Superficial focal proctosigmoiditis treatment. Causes of proctosigmoiditis: symptoms and treatment. Therapy for types of disease

What is proctosigmoiditis, symptoms, treatment of the disease? Such questions arouse genuine interest among patients. Processes inflammatory in nature in parts of the large intestine, which completes the entire digestive chain of organs, are called proctosigmoiditis. The pathology affects the sigmoid and rectum. The sigmoid colon, in full accordance with its name, is a branch colon, which is the main section of the large intestine.

In this section of the digestive chain, direct food processing no longer occurs. Here the body takes water and some trace elements from the mass into the blood. Along the way, absorbing vitamins and amino acids remaining after contact of the food mass with the intestinal microflora. It is at this stage that the formation of feces is completed. The process must be completed in the time required for stool to pass 15 centimeters of the rectum. This is followed by bowel movement.

Healthy people usually have no more than two bowel movements per day. When all 15 centimeters of the rectum are full, a signal is sent to the brain to go to the toilet. After defecation, the rectal area becomes empty until the next filling.

Sources of the disease

Morphologically, the sigmoid colon and rectum are close neighbors, therefore the inflammatory process spreads to both sections at once. A number of reasons contribute to this development:

Return to contents

Classification and types

Before treating proctosigmoiditis, the doctor needs to clearly determine the type of disease he is going to treat.

There are various options here:

1. The disease can be acute or chronic.
2. According to the type of inflammatory process, erosive, catarrhal and ulcerative proctosigmoiditis are distinguished.
3. Based on the effect on intestinal motility, spastic and paralytic sigmoiditis are distinguished.
4. The presence of complications divides the types of disease into early and late.

Return to contents

Symptoms of proctosigmoiditis

If a patient has proctosigmoiditis, the symptoms will be as follows:

1. System-wide weakness of the whole organism. Fever accompanied by vomiting and nausea. Numerous swelling, rashes, weight loss, allergies and various disorders psychological state, up to deep depression.
2. Constant pain, localized near the rectum, or distributed throughout the body. The pain tends to intensify during bowel movements. IN severe cases the pain intensifies with any change in body position.
3. Complete bowel disorder ranging from constipation to diarrhea.
4. There is an extremely painful urge to defecate, which does not lead to excretion of feces. An empty ampulla of intestine secretes blood, mucus, or pus instead.
5. With successful defecation, the amount of feces is depressingly small. In this case, there will be a strong odor and an unsolid consistency, and visually uncharacteristic impurities in the form of mucus and blood will be observed.

Return to contents

Possible complications

Acute form Sigmoiditis is almost never accompanied by complications, which are inherent mainly in diseases that follow a chronic scenario. IN similar situation The following diseases are very possible:

• anal fissures;
• haemorrhoids;
• rectal prolapse;
• paraproctitis;
• ulceration of the intestinal wall, perforation of the ulcer, bleeding.

Return to contents

Diagnosis of the disease

To diagnose proctosigmoiditis, a doctor must first find out the nature of the disease and the nature of its course. Chronic sigmoiditis can worsen in several cases. Overexertion of physical strength, suffered acute viral disease and a violation of the diet will certainly lead to an exacerbation of the disease.

To understand everything clinical picture illness, the doctor must prescribe a number of studies:

1. A general blood test will indicate possible signs intestinal anemia, and increased amount red blood cells will indicate an inflammatory process.
2. Examination of feces for the presence of foreign impurities in the form of undigested food, fatty acids, blood, mucus and the like.
3. A biopsy of rectal tissue should be done.
4. Visual examination of the mucous membrane of the rectum and sigmoid colon using a special device - a sigmoidoscope.

Return to contents

Treatment of proctosigmoiditis

How to treat proctosigmoiditis depends on the doctor. The severity of the disease is also important here. Some features of the course of the disease may require hospitalization of the patient, in other cases this can be done at home. There is no point in treating the symptoms of the disease; the main emphasis in treatment should be on eliminating the cause that provoked such a development of events.

