Dolichosigma of the intestine in a child: causes, symptoms, treatment

Dolichosigma is an unnatural structure of the sigmoid intestine. With such a violation, the sigmoid colon becomes somewhat longer, forming a reservoir for additional accumulation of feces. In some cases, dolichosigma does not manifest itself in any way in childhood and adulthood. If there are no pathological signs, experts can attribute this variant of intestinal growth to the norm. But when the extra loops of the sigmoid region give the patient painful sensations, do not allow him to go to the toilet normally, it is required to carry out compulsory treatment and find out the causes of the violation. In this material, we will tell you how to identify intestinal dolichosigma in a child, whether this disease can be cured, and what it is.

Classification of the disease and its features

The sigmoid colon can be located in several positions and have different sizes, taking into account these factors, the S-shaped, one-looped, two-looped and multilooped sigma sections are distinguished. The reasons that provoked the violation are also taken into account, due to which dolichosigma can be congenital and acquired.

We are talking about the pathological location and size of the sigmoid colon when a two-lobed or multilooped organ is registered in a patient. This allows the intestine to move freely in the abdominal cavity, twisting and preventing the passage of feces to the exit. Taking into account the peculiarities of dolichosigma, experts distinguish three stages in the formation of the disease.

Table 1. Stages of dolichosigma formation

Stage	Peculiarity
Compensation	Constipation does not last more than three days, periodically there are pains in the abdomen. You can cure a child by adjusting a diet and taking laxatives periodically.
Subcompensation	Constipation lasts up to a week, there is increased gas production and pain. Laxatives do not give the desired effect, enemas are often required.
Decompensation	Constipation lasts more than a week, the pain is constant and acute. The abdomen is enlarged, flatulence is noted, intestinal obstruction may occur. Only siphon enemas help.

Causes of dolichosigma in children

Dolichosigma is a pathological lengthening of the sigma region. The disease can proceed without obvious symptoms, but more often the patient manifests constipation and difficulty in emptying the intestines due to the large number of loops in the sigmoid colon.

The exact causes of the disease are unknown. There are several versions according to which a dolichosigma of a congenital nature can form.

1. Genetic predisposition is equally transmitted through the female and male lines.
2. The use of medicines during pregnancy that negatively affects the fetus.
3. Unhealthy influence of the environment, living in the risk zone near the chemical production and in the radioactive zone.
4. Lack of nutrients at the stage of formation of the gastrointestinal tract of the fetus, which in some cases entails lengthening of the sigma.
5. Postponed infectious and viral diseases of a pregnant woman at any time during the gestation of a child.

Acquired pathology is diagnosed in almost 100% of cases in adult patients, but due to infections of the gastrointestinal tract, nervous breakdowns, malnutrition, the disease can appear in children. In a child, the following factors can also cause dolichosigma:

• helminth infestation;
• insufficient nutrition of the child, especially in the first year of his life;
• incorrect introduction of complementary foods or the selection of a mixture;
• Taking inappropriate medications, especially antibiotics and steroids
• poor drinking regime of the baby, including in the first year of a child's life and breastfed.

Attention! In about 15% of cases, dolichosigma does not cause any problems for children, but in adulthood after 45-50 years there is a risk of developing severe constipation, hemorrhoids and other disorders associated with improper work intestines.

Signs of the development of dolichosigma in a child

Most often, when dolichosigma appears, the following signs are noted:

• long-term constipationwhich can last up to 10 days;
• sometimes, due to the long absence of the act of defecation, there is an unexpected bowel movement that is difficult to control;
• it hurts to defecate, feces come out slowly, has a dense consistency and an unpleasant odor;
• there may be severe pain in the left abdomen, sometimes it is aching in nature;
• the skin is characterized by pallor, severe dryness, which is associated with an insufficient amount of nutrients in the body;
• the patient has an increase in the volume of the abdomen, on palpation, there is pain on the left in the region of the sigmoid colon;
• a sick child is constantly faced with increased gas production and a feeling of fullness.

Attention! Such symptoms may be associated with an inflammatory process in the gastrointestinal tract, the presence of neoplasms or other disorders in the functioning of the intestines, therefore, mandatory medical advice is required, since sometimes the child's life is in real danger.

Diagnosis of the disease in children

To make an accurate diagnosis, it is required to collect the patient's history, to clarify when the first signs of the disease appeared and whether there is a genetic predisposition to it. After that, the diagnostic methods described in the table are applied.

