lumps with an admixture of blood occurs as a result of increased mucus production.

How to treat?

Therapy of sigmoiditis is carried out according to combined schemes and always includes several drugs that have a therapeutic and symptomatic effect. For any form of inflammation, the patient is shown therapeutic nutrition (table No. 4), as well as treatment with hydrocarbonate mineral waters.

Drug therapy is carried out according to the following scheme:

• enterosorbents for the removal of toxic products and allergens (Polyphepan, Activated Carbon, Smecta);
• drugs that restore damaged mucous membranes ("Methyluracil");
• antidiarrheal drugs (Lopedium, Imodium);
• laxative drugs ("Magnesium sulfate", "Lactulose");
• antispasmodics to eliminate pain syndrome ("Papaverine hydrochloride");
• antibiotic and antimicrobial drugs (penicillin and tetracycline drugs in combinations).

To increase the body's resistance, a course intake of prebiotics, immunomodulators, vitamin supplements is shown. Antispasmodic drugs for sigmoiditis are best used locally in the form of rectal suppositories.

Tumor diseases

Tumors of the sigmoid colon can have different localization, shape, size and etiology. Benign intestinal tumors occur in 140 out of 1000 people, that is, the prevalence of pathology is about 14%. The most common type of benign tumors of the sigmoid colon are polyps - hyperplastic outgrowths mucous membranes, which can develop in any part of the digestive tract, respiratory system, genitals and etc.

Polyposis of the sigmoid colon does not have pronounced symptoms and is diagnosed most often by accident during a routine or prophylactic examination of the intestine. With multiple polyps, the patient may be bothered by mild pain in the lower abdomen on the left side, upset stools, a feeling of a foreign body in the intestine. If the polyp is injured by dry feces or foreign agents (such as undigested grape seeds) in the feces small amounts of blood and mucus that the epithelial membrane produces for rapid recovery may be detected fabrics.

Other types of benign lesions of the sigmoid colon are listed in the table below.

Table. Tumors of the large intestine of benign etiology.

Tumor type	What it is	Clinical symptoms
Fibroma	Intestinal fibroma is formed by connective fibers and is localized mainly on the mucous membranes. Has a high risk of malignancy (becoming cancer).	Bloating and heaviness in the lower abdomen, squeezing and distention after eating. Periodic increase in basal temperature, nausea (occasionally vomiting is possible). Stool disorders with intestinal fibroids are manifested mainly by prolonged constipation.
Lipoblastoma	Formed from the subcutaneous fat layer (wen). When large, it can grow between muscle fibers and blood vessels and affect the periosteum.	Slimy stool, painful bowel movements, false urge to empty the bowels. Often, patients have flatulence, flatulence syndrome is very pronounced and does not depend on food intake.
Papilloma	A tumor formed by epithelial cells that looks like a tubercle. It develops as a result of systemic damage to the human papillomavirus. Localization of papillomas in the intestine occurs in a small number of patients (less than 1%).	Papillomas are almost always asymptomatic. In rare cases, minor changes in the appearance and structure of feces are possible. Some patients complained of recurrent anorectal and pararectal itching, not associated with genital hygiene.

Almost 90% of benign tumors are treated with surgery. Therapy can be carried out using resection or using gentle methods of exposure, for example, cryocoagulation - freezing with liquid nitrogen. If the tumor does not respond to operable treatment (this often happens with hormone-dependent formations), individual therapy is selected that suppresses the synthesis of certain hormones.

Sigmoid colon cancer

This is one of the most dangerous types of cancer, the survival prognosis for which rarely exceeds 1-2 years, even with timely treatment. Sigmoid colon cancer belongs to a group of malignant lesions of the colon and appendix, which are collectively referred to as colorectal cancer. Doctors include long-term smoking and alcohol abuse, uncontrolled intake of antibiotics, and obesity to factors that increase the risk of developing colon cancer. The dietary factor plays an important role: the lack of a sufficient amount of vegetable fiber in the diet increases the risk of colorectal cancer by 2-3 times.

It is almost impossible to recognize sigmoid colon cancer on your own due to the absence of specific symptoms. If the tumor has not metastasized, there will be no pain. The patient may complain of indigestion, heaviness in the lower abdomen, constipation, less often profuse diarrhea. If metastases are localized in the liver tissue, a symptom of cancer may be an enlarged liver and yellowing of the mucous membranes and skin.

Treatment of malignant tumors of the sigmoid colon includes surgical methods, chemotherapy, radiation exposure. After removing a part of the intestine, the patient will receive a stoma - a fistulous opening in the abdomen, through which the contents of the small intestine will be excreted. Feces from patients with ileostomy are collected in a special colostomy bag with a deodorizing plate to neutralize the odor.

Lengthening of the sigmoid colon

Congenital or acquired lengthening of the sigmoid colon is called dolichosigma. Pathology can lead to serious complications from the gastrointestinal tract, mainly which is a prolonged stool retention (up to 7-10 days), leading to poisoning and intoxication organism.

The main symptom of dolichosigma is the absence of regular bowel movements (usually the frequency of bowel movements is 1 every 3 days). Indirect signs are bloating, flatulence with flatus syndrome, heaviness in the lower abdomen. It is very important for prolonged constipation to immediately seek medical help, since laxatives drugs traditionally used to combat constipation are not recommended for elongated sigmoid intestine.

How to treat?

The diagnosis is usually revealed during an instrumental examination of the intestine (irrigoscopy, colonoscopy, capsule endoscopy). Treatment may include surgery, laser therapy, and electrical stimulation. Physiotherapy is used to restore the motor function of the large intestine. The patient also needs to adjust his diet: limit the intake of sucrose, refined foods, simple carbohydrates, fatty and fried foods. Carbonated drinks, meat products treated with "liquid smoke" and other carcinogenic additives must be completely excluded from the menu.

The basis of the diet of patients with dolichosigma should be boiled vegetables, baked fruits, milk porridge, cereal soups, dietary meat. If the disease is complicated by colitis, all dishes should be eaten only in boiled or stewed form, adding a minimum amount of salt and spices. Products that contribute to gas formation (cabbage, beans, peas, radishes, sorrel) may only be eaten thermally and no more than 1 time per week.

Diseases of the sigmoid colon are often disguised as other diseases, so any alarming symptoms should be a reason to see a doctor. Self-medication for intestinal pathologies is not allowed: any drugs, procedures and other interventions should be prescribed only by the attending physician. General analysis of feces that shows, you can find out from the link.

Video - Sigmoid colon and its diseases