Dolichosigma - a congenital abnormal elongation of the special department of the colon - the sigmoid colon.
This condition usually leads to disruption of passage of stool through the intestines, their prolonged retention in the lumen of the intestine and as a result, a disturbance of defecation and chronic constipation.
In rare cases, the condition dolihosigmoy does not manifest itself, and is an accidental finding during the examination of the digestive system.
Causes
Dolihosigmoy considered as a variant of the intestine, which in some children and adults leads to the formation of constipation problems.
Not all scientists are inclined to option dolihosigmoy how frank pathology rather dolihosigmoy consider option gut structure, which under certain conditions leads to problems with the chair. Only 25% of children with the presence of dolihosigmoy reveal problems with the chair, the other children is quite normal growing and developing.
Anomalies of intestinal structure themselves arise as a result of unfavorable course of pregnancy, the mother in the first trimester, when there is a tab the basic structures of the intestine and its departments. The majority presence dolihosigmoy today regard as a variant of "pre-disease".
bowel changes
Scientists are closely studying the structure of the gut at dolihosigmoy, and came to the conclusion that it was violated - is mainly dominated by the phenomenon of fibrosis, replacement normal tissues in the connective tissue, swelling, excessive growth of the remaining muscle fibers and impregnating the walls of the intestine tissue liquid. All this disturbs the normal functioning of the intestine and its reduction to help the passage of food masses on it. Also broken and full innervation of the intestine, which together gives a predisposition to constipation and spastic abdominal pain.
symptoms dolihosigmoy
The disease usually manifests itself in early childhood, parents report persistent problems with a chair in the form of constipation, stool is very dense or fragmented dry stool.
Furthermore, the second main complaint with dolichosigma become recurrent attacks of pain, spastic nature in the stomach, especially the lower part thereof along the intestine.
Usually constipation start to arise since the child translation in artificial mixture or after introduction of complementary foods, some children develop chronic constipation at the time of passing on the overall table with family 2-3 years.
In addition to violations of bowel movements, typical manifestations dolihosigmoy are:
- abdominal pain or spastic Expander nature,
- flatulence, Bloating,
- nausea and vomiting with prolonged constipation,
- malabsorption of vitamins, self-poisoning symptoms of metabolic products.
Child pale enlarged abdomen size against the general asthenia and thinness, tongue dry and furred thick coating may be halitosis. There have brittle nails and hair, Zayed corners of the mouth, under-eye circles.
developmental stage
During dolihosigmoy occurs in three clinical stages:
- compensated,
- subcompensated,
- decompensated.
When the compensated stage there are occasional problems with the chair in almost healthy child, but x-rays revealed elongation of the colon. There may be attacks of pain in the abdomen, but they are rare. Pain alleviated or disappear after enemas and discharge of stool. Physical development of children do not suffer, the stomach is not painful, normal shape.
In subcompensated dolihosigmoy form of constipation may occur for two or three days, then there is the chair independently. Constipation and stronger expression in times of low consumption of fiber fruits and vegetables. Problems with a chair, and abdominal pain occur almost every week, there is bloating, stool often will not leave on their own, which encourages parents to enemas. The abdomen can be inflated in the lower half, is increased in size.
Decompensation problems arise every day, stool is delayed up to five days, departs only after the enema, abdominal pain and flatulence strong, belly swollen, strongly increased in size, the physical development seriously suffers.
must be distinguished from the similar flowing dolihosigmoy Hirschsprung's diseaseWhich is heavier in terms of treatment.
Diagnostics
The basis of the diagnosis - a complaint to the persistent constipation, and abdominal pain in children since the introduction of a tighter supply. Basis setting dolihosigmoy diagnosis - palpation of the abdomen to the intestines as the definition of dense, filled with feces cord, which expanded and extended. But an accurate diagnosis will only install x-ray contrast agent. On X-rays will be clearly visible form and gut size, its relative location in the abdominal cavity.
Additional studies may be other than the above:
- cal flora (seeding)
- coprogram,
- Ultrasonic scanning of internal organs, especially liver ultrasound.
If necessary, additional research is conducted gastroscopy, Colonoscopy or sigmoidoscopy, A visual inspection of the bowel wall.
dolihosigmoy treatment
The mainstay of treatment - a surgeon and pediatrician supervision, conservative therapy with a balanced diet and laxative products. Also important is daily routine and diet, which must be observed without any breaks.
Children designate soft laxative agents - Duphalac or lactulose. It begs the dose individually based on the degree of violation before the regular soft stools.
In a hospital with advanced cases apply:
- dibazol and proserine courses for 15 days,
- B vitamins,
- method of electrical guts,
- to consolidate the results shown up care in a specialized sanatorium.
Surgical treatment dolihosigmoy assigned rarely, in special cases, where there is a strong, persistent and long-term constipation, bowel expansion progresses and reveals persistent defeat her neuromuscular apparatus.
In these cases, produce excessive resection of the bowel loops, in very rare cases, the intestine is completely excised.
Forecast
In most cases, dolihosigmoy life prognosis is quite favorable, as growth and development of many disorders are compensated, and the chair becomes an independent and complete.
Surgical treatment is now used in exceptional cases.
