Diverticulosis is a morphofunctional pathological process, which is characterized by the formation on the walls of the intestine saccular protrusions (diverticula).
Bowel diverticulosis - acquired disease, most common in older people living in the Western developed countries with high living standards. The people of Africa and vegetarians diverticular disease occurs much less frequently because of the decisive influence on the pathogenesis of diverticulosis environmental factors.
The diverticula can form in different parts of the intestine. For example, the sigmoid colon diverticulosis occurs in approximately 30% of the colon - 15% of the total defeat of the intestine is much less - only 5% of cases.
Causes of diverticulosis
The leading role in the appearance of diverticula have degenerative changes in the muscle walls of the weakness of the connective tissue (congenital or acquired), it discoordination motility, vascular pathology. Etiopathogenesis of the disease is associated with a change in lifestyle and diet of people in industrialized countries over the past 100 years. It is manifested in a decrease in people's diet of plant foods, the prevalence of meat and flour dishes, resulting in constipation. Propagation model of diverticular disease can become residents of North America, the proportion of fiber in the diet are from the late 19th century has decreased by 10 times.
In addition, the emergence of diverticular disease of the intestine contribute to excessive flatulence (bloating), obesity, intestinal infections, messy and prolonged use of laxatives.
There are also anatomical background to the emergence of diverticular disease, including:
- The specific formation of the outer muscle layer of the three bands, weaken the bowel to external and internal influences;
- Character receptacles, whereby the walls are formed intestine place of least resistance;
- Have haustrum (folds in the colon) and create favorable conditions for increased intracolonic pressure.
Symptoms of diverticulitis
Most patients with diverticulosis intestine, note the absence of symptoms of the disease, but in some cases, patients may complain of slight abdominal pain (usually in the left half of it), violation of stool (constipation or diarrhea), rumbling, bloating. If delayed treatment accumulation of feces in the diverticulum leads to the inflammatory process (diverticulitis), which is characterized by severe bloating, severe abdominal pain, presence of blood in the stool and mucus.
When diverticulosis of the colon pain is localized mostly in the left iliac region - in the projection of the sigmoid colon - and a spastic character, intensifying as the filling of the colon feces. Often, abdominal palpation is impossible to determine the localization of the pathological process, which is associated with bowel motility discoordination.
Chills, fever, painful spasms in the abdomen show of complications of diverticular disease - diverticulitis.
Diagnosis and treatment of diverticulosis
Diagnostics of such diseases as colon diverticulosis engaged gastroenterologist. In addition to the general survey, to identify the disease should be the appointment of the following studies:
- Analysis of blood and feces;
- CT scan;
- Barium enema (x-ray of the intestine after filling it with contrast material enema);
- Colonoscopy (examination of part of the colon through a flexible tube through the anus).
And barium enema, and colonoscopy is unpleasant and painful procedure, but their implementation allows sufficient reliability to identify bowel diverticulosis.
If the symptoms and complications of diverticular disease of the sigmoid colon, and the colon are absent, the treatment of this disease is carried out as follows:
- Admission Cerucalum and festal;
- When diarrhea or flatulence appointed intestopan, Biseptol, sulgin.
Treatment of diverticulosis in more complex cases by using:
- Gastric lavage;
- Discharge intestine by klizmirovaniya;
- Infusion Therapy crystalloid solutions;
- Receiving broad-spectrum antibiotics.
In severe forms of diverticular disease complicated by recurrent bleeding, treatment of disease is carried out surgically. It is characterized by resection - removal of the affected areas of the intestine. In addition to resection surgery for diverticulosis involves intravenous antibiotics and drainage of the abdominal cavity.
Power in diverticulosis
In milder forms of the disease diet can replace a full treatment of diverticulosis. Nutrition for diverticular disease should meet the following principles:
- Eating foods rich in fiber: bread from wheat flour, fruits, vegetables, whole grain cereals, bran;
- Limitation of refined food - white bread, cakes, pastries, semis;
- Drinking enough water - at least 1, 5 liters per day;
- Excluding tobacco and alcohol;
- Restrictions on products containing caffeine: Chocolate, strong tea, coffee, cola;
- Eating fermented milk products - yogurt, yogurt, sour milk, except for whole milk.
In addition to the compliance aspects of nutrition, diverticulosis patients is recommended to move more, to do gymnastics, and in any case do not contain the natural urge to defecate.