Table 2. Methods for diagnosing dolichosigma

Procedure	Peculiarity
Palpation	The doctor probes the abdomen and rectum to detect the possible presence of tumors and other neoplasms.
Ultrasound	Allows you to see the extra loops in the sigmoid colon.
X-ray	Allows you to see the extra loops in the sigmoid colon.
Irrigography	Allows you to see excess loops in the sigmoid colon using a barium mixture.
Colonoscopy	With the help of a camera on the hose, the state of the intestinal mucosa, the presence of excess loops and pathological neoplasms are assessed. You can take a tissue biopsy.
Recto-manoscopy	With the help of an endoscope, the condition of the intestinal mucosa is assessed.

Additionally, all patients must pass a number of laboratory tests. These include general and biochemical blood tests. Be sure to check for blood clots in the stool. With the help of a comprogram, a possible violation of microflora and the presence of undigested products in feces are detected. Sometimes a blood or feces test is prescribed for helminthiasis.

Attention! The examination of the patient should be comprehensive in order to exclude other causes of intestinal dysfunction, including oncological processes. Only after receiving the data of analyzes and functional diagnostics can dolichosigma and its exacerbation be confirmed or refuted.

Features of treatment for dolichosigma

The complexity of the treatment of pathology lies in the fact that even after taking medications and following a diet, the period of remission can last no more than 8 weeks, since the extra loops have not gone anywhere, and the feces gradually begin again in them linger. Therefore, it is so important to monitor the child's condition and not even break his diet once.

To support the digestive tract, every two to three months, the pediatrician and gastroenterologist prescribe drugs such as Proserin and Dibazol. They can be used in the form of injections and orally. Doses for each child can only be determined by a doctor, since it is required to take into account the age, weight, severity of dolichosigma and the presence of other pathologies of internal organs. Treatment with Proserin and Dibazol is continued for two to three weeks.

At the stage of their use, vitamins of group B are necessarily prescribed. They can be taken as pills and injections. It is also useful to take folic acid, ascorbic acid and mineral complexes. Their dosage is also determined only by the pediatrician. If necessary, use laxatives, pain relievers, probiotics and enemas. Pain relievers are selected by a doctor.

Attention! Additionally, the sick child is prescribed abdominal massage, acupuncture, exercise therapy and spa treatment. The exact number of procedures depends on the severity of the baby's condition and his age.

Physiotherapy procedures for dolichosigma

Most often, with such a pathology, the following procedures are prescribed.

1. Interference therapy, which consists in the effect on the digestive tract of a current of moderate strength. Under the electrodes, the patient does not feel pain, but only small vibrating movements. They are placed on the sigmoid colon and can be inserted into the anus if constipation is severe. The therapy lasts no more than 20 minutes, the course of treatment is daily 10-15 days. They are used from the first months of a child's life, usually from six months. It helps in the first or second stage of dolichosigma, in the third it is already ineffective.
2. Acupuncture. The specialist places needles on the nerve points on the child's body that stimulate the digestive tract, helps with minimally expressed symptoms of dolichosigma. The exact number of procedures is determined individually. Acupuncture is usually prescribed only after the first year of life, in most cases due to the thinness of the child's skin - after 3-5 years.
3. Laser therapy. Appointed from 1.5-2 years. The area of ​​the sigmoid colon from the abdomen and back is exposed to a laser for 1-2 minutes, the power and frequency of use of which are selected individually. It helps in the first or second stage of dolichosigma, while in the third it is ineffective.

Attention! Physiotherapy procedures have the desired effect only if you follow a diet with a lot of fiber.

Laxatives for dolichosigma

They are effective at the initial stage of dolichosigma development. The use of a laxative is required only for clear medical indications, paying attention to the child's age. It is impossible that the intake of drugs in this group was permanent.

Glycelax

It is a glycerin-based rectal suppository. Improves intestinal motility, softens feces. Approved for use from birth, the dose is selected by weight and can be from 1/3 of a candle to a whole suppository. It is recommended to put the drug in the morning.

Bisacodyl

Approved for use from two years old, in childhood it is required to put rectal suppositories. The drug irritates the intestinal wall, normalizing its peristalsis. Bisacodyl is used for up to seven years at a dosage of 5 mg, which is equal to half a candle.

Guttalax

The drug can be used from the fourth year of life. Available in the form of drops and tablets. In the first case, to provide a laxative effect, it is required to give 5-10 drops of the active substance, if necessary, the dosage is adjusted in subsequent doses. In the form of tablets, the agent should be taken in 0.5-1 tablets.

Preparations for normal microflora

Probiotics displace pathogenic bacteria, normalizing the general condition of the child and reducing the manifestation of intoxication. They are used in courses of 1-3 weeks in combination with other drugs or separately.

