Proctosigmoiditis - causes of the disease, diagnosis of the ICD 10, focal and spastic inflammation of the rectum and sigmoid colon

Recently, it is not uncommon for a patient undergoing a gastrointestinal disease examination to be diagnosed as having a proctosigmoiditis. This disease is characterized by the development of a pathological inflammatory process that is localized on the mucosa of the rectum and sigmoid colon. It arises for the most part in the case when there has not been adequate treatment of colitis, which has passed into a chronic form, and can have both a focal and spastic type of development. The proctosigmoiditis is classified according to the following manifestations:

  • By the nature of the disorders occurring in the motor function of the intestine, it can be either spastic, or focal or paralytic;
  • Inflammation of the mucosa of the lower parts of the digestive organs is divided into erosive, ulcerative and catarrhal species;
  • The course of proctosigmoiditis is both acute and chronic, differing from each other only by the severity of the concomitant symptomatology.

All these manifestations are necessary for specialists to make an accurate diagnosis.

Reasons for the development of proctosigmoiditis

The specialists tend to attribute the etiology of this pathology to the following factors affecting the organism:

  • Protozoan or bacterial infection that lasts for a long time;
  • Dysbacteriosis or allergic reactions also cause proctosigmoiditis;
  • Occurrence in the patient can occur in the presence of a history of diseases of the gallbladder, liver, as well as gastritis, taking place against a background of reduced acidity, because they are incomplete splitting of food residues due to enzymatic deficiency, which leads to irritating effects on the mucosa;
  • Often causes the development of proctosigmoiditis and a factor of mechanical or chemical irritation with mucous alcohol, spicy food and coarse fiber. It can also be affected by mucosal trauma caused by the release of dense feces occurring during constipation.

In addition, patients at risk, that is, suffering from gastrointestinal diseases, should beware of uncontrolled intake of laxatives, as they also provoke the development of proctosigmoiditis. The same action can have a long-term use of anti-inflammatory drugs of non-steroid type or antibiotics.

Types of the development of the disease proctosigmoiditis

With this pathology localized in the lower intestine, its varieties such as focal, paralytic and spastic proctosigmoiditis are distinguished. All of them have similar symptoms, but some differences both in clinical signs and features of motor disability, and in form:

  1. Spastic proctosigmoiditis is the most easily amenable to therapy, and, for the most part, results in complete recovery of the patient. It corresponds to the acute form of the flow and is characterized by such signs as weakness of the functional action of the sphincter of the anus, false desires for defecation and pain in it, involuntary bloody, mucous or purulent discharge instead of stool. Treatment of this type of pathology consists mainly in observing the appropriate diet and using folk remedies that relieve unpleasant symptoms;
  2. Focal proctosigmoiditis can be characteristic of both acute and chronic type of course. It is characterized by the fact that on inflamed mucosa due to additional chemical or mechanical irritation erosive foci arise, which can often bleed. Treatment with this variety requires a longer, with the use of medications;
  3. Paralytic proctosigmoiditis. This is the most severe form that develops in chronic course. The reason for it is both infectious lesions of the digestive organ, and the patient's constant non-compliance with the instructions of the specialist. The clinical manifestation of proctosigmoiditis taking place in this form are paralytic disorders in the mucosa of the rectus and the sigmoid colon. They develop due to the long-flowing inflammatory process, as well as the formation of numerous erosions and ulcers on the walls of the lower gastrointestinal tract. The treatment of this form of proctosigmoiditis is very long and is mainly aimed at achieving longer periods of remission.

In order for the treatment of any kind of this pathology to have the greatest positive effect, it is required to conduct all the studies that can show the specialist how its form of flow, manifested in the mucous changes and the nature of development, and the cause of the occurrence. Only in the presence of all these indicators can be selected the most correct tactics of therapy of proctosigmoiditis.

Diagnosis of proctosigmoiditis

The main method of investigation for suspected proctosigmoiditis is an instrumental method using rectoscopy. It is performed after the patient is questioned and the palpation of the anus is performed, with confirmation of the possibility of developing proctosigmoiditis. This method allows to reveal the place of localization of the negative process and the presence of defects( internal hemorrhoids, fistulas, anal fissures), which contributes to the formulation of the most accurate diagnosis.

When the process occurs not only in the rectum, but also spreads into the sigmoid colon, it will also be necessary to perform a colonoscopy, in order to be able to exclude other diseases with similar symptoms. But for carrying out these procedures, which give the greatest accuracy to the diagnosis such as proctosigmoiditis, it is necessary to apply only to a specialized institution. This must be done for the reason that preparation for them is quite serious, and if it is not carried out, a reaction is possible that will give a false impression of inflammatory changes in the rectum and sigmoid colon.

Methods for treating proctosigmoiditis

When the patient is diagnosed with the disease as a result of the research, do not despair immediately. No matter how terrible and unpleasant this inflammation of the rectus and sigmoid colon did not seem, with proper therapy it is possible to achieve, if not complete recovery, the longest periods of remission.

The tactics of treating proctosigmoiditis completely depend on the severity of the course. But in whatever stage this pathology was, and whatever form it had, focal or spastic, the basis of therapy with it will be the compulsory observance of a sparing diet. In order to treat the proctosigmoiditis at the proper level, the patient should give preference to dietary dishes, which are presented by liquid porridges on water and mucous soups. Vegetables and fruits are allowed only without the skin and in a processed form, otherwise they can cause the aggravation of the symptoms of proctosigmoiditis.

Against the backdrop of the diet, other methods of therapy are conducted. With regard to drug treatment, this pathology prescribes antibiotics, eubiotics, cholinolytics, and other drugs that help restore intestinal microflora. Also, compulsorily when prescribing treatment necessary for high-quality therapy of proctosigmoiditis, specialists prescribe medicinal enemas that have a direct effect on the mucosa. Additional therapeutic methods are spa treatment at sources of mineral waters and physiotherapy procedures.

Classification of proctosigmoiditis according to ICD 10

Due to the fact that to date, endoscopic studies have not been performed at the proper level, proctosigmoiditis has often not been differentiated from other bowel pathologies, and therefore it has not received appropriate treatment. With the development of instrumental diagnostic methods, all varieties of proctosigmoiditis were classified in ICD-10 in one group with code K63.8.1, which enabled specialists to conduct more adequate treatment of this disease of the digestive organs.

Thanks to a nosological classification, a specialist can easily isolate this pathology among many other similar in terms of symptoms and location of localization. In addition, according to the ICD 10 code, it is quite easy to select the appropriate proctosigmoiditis or its variants for treatment. Yes, and the diagnosis made in accordance with the international classification of diseases is most understandable to specialists, therefore, when the doctor is forced to change the patient does not have to go through again all the not very pleasant endoscopic examinations, and also to specify the method of the treatment.

The prognosis of proctosigmoiditis can be called favorable. The course of the disease, although it can take a chronic character, but recurrent, not progressive. Treatment in most cases is effective, in almost half of patients, a stable remission is achieved. The risk of developing colorectal cancer in this group is the same as in the general population.

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