A diagnosed source of the disease in the form of an infection will definitely require antibacterial therapy. Enveloping and astringent medications should be prescribed. However, the use of anti-diarrhea medications is strictly not recommended. Therapy for proctosigmoiditis boils down to the need to transfer the acute phase of the disease to a calmer course of the disease. Having successfully completed this task, you can begin to cleanse the diseased area of ​​the intestine from pathogenic bacteria. Such intestinal therapy causes serious damage to the intestinal microflora, so the next step should be the restoration of normal rectal microflora. Traditionally, probiotics are prescribed for this.

The nature of the manifestations of this disease does not always allow them to be tolerated long time, therefore it is necessary to help the patient cope with the painful manifestations of the disease. Pain of a spastic nature requires the use of antispasmodics; manifestations of flatulence will go away with use medicines, reducing the amount of gases produced by the intestines. Symptomatic treatment when similar disease simply necessary.

Proctosigmoiditis is an inflammatory process of the mucous membrane localized in the area of ​​the sigmoid and rectum.

These are the final sections of the large intestine and the gastrointestinal tract as a whole. In the sigmoid colon, water is absorbed and feces are formed. The main purpose of the rectum is to remove feces from the body.

Due to the proximity, the inflammatory process affects both parts of the intestine. The disease can occur in a chronic or acute form, depending on the cause, neglect and other factors.

Causes and risk factors

The disease can be caused by chemical, mechanical or any other damage to the mucous membrane of the sigmoid and rectum.

The disease can be caused by various reasons:

At risk are people who do not adhere to proper nutrition.

Consumption of alcohol, as well as foods that irritate the mucous membranes (acute, fried food) often leads to the development of an inflammatory process.

People suffering from are also at risk. Rough feces When passing through the intestine, they cause injury to the mucous membrane.

In the chronic form, digestive disorders are also observed. There may be constipation, diarrhea, impurities in stool, flatulence and other problems. The patient's weakness depends on his individual characteristics body.

Diagnosis of the disease

During a visit to the doctor, the patient talks in detail about complaints and symptoms. This helps the doctor determine the cause of the disease or exacerbation if we're talking about about the chronic form. The patient must donate blood, urine and feces for clinical research.

But since this disease has similar symptoms with other intestinal diseases, in particular the rectum, then for correct diagnosis applies instrumental examination using a rectoscope.

Rectoscopy helps to determine the area of ​​localization of inflammation, as well as associated problems (fistulas, bleeding).

In rare cases (when the disease is advanced) if the development of cancer perform a biopsy of the intestinal mucosa.

Treatment of the disease

The main goal of treating proctosigmoiditis is to relieve the inflammatory process in the rectum and sigmoid colon.

In addition, the patient is prescribed medications aimed at relieving symptoms and restoring intestinal microflora.

Required condition effective treatment is following a strict diet, which relieves the burden on the intestines and prevents irritation of the mucous membrane. It is allowed to eat liquid or semi-liquid pureed food.

Vegetables and fruits must be subject to heat treatment.

Be sure to exclude coarse fiber, spicy, fried, smoked foods, as well as coffee, alcoholic beverages, and strong tea from the menu.

Local therapy

Local treatment must be carried out using suppositories with an anti-inflammatory effect. Also, to relieve inflammation, the doctor may prescribe it with a decoction of chamomile or other herbs, collargol, rosehip oil or.

The prescription of drugs directly depends on the cause of the disease. If the disease is caused by an infectious environment, a course of antibiotics must be prescribed.

Treatment of proctosigmoiditis is always accompanied by a violation of the microflora, so the patient needs to take biocultures for recovery normal flora intestines.

Symptomatic treatment

Depending on the symptoms that accompany the disease, the patient is prescribed medications:

• painkillers;
• antipyretics;
• to resume bowel function (from bloating, constipation, nausea, and so on).

Sanatorium treatment

For patients suffering from a chronic form of the disease, it is indicated sanatorium treatment. Patients are advised to drink alkaline mineral water, apply mud therapy and other physiotherapeutic procedures.

Folk remedies

Alternative medicine also offers a number of recipes for treating proctosigmoiditis at home.