Linex for children

The medication should be taken with food from birth. Up to seven years, the contents of one sachet are dissolved in a small amount of water and taken at a time, young children can drink Linex in small portions. From the age of seven, the dose is equal to two sachets at a time. Treatment continues for up to three weeks.

Bifiform Baby

The oil-based solution gently envelops the entire digestive tract, preventing bacteria from poisoning the body. Bifiform Baby should be taken once, it is better to do it in the morning, 0.5 g of active substance. Prescribe a medication from birth. The course of therapy is at least 10 days, taking into account the severity of dolichosigma.

Biovestin

The probiotic has been approved for use since birth. It is produced in the form of a solution in sterile ampoules. It is recommended to take Biovestin before meals, the ampoule is preliminarily opened, and the contents are diluted in 20-50 ml of water or juice. The dosage of the probiotic is 1 ml for each year of the child's life. The remedy is taken once a day for at least two weeks.

Laxative enema for children

If the drugs have not given any effect, in the first or second stage, you can try the usual cleansing enemas. They can be prepared from pure water or infusion of chamomile, string, St. John's wort. When choosing herbs, you should observe a dose of 200 ml of boiling water, a tablespoon of raw materials is taken, which is steamed for at least two hours. After that, all the grass from the solution must be removed.

During the manipulation, the child must be laid on its side, bending its legs. The amount of water that flows into the intestines should be monitored. The large volume of fluid causes severe pain and can cause distension of the intestinal mucosa. For children under one year old, it is enough to inject 5-20 ml, from two to three years, the amount of water can be equal to 50 ml for a single injection. From four to six, it is allowed to inject 100 ml of liquid, but it is important to monitor the reaction.

If after 7-10 minutes the water comes out without feces, you can try re-introduction. Before introducing a new amount of water, make sure that the old fluid has already come out. If three times use of the solution does not work, you should seek help from a doctor.

For more information on how to give your child an enema at home, you can find in our article.

Attention! During the procedure, you should use the thinnest tube possible, the end of which is lubricated with a large amount of oil or petroleum jelly.

Siphon enema with dolichosigma

It is used only in the severe stage of dolichosigma, when laxatives have no effect. A siphon enema is of a flushing nature, flushing out feces and accumulated toxins from all parts of the large intestine. Such manipulation is contraindicated in rectal bleeding and intestinal trauma.

To carry out the procedure, a strict algorithm must be followed:

• the child is laid on the left side, tucking his knees;
• taking into account the patient's age, it is necessary to prepare up to 10 liters of warm water;
• as soon as the baby is laid down, it is necessary to take a tube no more than 1 cm wide and 150 cm long, one end of it is lubricated with petroleum jelly and inserted into the anus;
• then the hose should be raised to a height of one meter and pour warm water into the funnel, as soon as the level is in the middle of the tube, it is lowered;
• you do not need to take out the hose, the feces will come out through the funnel, so you need to take care of a basin or any container for collecting dirty liquid;
• after all the water has left the intestines, the procedure is repeated again until the liquid becomes light.

Attention! The frequency of siphon enemas is determined by the attending physician. Sometimes they are carried out once a week, with severe intoxication, manipulations can be more frequent.

Surgical treatment and its need

Surgical treatment of dolichosigma in childhood is rarely used. Such cases are strictly defined by specialists.

1. The operation is indicated if constipation persists even after three courses of conservative therapy, including massages, acupuncture and exercise therapy.
2. The child has fecal stones that can cause intestinal obstruction.
3. Intoxication of the baby's body, the patient becomes lethargic, signs of dysfunction of internal organs may appear. There are lags in speech, mental and physical development.
4. The presence of a multi-loop sigma with clear signs of an inflammatory process in it and with intestinal obstruction. In the latter case, we are actually talking about hours when the baby can be saved.

During an operation to eliminate dolichosigma, the surgeon cuts off unnecessary loops, allowing the feces to move freely.

Attention! In very rare cases, a sick child develops such a severe form of intoxication that it leads to a complete lack of immune defense. As a result, AIDS develops, which has nothing to do with the immunodeficiency provoked by HIV. But at the same time, the consequences of such a state are the same and lead to death.

Diet for dolichosigma in children

A healthy diet is almost the main component of a quick recovery and elimination of symptoms of the disease.

If a child has been diagnosed with dolichosigma, his nutrition should include:

• a sufficient amount of water, the daily dose is calculated taking into account the age and weight of the baby;
• cereals and products from them;
• fermented milk products that are able to maintain the microflora of the gastrointestinal tract in a normal state;
• lean meat, which is used with vegetables, they should be baked or boiled;
• breast milk up to 6-12 months, if the mother does not have a deficiency, and the baby is allergic.

