Many people wonder where the rectosigmoid colon is located. What diseases are associated with this area? We will understand in this article.
Rectosigmoiditis is an inflammation of the distal colon, that is, the rectum and sigmoid colon. This disease can be acute, and also can go into a chronic form. The acute form of the disease is manifested by cramping pain, diarrhea, nausea, tenesmus, weakness, and, in addition, chills and hyperthermia. Against the background of chronic rectosigmoiditis, pains are aching or pulling. In addition, false urge with diarrhea is observed, intoxication syndrome is possible.
Rectosigmoid diseases of the rectum are diagnosed taking into account complaints, on the basis of examination, rectal and endoscopic examinations. Also, patients pass stool tests, and a biopsy is performed. Treatment involves dieting, antibiotic therapy, symptomatic treatment and the use of local anti-inflammatory drugs.
So, where is the rectosigmoid colon?
Anatomy
The rectosigmoid compound is a section of the rectum that is fifteen centimeters above the anus. The human rectum extends from the anorectal junction to the sigmoid colon.
The rectosigmoid section is located in the bone pelvis, this area is surrounded by muscles, organs of the genitourinary system, and, in addition, ligaments and various connective tissue structures. This section controls the natural mechanism of bowel movement. The rectum in humans is partly located extraperitoneally. Its proximal border is a rectosigmoid compound.
Rectosigmoid section consists, as a rule, of the mucous membrane, and, in addition, the submucosal layer. It also forms the muscle membrane. Outside, it is covered with powerful fascia.
The mucous membrane of the rectosigmoid part of the rectum is covered with a cylindrical epithelium, which has a large number of goblet cells. This shell, among other things, contains a lot of libercune glands, which are almost entirely composed of mucous cells. For this reason, in the presence of pathological processes from the rectum, an abundant amount of various mucus is secreted.
Blood supply in the rectosigmoid part of the rectum is carried out by the lower, and at the same time, the middle and upper hemorrhoidal arteries. Of these, the upper artery is unpaired, and the other two are paired, they approach the rectum from the sides.
Basic information about rectosigmoiditis
What pathologies arise in the rectosigmoid colon?
Rectosigmoiditis belongs to the group of acute and chronic inflammatory pathologies of various origins that affect the rectum and sigmoid colon. Rectosigmoiditis is the most common form of colitis. It occupies a leading position in frequency among proctological pathologies. Often it is diagnosed in adults. In particular, the likelihood of developing this disease increases between the ages of twenty and forty years and after fifty-five.
Rectosigmoiditis and its causes
Inflammation of the rectosigmoid part of the colon occurs with specific and some nonspecific infections, and, in addition, against the background of inflammatory bowel diseases, in the presence of helminth infections, malnutrition and stagnation as a result of stool. Among other things, the cause of rectosigmoiditis may be poisoning with toxic compounds along with local disturbances in blood supply. Also, the causes of this disease may be:
- The spread of inflammatory processes from neighboring organs.
- The presence of chronic diseases in areas of digestion.
- Diseases of the pancreas and liver.
- Conducting radiation therapy.
Infectious rectosigmoiditis can develop under the influence of pathogens. The non-specific nature of the disease includes inflammation of the lower intestine in the presence of salmonellosis, dysentery, cholera and other similar infections with oral transmission. A specific type of rectosigmoiditis can be observed against the background of local infection with the causative agent of syphilis, gonorrhea and a number of other diseases that are transmitted sexually.
The parasitic nature of the disease of the rectosigmoid region can occur in the presence of giardiasis, ascariasis, enterobiosis, and other helminthiases. The causes of alimentary rectosigmoiditis are the following factors:
- Alcohol abuse.
- The presence of excessive addiction to spicy, and at the same time to salty and fatty foods.
A stagnant form of the disease develops with constipation due to trauma to the intestinal walls with excessively dense feces. The toxic nature of rectosigmoiditis can be diagnosed against the background of an overdose of certain drugs, due to poisoning by mushrooms and so on.
Sometimes this disease occurs due to the passage of infection from nearby tissues and organs, for example, against the background of paraproctitis, vaginitis or urethritis. Rectosigmoiditis often affects patients who have other chronic diseases of the digestive system. For example, rectosigmoiditis can occur in the presence of gastritis, cholecystitis, diseases of the pancreas, gall bladder or liver. Among other things, the cause of rectosigmoiditis, as well as cancer of the rectosigmoid department, may be radiation therapy for oncological pathologies of the pelvis.