These are homemade ointments, suppositories, baths or microenemas based on herbs that have anti-inflammatory properties (chamomile, licorice root, calendula, and so on).

But before you use folk remedies Be sure to consult your doctor so as not to worsen your condition.

Complications of the disease

Chronic proctosigmoiditis may have the following complications:

If the inflammatory process affects the perirectal tissue, it develops.

An advanced form of the disease can lead to peritonitis or intestinal perforation. These diseases pose a threat to the patient's life. In addition, chronic disease increases the chance of developing intestinal cancer.

Disease prevention

Proctosigmoiditis, like any other disease, is easier to prevent than to treat. To reduce the risk of developing the disease, you need to:

• follow the basics of proper nutrition;
• do not abuse food that irritates the mucous membranes (spicy, fried, smoked);
• give up bad habits, including alcohol;
• reduce coffee consumption, strong tea and carbonated drinks;
• lead active image life;
• treat all pathologies of the gastrointestinal tract and other internal organs.

If the disease is not neglected, it is easily treatable and does not pose a threat to the patient’s life. But when neglected form may develop serious complications, therefore, if you have symptoms, visit a proctologist who will prescribe effective treatment.

Proctosigmoiditis, or colitis, is a chronic inflammatory disease of the colon. Characterized by frequent occurrence relapses. Affects the mucous membrane of the colon, sigmoid and rectum.

Types of proctosigmoiditis

There are many varieties of this disease. Depending on type pathological process The following forms are distinguished:

• Catarrhal;
• Erosive;
• Ulcerative form;
• Ulcerative-necrotic;
• Atrophic form;
• Hypertrophic form;
• Hemorrhagic;
• Purulent-hemorrhagic.

The picture shows an inflamed colon mucosa.

Causes of the disease

Depending on the impact various factors on the intestines, there are many reasons for the development of the disease. Here are some of them:

1. Unhealthy eating. Abuse of salty and spicy food, spices, alcoholic drinks leads to chronic inflammation;
2. Constant constipation are a risk factor for the development of proctosigmoiditis;
3. Atherosclerotic damage to intestinal vessels. Occurs in older people and leads to constant tissue ischemia;
4. When the colon is exposed to radiation. Rarely occurs in people who have been prescribed radiation therapy for malignant tumors;
5. Infectious factor. Acute diseases of the colon are usually caused by infectious agents. These are bacteria, viruses, and sometimes helminths. Infection most often occurs orally through food and drink. Less commonly, the pathogen enters the intestinal wall through the blood. As a rule, this happens with inflammatory diseases of adjacent organs - hemorrhoids, paraproctitis, vaginitis, prostatitis, cystitis and other inflammatory diseases;
6. Toxic damage to the colon. Occurs when poisoned by poisonous chemicals, mushrooms, berries;
7. Negative Impact antibacterial drugs sometimes causes serious disorders in the composition of the intestinal flora. Beneficial microorganisms of the large intestine are killed, and pathogenic ones take their place.

Manifestations of proctosigmoiditis

Like any inflammatory disease, proctosigmoiditis can be acute or chronic. Symptoms acute illness typical for inflammation:

• presence of fever;
• deterioration in general health;
• abdominal pain, especially in the lower left;
• constant desire to go to the toilet;
• feeling of foreign bodies in the intestines;
• Availability large quantity mucus and blood in the stool;
• feeling incomplete emptying intestines;
• nausea;
• flatulence.
  Manifestations of the chronic form of sigmoproctoiditis:

– permanent aching pain, usually worsen after defecation;

– pain can radiate to the sacrum and coccyx area;

– anal itching;

Chronic forms of the disease are characterized by an undulating course. From time to time, the patient may have no symptoms of the disease. But in the presence of provoking factors, such as a gross violation of the diet or taking large doses of alcohol, colitis can worsen. In this case, the patient develops all the symptoms characteristic of acute course diseases.

Prevention of proctosigmoiditis

Prevention inflammatory diseases colon is simple and consists of maintaining healthy image life. It is necessary to establish healthy diet, rich in fiber To do this, you need to include an adequate amount of vegetables and fruits in your diet year-round.

