Divertuculosis

The divertuculosis represents morfofunktsionalny pathological process which is characterized by education on walls of intestines of sacculate protrusions (diverticulums).

Intestines divertuculosis - the disease acquired, most of which often is found at the elderly people living in the developed countries of the West with the high standard of living. At inhabitants of Africa and vegetarians the diverticular disease is observed much less often that it is connected with decisive influence on a pathogeny of a divertuculosis of factors of the environment.

Diverticulums can be formed in various departments of intestines. For example, the divertuculosis of a sigmoid gut meets approximately in 30% of cases, colonic - in 15% of cases, total damage of intestines happens much less often - in only 5% of cases.

Divertuculosis reasons

In the course of emergence of diverticulums dystrophic changes in muscular walls have the leading value: weakness of connecting fabric (inborn or acquired), a diskoordination of its motility, vascular pathologies. The etiopathogenesis of a disease is connected with change of a way of life and character of food of people in the industrial countries for the last 100 years. It is shown by reduction in a diet of people of products of plant origin, the dominance of meat and farinaceous dishes leading to locks. Inhabitants of North America whose cellulose share in a daily diet since the end of the 19th century decreased by 10 times can become model of spread of a diverticular disease.

Besides, emergence of a divertuculosis of intestines is promoted by plentiful gas generation (meteorism), obesity, intestinal infections, chaotic and long reception of purgatives.

Distinguish also anatomic premises to emergence of a divertuculosis among which:

• Specific formation of an outside muscular layer in the form of three strips weakening a gut before external and internal influences;
• Character of an arrangement of vessels therefore on walls of a gut places of the smallest resistance are formed;
• Existence гаустр (folds on a large intestine), creating favorable conditions for the increased intra intestinal pressure.

Divertuculosis symptoms

Most of the patients suffering from an intestines divertuculosis note lack of symptoms of a disease, however in certain cases patients can complain of insignificant abdominal pains (most often, in its left half), disturbances of a chair (locks or ponosa), rumbling, swelling. At untimely treatment accumulation of fecal masses in a diverticulum leads to inflammatory process (diverticulitis) which is characterized by the expressed meteorism, severe pain in a stomach, presence at a chair of blood and slime.

At a divertuculosis of a large intestine pain is localized preferential in the left ileal area - in a projection of a sigmoid gut - and has spastic character, amplifying in process of filling of a large intestine fecal masses. Often at a palpation of a stomach it is impossible to define localization of pathological process that is connected from diskoordinatsiy motility of a gut.

The fever, fever, cricks in the bottom of a stomach testify to the arisen complication of a diverticular disease - a diverticulitis.

Diagnosis and treatment of a divertuculosis

As the divertuculosis of a large intestine is engaged in diagnosis of such disease the gastroenterologist. In addition to the general survey, detection of a disease requires purpose of the next researches:

• Blood test and calla;
• Computer tomography;
• ULTRASONOGRAPHY;
• Irrigoskopiya (a X-ray analysis of intestines after its filling by means of an enema a contrast agent);
• Kolonoskopiya (survey of the site of a gut by means of a flexible tube through an anus).

Both the irrigoskopiya, and kolonoskopiya are unpleasant and painful procedures, however their carrying out allows with sufficient reliability to reveal an intestines divertuculosis.

If complications and symptoms of a divertuculosis of a sigmoid gut, and also thick are absent, then treatment of this disease is carried out the following:

• Diet;
• Reception of cerucal and festal;
• At diarrhea or a meteorism Intestopanum, Biseptolum, sulfaguanidine are appointed.

Treatment of a divertuculosis in more difficult cases is performed with the help:

• Gastric lavages;
• Unloadings of intestines by a klizmirovaniye;
• Infusional therapy by crystalloid solutions;
• Reception of antibiotics of a broad spectrum of activity.

At the severe forms of a divertuculosis complicated by recurrent bleedings, treatment of a disease is performed in the surgical way. It is characterized by a resection - removal of affected areas of a gut. In addition to a resection, surgical intervention at a divertuculosis provides intravenous administration of antibiotics and drainage of an abdominal cavity.

Food at a divertuculosis

At easy forms of a disease the diet can replace with itself full treatment of a divertuculosis. Food at a diverticular disease has to correspond to the following principles:

• Consumption of products rich with cellulose: bread from coarse flour, fruit, vegetables, wholegrain porridges, bran;
• Restriction in the refined food - white loaf, cakes, cakes, semi-finished products;
• Consumption of enough water - not less than 1,5 liters a day;
• Exception of smoking and alcohol intake;
• Restriction in the products containing caffeine: chocolate, strong tea, coffee, Coca-Cola;
• Consumption of fermented milk products - kefir, yogurt, a yogurt, except for whole milk.

In addition to respect for aspects of healthy nutrition, the sick divertuculosis is recommended to move, do more gymnastics and not to constrain natural desires to defecation at all.