Colon diverticula: prevention

For the prevention of diverticulitis and treatment it is necessary to normalize the intestinal microflora. For this purpose, it is necessary not only to influence certain conditionally pathogenic microorganisms, but also to increase the reactivity of the macroorganism. Patients prescribe vitamins, desensitizing agents, eubiotics, biological preparations (bifidumbacterin, lactobacterin, bifikol for 1.5-2 months).

When exacerbation of chronic diverticulitis is recommended bed rest. The patient should be hospitalized to avoid complications. In severe cases during the first 1-3 days parenteral nutrition, detoxification therapy with compensation of fluid deficiency, electrolytes, vitamins are shown, for the next 5-10 days - semi-liquid easily assimilated food with reduced calorie content (table type No. 4) for the purpose of maximum mechanical and chemical bowel movements. Then the diet gradually expands. From the first hours, in addition to spasmodic and cholinolytic agents, antibiotics of a wide spectrum of action for 10-14 days (ampicillin, tetracycline, gentamicin, ciprofloxacin, etc.) are given. Difficultly adsorbed antibiotics and sulfonamides are ineffective, since the treatment involves the elimination of an infection localized not only in the luminal gut, but also in the tissues. Studies of the flora of stool and blood in an acute picture of the disease can not initially help in the choice of antibiotics, but in the future they make possible the correction of therapy.

In future, according to the indications (with the preservation of signs of inflammation), the course of treatment is carried out by other means with antibacterial action - metronidazole, nitrofu-wound line preparations, nicodine, inte- trix. The latter is an intestinal antiseptic with a wide range of anti-infective activities, including intestinal antifungal, effective for diarrhea.

With persistent constipation with exacerbation of chronic diverticulitis, laxative agents of contact action - gutalax, bisacodyl or norma, which increases the volume of intestinal contents due to direct and osmotic action (due to metabolism by its colon bacteria with the formation of low molecular acids) are used. Acidification of the contents of the colon helps normalize the intestinal microflora. Vaseline oil may be prescribed for a short period of time. Enema due to the danger of perforation of diverticula during this period is contraindicated.

In most patients with exacerbation of chronic diverticulitis conservative treatment gives definite results. With the development of the above complications, surgical treatment is required. Choosing the right time for surgery is a difficult and critical decision in clinical gastroenterology.

The method of "embolizing" vessels is used to stop bleeding from the distal parts of the digestive tract, in particular with bleeding from diverticula of the colon, since the colon has a relatively limited collateral blood supply, and the surgical treatment of such bleeding is quite complex.

Against the backdrop of the aggravation of the inflammatory process (stage II of treatment of exacerbation of chronic diverticulitis), funds are prescribed with a local astringent, enveloping, adsorbing action, eubiotics. At the III stage (3-4 weeks later), microclysters with a solution of collargol, antipyrine, chamomile (within 10-14 days).

With chronic diverticulitis without exacerbation of antibacterial drugs are not recommended. Treatment immediately begins with stage II. With a slow inflammatory process, it is advisable to conduct a 7-10-day course of anti-inflammatory treatment.

At a diverticular disease of a colon patients are subject to a dispensary observation.

[1], [2], [3], [4], [5]