It is necessary to ensure the proper level motor activity, drinking regime to prevent the development of constipation.

A complete cessation of large doses of alcohol and smoking will not only reduce the risk of the disease, but also extend the period of remission in the presence of the disease.

Adequate antibiotic therapy. Should only be carried out by a doctor, and it is advisable to simultaneously take probiotic preparations to protect beneficial bacteria.

Diet for the treatment of proctosigmoiditis

Without following a strict diet drug treatment will not lead to stable remission of the disease!

Maintaining proper nutrition is an integral part of treatment.
It is necessary to completely exclude salty, spicy, fatty foods, alcoholic beverages, smoked products, canned food and any products containing aggressive preservatives, dairy products, fresh fruits and vegetables that lead to increased gas formation.

Preference should be given to food that does not irritate the intestinal wall. These are puree soups, water-based porridges, thermally processed vegetables and fruits.

Treatment of proctosigmoiditis with suppositories

Treatment with candles has a number of advantages. Active substance directly delivered to the area of ​​inflammation. The drug is located in the intestinal lumen and does not circulate in the general bloodstream, which is why it does not lead to side effects.

In case of exacerbation, suppositories with sulfasalazine help well - used once a day in a dosage of 1 gram, and glucocorticosteroids in a standard dosage 2 times a day. The specific type of suppositories containing potent anti-inflammatory substances is prescribed by the doctor, as there are contraindications. They are used in cases of severe exacerbation.

Suppositories with sea buckthorn oil, propolis, and methyluracil are effective. They can be treated independently. The dosage of all suppositories is standard; they need to be used twice a day until the symptoms subside.

Inflammatory processes in the intestines and the digestive system as a whole are extremely unpleasant phenomenon. That is why it is necessary to understand what simple sigmoiditis is, what its types are and methods of treatment. This will help avoid the development of complications and critical consequences in the future.

This disease is an inflammatory process that forms directly in the mucous part of the sigmoid and rectum. Proctosigmoiditis is characterized by a recurrent course associated with inflammatory pathologies. Most often they occur in other departments digestive system– it could be gastroenteritis or enteritis.

In addition, proctosigmoiditis also exists in its own separate form, which is spastic colitis. The pathology is most characteristic of female representatives and is formed against the background of hormonal disorders, frequent overwork and prolonged stress.

Proctosigmoiditis is a disease that can be associated with the most different symptoms. The acute form of the disease is associated with:

• holistic weakness;
• increase temperature indicators;
• chills, intense spasms in the peritoneum;
• attacks of nausea;
• flatulence.

The acute form of the disease is also characterized by bloody discharge, the appearance of pus. The patient may exhibit frequent urge to defecation (most often false), and after bowel movement relief does not occur. Additional signs There may be diarrhea, occasionally constipation, as well as a feeling foreign body in the intestine, while the pain has a specific localization, namely in the left part of the peritoneum.

In certain situations, patients complain of spasms in the sphincter area. As a result, serious pain occurs in the anus itself.

Chronic proctosigmoiditis can be suspected based on similar symptoms, but against a background of milder manifestations. For example, painful sensations are more often aching than sharp and are localized in the lumbar region. After the act of defecation, the painful sensations become more and more severe, often associated with a burning sensation in the anal area. The reasons for its formation and other features will be discussed further.

Catarrhal

Catarrhal proctosigmoiditis- This specific form of this disease, which is formed as a result of recent and acute lesion large intestine. In this case, the inflammatory process in the sigmoid colon is significantly expressed. The symptoms of the pathology coincide with the manifestations of the chronic form.

In order to establish the causes of the development of catarrhal proctosigmoiditis, it is necessary to carry out comprehensive examination, which will determine the presence of candidiasis, helminthic infestation or dysbacteriosis. As additional diagnostic measures irrigoscopy is prescribed.

Chronic

With this type of pathology, long-term remissions may well be observed. They are interrupted by aggravation of the patient’s condition due to a violation of the diet or after consumption alcoholic drinks.