Symptoms of rectosigmoiditis
For the acute form of the disease, a sudden onset with the onset of weakness is typical, in addition, the patient may feel overwhelmed, expressed deterioration of well-being, hyperthermia, chills, nausea and vomiting. Patients suffering from rectosigmoiditis usually complain of intense cutting, cramping pain in the left abdomen. In addition, diarrhea can be observed along with frequent tenesmus, accompanied by the release of a certain amount of feces, mucus and blood, including. Flatulence with a feeling of incomplete intestinal emptying may be noted. As part of the initial stages of rectal examination, a spasm can be detected, and subsequently complete relaxation of the sphincter.
In the presence of chronic rectosigmoiditis, the clinical picture is usually less bright, exacerbation, in turn, can alternate with remissions of different durations. The causes of symptoms, as a rule, are malnutrition along with alcohol abuse. Against the background of an exacerbation, patients suffering from rectosigmoiditis may complain of aching or pulling pain in the left half of the abdomen. Pain is often given to the lower back and perineum. Against the background of bowel movements, the pain syndrome may intensify. Itching is very often observed in the anus, along with increased stool, tenesmus and bloating. Cramping and sphincter relaxation are less pronounced than with acute rectosigmoiditis.
Pathology diagnostics
The proctologist makes a diagnosis of this disease, taking into account complaints, a history of pathology and data on examination of the pre-canal area. In addition, abdominal palpation is performed, digital rectal examination is performed, sigmoidoscopy and a number of laboratory tests are performed.
Against the background of palpation of the abdomen of a patient suffering from rectosigmoiditis, the soreness that the patient feels in the left iliac region is usually determined. During the study of the perianal zone, areas of maceration and irritation are often detected. As a result of rectal examination , spasms or relaxation of the sphincter along with swelling of the intestinal mucosa can be detected. Traces of mucus and blood may remain on the glove. Sigmoidoscopy, as a rule, confirms the presence of inflammation in the patient, making it possible to determine the type and severity of inflammatory processes.
Based on blood tests, leukocytosis is detected along with an increase in ESR. A coprogram usually indicates the presence of blood and elements of the intestinal mucosa in the feces. Against the background of rectosigmoiditis due to helminthiosis, pinworms with roundworms and other parasites can be found in the feces. With rectosigmoiditis, which develops as a result of infection, pathogens can be present in the fecal masses. In doubtful situations, during a sigmoidoscopy, a biopsy is performed. As for the final diagnosis, it is set taking into account the results of a histological examination. Now we will consider how treatment of a disease such as rectosigmoiditis is carried out.
Methods of treatment of rectosigmoiditis: main directions
The treatment of this disease is often conservative. As a rule, it includes the implementation of etiopathogenetic and symptomatic therapy.
Patients are prescribed a sparing diet, which reduces irritation of the intestinal wall. Coarse fiber, too cold and too hot, spicy, smoked, fried and fatty foods, is excluded from the diet. It is recommended to use warm soups, and, in addition, dietary main dishes, which are steamed.
Against the background of the parasitic form of rectosigmoiditis, antiparasitic drugs are prescribed. In the presence of a radiation form of the disease, appropriate therapy is terminated, and in the case of detection of pathogenic bacteria, antibacterial treatment is carried out.
With any form of rectosigmoiditis, cleansing enemas are used. Usually, enemas based on chamomile are performed, with the addition of fish oil, a solution of collargol or sea buckthorn oil. Sedentary baths are also used along with suppositories with anti-inflammatory and regenerative effects.
Enveloping and astringent preparations may be prescribed. In the presence of severe pain, patients are shown antispasmodics, and against the background of flatulence, medications are required to reduce gas formation. In the presence of ulcerative rectosigmoiditis, hormone therapy may be needed, which is usually carried out in the form of local remedies - suppositories or microclysters.
After eliminating the inflammatory process in the rectosigmoid colon, it is recommended to take medications that help restore the intestinal microflora. Given the timely and adequate treatment of rectosigmoiditis, the prognosis is usually favorable.
Treatment of rectosigmoiditis
What kind of treatment the patient expects depends on the established cause and the diagnosis. Quite often, doctors prescribe conservative therapy with traditional methods. Based on the information received, the treatment is carried out in a hospital so that the doctor can monitor the condition of the patient and respond in time to any changes. The patient is given etiotropic therapy and the symptoms are eliminated. As part of this treatment, the following recommendations are required:
- With the development of radiation bowel damage, it is necessary to stop the appropriate therapy or adjust the dosage of radiation.
