Intestinal diverticulosis - what is it? How to treat?
Intestinal diverticulosis is characterized by the presence of diverticula in it. From Latin, diverticulum is translated as "road to the side", which characterizes this pathology in the best possible way. With bowel diverticulosis, symptoms may not be present. Various factors lead to the development of the disease, but the main cause of the disorder is the weakness of the connective tissue. When multiple diverticula form in the intestine, they indicate the development of diverticulosis. Such a diagnosis is made to patients who suffer from both the pathology itself and its complications.
- Characteristics of the disease
- Causes of diverticulosis
- Bowel diverticulosis symptoms
- What is the danger of diverticulosis?
- Diagnosis of diverticulosis
- Intestinal diverticulosis treatment
- Prevention of diverticulosis
Characteristics of the disease
Diverticula form in the lining of the intestinal wall. In appearance, they resemble a hernial protrusion. Most often, diverticula form in the intestine, but sometimes they can appear in the stomach and esophagus.
The disease develops due to a violation of the normal peristalsis of the intestinal wall. This often happens due to inaccuracies in nutrition, as well as with low physical activity. Bloating and overfilling of the intestine with gases leads to overstretching of its walls, since the accumulated gas bubbles increase the pressure inside the organ. This provokes the formation of diverticula. Another reason for their occurrence is the weakness of the intestinal muscles.
There are 3 forms of diverticulosis:
- Asymptomatic disease.
- Diverticulosis with clinical manifestations.
- Diverticulosis with complications.
Causes of diverticulosis
The reasons leading to the development of diverticulosis:
- Chronic constipation.
- Flatulence and bloating.
- Postponed intestinal infections.
- Formation of atherosclerotic plaques in the vessels that feed the intestines.
- Leading a sedentary lifestyle.
- Age over 60.
- Complicated family history.
- Violation of blood circulation in the intestine.
- Chronic bowel disease.
- Improper nutrition.
Bowel diverticulosis symptoms
Diverticulosis is often not associated with any symptoms. For a long time, a person does not even suspect that he has such a problem.
In other cases, the pathology is manifested by such signs as:
- Abdominal pain on the left side.
- Stool disturbance, alternation of diarrhea and constipation.
- Rumbling in the stomach.
- Nausea and vomiting.
Symptoms increase with inflammation of the diverticulum. At the same time, the patient's body temperature rises, blood appears in the stool, and bloating increases. Pain during exacerbation of the pathology is concentrated in the iliac fossa on the left side. As the inflammatory response progresses, the symptoms intensify, they are expressed as follows:
- Alternating diarrhea and constipation.
- Lack of appetite.
- Vomiting and nausea.
- Increased pain.
- Increased body temperature.
- The appearance of mucus in the stool.
- Increased heart rate.
- Onset of symptoms of peritonitis.
- An increase in the level of leukocytes in the blood.
- Fetid flatus, bloating.
- Increased urge to have bowel movements. After the act of defecation, the patient retains a feeling of incomplete emptying of the organ.
If a person is not helped in time, the inflammation will intensify, the intestinal wall will burst and peritonitis will occur.
What is the danger of diverticulosis?
Since the intestines are severely affected with diverticulosis, this threatens the development of complications such as:
- Perforation of the intestinal wall.
- Phlegmon of the retroperitoneal space.
- Internal bleeding.
- Formation of a fistula.
- Intestinal obstruction.
Diverticulosis increases the risk of a malignant tumor in the intestine.
Diagnosis of diverticulosis
A patient with suspected diverticulosis is examined, his history is studied, and then a referral is given to the following diagnostic procedures:
- Donation of blood and urine for general analysis.
- Feces delivery for coprogram.
- Colonoscopy. The procedure is indicated for patients who suspect not only diverticulitis, but also polyps, carcinomas or other neoplasms. Colonoscopy is prescribed for patients who are admitted to the hospital with rectal bleeding.
- Conducting irrigoscopy. The procedure is carried out using a contrast agent. Pictures of the intestines are performed on an X-ray machine. The doctor is able to track the movement of the contrast agent and its exit from the intestinal wall.
- CT. This method is used in severe cases.
- Scintigraphy. Scan is performed with technetium-labeled erythrocytes.
Intestinal diverticulosis treatment
Treatment of diverticula in the intestine depends on the stage of development of the disease, the presence of complications and other factors.
Possible options for medical care:
- If the diverticulum was discovered by chance, and it does not cause concern to the person, then the doctor prescribes a dietary meal for the patient. The diet should be based on fiber-rich foods.
- If the patient develops symptoms of the disease, then in addition to diet, he will need to take antibiotics. This will eliminate the resulting inflammation.
- With the development of complications or at a high risk of their occurrence, the patient is referred for surgery.
A person's diet should include food that is a source of soft fiber.
Basic nutritional rules to follow:
- Increase in the proportion of foods that are a source of dietary fiber in the menu.
- Refusal to eat foods that provoke an increase in gas formation.
- Drinking fermented milk drinks to prevent constipation.
- Fractional food intake, refusal to overeat.
Foods that should be present in the diet:
- Bran bread.
- Coarse flour products.
- Cooked porridge with vegetable oil.
- Fresh and baked vegetables.
- Low-fat fermented milk drinks.
- Vegetable soups and fish broths.
- Steamed omelet casserole.
You need to remove such products from the menu as:
- Bread, sweets, premium flour products.
- Rice and semolina.
- Spicy, fatty and salty foods.
- Alcoholic drinks.
- Coffee, soda.
It is not recommended to eat foods that are a source of coarse fiber. This applies to turnips, pineapples, radishes, persimmons. They are dangerous because they irritate the intestinal walls and can aggravate the problem.
If the diverticula become inflamed, but there are no complications of the pathology, the person can receive outpatient treatment.
In addition to following the diet, he will be prescribed medications such as:
- Broad-spectrum antibiotics, butyric acid preparations, 5-aminosalicylic acid preparations.
- Digestive enzymes (creon, festal, pancreatin, mezim and others).
- Drugs that simulate the work of the digestive tract: Domperidone, Motilium, Passages, Motilac, Metoclopramide, etc.
- Antispasmodics: Drotaverin, No-shpa, Spazmol, Spazmonet.
- Laxatives: Duphalac, Normase, Portalac in syrup, Goodluck, Lactulose, Livolyuk-PB.
If, after 3 days from the start of therapy, the patient's well-being does not improve, then he is hospitalized. The doctor directs the patient for additional diagnostic tests. If necessary, he undergoes an operation.
When is surgery indicated?
Indications for surgery for diverticulosis:
A history of 2 acute attacks of the disease and lack of effect from drug treatment. If the patient is over 40 years old, then he is referred for surgery with a single exacerbation of the pathology.
- Massive intra-abdominal bleeding.
- Bowel obstruction.
- Formation of phlegmon or development of peritonitis.
- Formation of an abscess, detection of fistulas.
The operation is reduced to the removal of that part of the intestine where the inflamed diverticulum is located. The course of the procedure depends on the individual characteristics of the course of the disease. In an emergency, a stoma can be inserted into the abdominal wall.
Prevention of diverticulosis
Preventive measures to avoid the development of diverticulosis:
- Refusal of hypodynamia, regular sports.
- Adequate fiber intake.
- Body weight control.
The author of the article: Bykov Evgeny Pavlovich | Oncologist, surgeon
Education: graduated from residency at the Russian Scientific Oncological Center. N. N. Blokhin "and received a diploma in the specialty" Oncologist"