Chronic proctosigmoiditis is usually formed due to:

• destabilization of the enzymatic functions of either the stomach or pancreas;
• dysbiosis of the gastrointestinal tract, which is formed due to long-term treatment antibiotics;
• initial forms chronic pathologies(let's say Crohn's disease);
• hereditary predisposition.

It is recommended to follow a diet and take probiotics, enzymatic preparations V for preventive purposes to prevent worsening of the chronic form of the pathology. The features of the treatment will be discussed later in the article.

Erosive

Erosive proctosigmoiditis is a consequence of untreated catarrhal form of proctosigmoiditis. In other words, this is a relapse with transition to more complex shape, in which extensive formations begin to form on the intestinal mucosa ulcerative lesions.

There are many symptoms of this disease, the main one being constant pain during bowel movements and movement. Characteristic feature is the localization on the left side. Gastroenterologists pay attention to the fact that:

1. Stool becomes irregular. It is often followed by constipation and diarrhea.
2. False urges to empty the bowel are noted. They are characterized by blood discharge mixed with mucous patches.
3. There is a possibility that stool will be released in small quantities. Most often they have a foul odor and bloody impurities. All this is evidence that there are bleeding ulcers on the intestinal walls.

Surface

Superficial proctosigmoiditis is the simplest and best treatable form of the disease. IN in this case inflammatory processes, although they cover the entire mucous surface of the straight and sigmoid colon, but they occur exclusively on the surface, without penetrating into the depths of tissue structures.

The course of the pathology is recurrent, combined with inflammatory processes, which occur in other parts of the digestive system. The symptoms of the disease are similar to those functional disorder intestines and is not always clearly expressed:

1. The pain is either aching or spasm-like, localized in the left half of the peritoneum. In some cases, they get a so-called “spill”, spreading character.
2. Stool disorders. Most often it is diarrhea, but constipation may occur.
3. Feces are released into small quantity, are characterized by a fetid odor. After bowel movement, the feeling of incomplete emptying still persists.

In addition, the superficial form of proctosigmoiditis is characterized by some general physiological signs, namely weakness and malaise with an increase in temperature, frequent nausea, permanent fatigue. When making a diagnosis before starting treatment for proctosigmoiditis, colonoscopy is used. It reveals visual changes that occur on the superficial part of the intestinal mucosa. Most often this is redness and minor swelling.

Treatment of proctosigmoiditis - suppositories and other drugs

On initial stage treatment involves the use of eubiotics and bacteriophages, which help normalize intestinal microflora. If it worsens pain syndrome and the appearance of flatulence, enzymatic names are used.

Speaking directly about tablet forms, attention is paid to the use of antibiotics, antispasmodics and antihistamines. One of the most common therapeutic compounds for the treatment of catarrhal proctosigmoiditis is Mesacol. It is characterized by antimicrobial and anti-inflammatory effects.

Another feature is the release in six types dosage forms, namely rectal suppositories, suspensions, rectal suspensions, as well as three types of tablets (coated and uncoated, prolonged action). You should also remember that:

• the form and amount of Mesacol is prescribed depending on the type and degree of complexity of the pathology;
• for extensive forms of the disease, tablets are used, for more local forms - suspensions and suppositories;
• local therapy consists of using microenemas with Collargol;
• suppositories for proctosigmoiditis are used with Prednisolone, Sulfasalazine and Hydrocortisone.

Experts point out that the drugs listed last are used exclusively for serious forms of pathology.

Briefly about the diet

Diet for any form of proctosigmoiditis is one of the cornerstones of treatment. Patients are advised to monitor portions and the composition of their own menu as strictly as possible. Heavy, fatty or spicy foods are not recommended for consumption, as well as salty food. Alcoholic and carbonated drinks are strictly prohibited.

If a person has been diagnosed with lactose intolerance, it is recommended to avoid dairy products. It is strongly recommended to completely eliminate strong types of coffee and tea from your diet. Drugs for the treatment of proctosigmoiditis must be taken at a certain time, and the diet should be adjusted specifically to this course.