Attention! With dolichosigma in a child, food needs to be built not only taking into account its usefulness, but also regularity. It is necessary to feed the baby often, but in small portions.

Traditional methods of treating dolichosigma in children

Homemade recipes in childhood can be used strictly after consultation with the attending physician, especially for multi-day constipation. In severe cases of dolichosigma, folk methods can lead to the death of the child, since attempts to move feces cause intestinal obstruction.

Flax seeds

A tablespoon of seeds is required to pour 100 ml of boiling water and insist for 20-30 minutes, strain the solution well. You can use the product from the first year of life, 2.5-5 ml of infusion. For better assimilation, it must be diluted in the same amount with water or milk. Flax seeds are used 1-2 times a day for 10 days.

Hop cones

This product is suitable for children from two to three years old. Cones should be poured in a ratio of 1 to 20 with dark bread kvass, the solution is stored in the refrigerator, you do not need to decant it. Stir the medication thoroughly before each use, drink it in the morning and in the evening at a dose of 1 ml / kg of body weight. Duration of treatment is 3-7 days.

Raisins and prunes

You can make compote from them, but infusion turns out to be more effective. In equal proportions, it is required to mix dried fruits and take a tablespoon of chopped raw materials. It is poured with 200 ml of boiling water and insisted for 2-3 hours. The product should be taken in the morning and in the evening at a dosage of 1-2 ml / kg of body. The duration of treatment is until the appearance of the stool.

Castor oil

A remedy is used for constipation for more than three days. In childhood, it is required to give half a teaspoon of the active substance once a day. Do not take castor oil for more than 2 days.

Oregano in oil

Three tablespoons of dry herbs are poured into 500 ml of vegetable oil and kept at room temperature for a day. It is required to take the medicine 5 ml three times a day one hour before meals. The duration of treatment is no more than two weeks.

Acupressure

After waking up, without getting out of bed, you need to gently press under the right rib for 2-3 minutes. In addition to pressing on this area, you can massage it a little in a circle. Then you need to go down two fingers from the navel and press on the stomach again. In this position, they freeze for 1-2 minutes. Breathe calmly during the entire procedure. In case of sharp pain during the massage, you must immediately call a doctor. The procedure is carried out daily, the duration of the course is not, it is specified by the doctor.

The prognosis of the development of the disease and its possible consequences

If therapy is started immediately, in 90% of cases it is possible to completely suppress unpleasant symptoms, transferring it to the stage of remission. Otherwise, due to constant constipation, intoxication of the body may develop, hemorrhoids will appear, in some cases, intestinal obstruction develops, which can only be cured by urgent surgical intervention. Also, due to the constant retention of feces, the child has low body weight, an unstable psycho-emotional state, a drop in hemoglobin levels, dry skin and mucous membranes.

Prevention of dolichosigma in children

To avoid the development of pathology, you should adhere to the following recommendations:

• during pregnancy, a woman should lead a healthy lifestyle, eat well, take prescribed vitamins, and visit a doctor regularly;
• after birth, it is important to try to maintain breastfeeding so that there is no increased load on the digestive tract;
• when transferring a child to a common table, it is required to select a healthy diet with a large amount of lean meat, cereals, dairy products, non-allergenic vegetables, fruits, homemade fruit drinks and fruit drinks;
• with symptoms of an inflammatory process in the gastrointestinal tract, it is necessary to immediately undergo an examination by a doctor and, upon confirmation of the diagnosis, take antibacterial drugs;
• drink multivitamins twice a year, it is recommended to do this in March and September;
• with a high probability of infection with helminths, also in March and September, drink a single course of medicines against helminthiasis;
• be sure to monitor personal hygiene, washing the child every day with clean water, so as not to infect and not provoke an inflammatory process.

Attention! Preventive methods have the necessary effect even with congenital dolichosigma. They do not eliminate unnecessary loops, but they do not allow unpleasant symptoms of the disease to develop, saving the patient from the need to take medications.

Dolichosigma is a rather serious violation in the structure of the intestine, since if the principles of correct food, frequent infection of the gastrointestinal tract and the appearance of constipation in the patient may develop intestinal obstruction. It is important to carefully monitor the child's diet, especially with congenital pathology, and also visit a pediatrician every few months to monitor the course of the disease. In case of an exacerbation, one should not refuse to take medications and, if they are ineffective, be sure to agree to surgical treatment.

Video - Sigmoid colon and its diseases