- Prescribing an antibacterial drug to reduce the effects of negative organisms.
- Prescribing probiotics used to normalize intestinal microflora.
- To combat spasms, the patient is prescribed antispasmodics.
- The use of infusion therapy is used to restore water balance in the body. This measure is used to reduce intoxication, and, in addition, helps with diarrhea.
- The use of special drugs to improve intestinal microflora and mucosal structure.
Adenocarcinoma and rectosigmoiditis
Adenocarcinoma is a malignant tumor that usually forms from glandular cells. This malignant formation can be located in different mucous membranes, internal organs or on the skin. But often a tumor in the rectosigmoid part of the intestine is located, which is its most frequent localization. This is observed in ninety-five percent of cases. A tumor is often a complication of rectosigmoiditis. Next, we consider in more detail what this adenocarcinoma represents.
Pathology Description
So, as we already know, a rectosigmoid compound is a section of the rectum that is fifteen centimeters above the anus. Adenocarcinoma located in this area is also called a sigmoid colon tumor. During diagnosis using magnetic resonance imaging, the anus, as a rule, is not displayed, in this regard, the tumor localization area is determined by measuring the interval from the anorectal transition to the neoplasm itself.
Rectosigmoid adenocarcinoma of the intestine has the property to develop very quickly, and, in addition, refers to one of the most progressive variations of cancer. Adenocarcinoma quickly forms metastases, accompanied by the most painful symptoms for the patient.
Symptomatology
The main symptoms of a rectosigmoid colon tumor include the following symptoms:
- The occurrence of pain in the intestines.
- The appearance of blood in the feces.
- The occurrence of bloating with a strong emission of gases, which have a sharp putrefactive odor.
- The patient's complete refusal of food along with the loss of appetite
- The appearance in a person of lethargy, apathy, depression and unwillingness to live. I must say that such symptoms can be observed in a patient even before he knows his immediate diagnosis.
- Deterioration of complexion, and, in addition, the skin throughout the body.
- The occurrence of vomiting, nausea, along with the rejection of any products by the stomach immediately after eating.
- The complete lack of interest in food, along with the rejection of various, previously very beloved smells.
- Lightning weight loss, and with it the loss of more than ten kilograms of weight in less than three months.
- The occurrence of stench from the mouth along with belching with air before and after food.
- Skin tack and cold sweat.
- Blurred pupils and yellowness of the face.
Unfortunately, at the initial stage of development of a tumor of the rectosigmoid colon, the symptoms are invisible or completely absent. In this regard, without accurate preliminary diagnosis and without screening, it is difficult for a patient to suspect them on their own. The sooner adenocarcinoma is detected, the greater the patient’s chances of survival and the more comforting the prognosis. It is also worth noting that, depending on the health of the patient, his age, race and gender, the tendency to cancer of the rectosigmoid colon may be greater or lesser.
The main causes of adenocarcinoma
The causes of rectosigmoid adenocarcinoma can be as follows:
- Two or more close relatives had this cancer.
- Lack of fiber in food, and, in addition, the use of raw plant foods.
- The presence of weak peristalsis.
- A person's strong addiction to meat food, especially pork.
- The complete absence of physical activity in humans.
- The presence of obesity and overweight along with diabetes.
- Passion for smoking and alcohol in large quantities. It is worth noting that alcoholics have a few times higher chances of getting this type of cancer than people who moderately consume alcohol.
- The presence of inflammatory diseases of the stomach or intestines.
- The presence of chronic dysbiosis.
- Passion for promiscuous sexual contacts.
How is rectosigmoid colon cancer treated?
Treatment of this pathology
The main method for treating this cancer is surgical resection. It can be full or partial. In addition to the cancerous area, regional lymph nodes are also removed. Tissue samples from nearby lymph nodes must necessarily undergo a histological examination for the presence of cancer cells.
But the situation is complicated if the tumor of the rectosigmoid compound is inoperable. When surgery is not possible, complete removal of a small portion of the intestine with the formation of a colostomy is performed (this is a special tube for removing digestion waste).
Another treatment for cancer of the rectosigmoid colon is radiation therapy, which can be postoperative or preoperative. The first may be necessary if the cancer spreads to the walls of the abdomen and the area behind the peritoneum. The time for postoperative radiation treatment is two weeks after the surgery.
Chemotherapy is used for rectosigmoid adenocarcinoma in combination with other treatment options. Chemotherapy drugs are Fluorouracil along with Capecitabine, Oxaliplatin, Tegafur and others. The course of treatment, as a rule, is about three months.