Sigmoiditis (diverticulitis): symptoms and treatments

Sigmoiditis is a inflammation of part of the colon called “sigmoid” and more particularly diverticula. It manifests itself in various symptoms including strong pain in the lower abdomen. There are several treatments to cure it. Some dietary precautions are to be adopted to relieve crises. What are the causes sigmoiditis? How to establish the diagnostic ? What are the foods to avoid? How to calm an attack of sigmoiditis?

Definition: what is sigmoiditis?

Sigmoid is an adjective denoting something in the shape of an “S”. We speak in particular of the sigmoid colon, sometimes just the sigmoid, to define the terminal part of the large intestine or colon, located between the descending colon and the rectum. The sigmoid colon is the part of the colon most affected in the inflammation of the diverticula, kinds of small pockets developed at the expense of the colonic wall: we then often speak of acute diverticular sigmoiditis. Sigmoiditis is a inflammation or infection of the part of the colon called the “sigmoid” and more particularly of the diverticula which are present there. Diverticula are small hernias of the mucosa, the inner lining of many organs, located in the large intestine. They form at the level of areas of weakness of the wall: we speak of diverticulosis. When they appear, they create grooves where bacteria can lodge, which can cause inflammation: this is called sigmoid diverticulitis, or diverticular sigmoiditis.

What are the symptoms of sigmoiditis?

“Diverticula are asymptomaticit is their complication that generates symptoms” Dr. Tarrerias, gastroenterologist and proctologist, immediately advances before continuing: “It could be infection of a diverticulum (diverticulitis), sigmoid (sigmoiditis), or even an abscess and more rarely from peritonitis or a fistula.” The diverticulum may also bleed if inflamed and induce hemorrhage especially if the patient is taking blood thinners. Sigmoiditis is a pathology that manifests itself by severe pain in the lower abdomen, mainly at the level of the left iliac fossa, the iliac fossa being the lower part of the abdomen; a moderate fever can also be associated.

What causes sigmoiditis?

The causes of sigmoiditis are poorly understood, but a diet low in fiber could be a contributing factor.

When to consult for sigmoiditis?

Symptoms can easily be confused with those of other digestive disorders. Constipation that persists, unusual pain in the lower left abdomen, blood in the stool, and nausea should lead to consultation.

To confirm sigmoiditis, additional examinations are prescribed such as blood tests, to look for markers of inflammation as well as the to scanwhich is the best test to confirm sigmoid diverticulitis.

Fruit and vegetable seeds should be avoided

What treatments to treat sigmoiditis?

First recommendation of Doctor Tarreiras as soon as the diagnosis is confirmed: “The patient must be left on an empty stomach in severe forms, or put on a diet without residues. Of the antibiotics are also given, usually for a period of 3 weeks.

When to operate for sigmoiditis?

The gastroenterologist explains that surgery is rarely preferred today : “Surgical sigmoidectomy is avoided as much as possible, preferring drainage of an abscess under radiological control. Sigmoidectomy is reserved for stenotic forms of the sigmoid and complicated by occlusion or subocclusion.

What foods to avoid in case of sigmoiditis?

For about ten days, the diet is also part of the treatment. The patient must respect a residue-free diet, which allows the intestines to rest. Various fiber-rich foods should be avoided, such as vegetables, fruits, bread, milk and dairy products, cold cuts… The foods allowed are meat, fish, pasta, rice, sweet products, cooked cheeses, rusks. Some foods can be eaten according to certain rules of preparation.

To prevent the appearance or reappearance of sigmoiditis, Dr. Tarrerias recommends above all the treatment of constipation: “Reducing the hyperpressure in the colon would limit the formation of diverticula and it is certain that the regularization of transit avoids the formation of stercoliths (small clusters of hard stools) which become blocked in the diverticula, generating their inflammation and bleeding. ” In case of diverticulosis it is therefore essential to use long-term transit regulators, or a high fiber diet. The gastroenterologist concludes with one last piece of advice: “On the other hand, we must avoid glitches which are stored in the diverticula: deseed the tomatoes and watch out for the grape seeds.”

What are the complications of sigmoiditis?

If sigmoiditis is not treated quickly, it can lead to complications:

• formation of a abscess characterized by exacerbation of clinical signs
• rupture of the colon wall either in the peritoneal cavity (membrane that surrounds the abdominal organs), responsible for a peritonitis, or in another organ located nearby. We will then speak of a fistula.

Thanks to Doctor Anne-Laure Tarrerias, gastroenterologist and proctologist in Paris.