OVERVIEW

What is sigmoiditis?

Sigmoiditis refers to a broad category of diseases characterized by inflammation of the sigmoid colon caused by various pathogenic factors. Its primary pathological features include mucosal congestion, edema, erosion, and other changes^[1].

Sigmoiditis can occur at any age. Based on etiology, it may result from viral, bacterial, or Mycobacterium tuberculosis infections, as well as immune-related conditions such as Crohn's disease or ulcerative sigmoiditis.

The main clinical manifestations of sigmoiditis include abdominal pain, diarrhea, or constipation. Mild cases may involve 3–4 loose bowel movements per day, while severe cases can present with over 10 episodes of diarrhea daily, accompanied by abdominal pain, mucus discharge, or even purulent stool. Tenesmus (a persistent urge to defecate despite incomplete evacuation) may also occur. Some patients experience alternating constipation and diarrhea, along with symptoms like weight loss and fatigue.

Is sigmoiditis common?

Sigmoiditis is a relatively common clinical condition, characterized by inflammatory lesions of the sigmoid colon mucosa due to damage.

Its triggers are diverse, including poor dietary habits, lifestyle factors, environmental influences, infections, and autoimmune disorders. It can affect individuals of any age.

Can untreated sigmoiditis lead to cancer?

Untreated sigmoiditis may potentially progress to cancer^[2].

Sigmoiditis involves mucosal damage in the sigmoid colon, leading to congestion, edema, and erosion. Persistent untreated inflammation may increase the risk of malignant transformation. Early medical consultation and standardized treatment are crucial to prevent complications.

SYMPTOMS

What are the common manifestations of sigmoiditis?

The common clinical manifestations of sigmoiditis include changes in stool characteristics, abdominal pain, mucus or bloody stools, tenesmus, and other symptoms.

1. Changes in stool characteristics. During the active inflammatory phase of sigmoiditis, the main symptoms are loose stools and diarrhea, with mild cases involving 3–4 bowel movements per day and severe cases reaching dozens of times per day.
2. Abdominal pain. Mild to moderate pain, usually in the lower left abdomen, may extend to the entire abdomen in severe cases and can recur repeatedly.
3. Mucus or bloody stools. Due to prolonged severe irritation damaging the intestinal mucosa, mucus secretion increases, leading to mucus in stools. In cases of ulceration, pus and bloody mucus may also appear in stools.
4. Tenesmus. Persistent inflammation stimulates the rectum and anus, creating a frequent urge to defecate, which may temporarily ease after bowel movements.
5. Other symptoms. These may include nausea, bloating, loss of appetite, weight loss, fatigue, and similar symptoms.

CAUSES

What are the causes of sigmoiditis?

There are many causes of sigmoiditis, which may be related to genetic factors, infectious factors, immune factors, etc.

1. **Genetic factors.** The probability of developing ulcerative sigmoiditis or Crohn's disease in the next generation with a family history is significantly higher than in the general population.
2. **Infectious factors.** Infections caused by bacteria, viruses, or Entamoeba histolytica can trigger inflammation of the sigmoid colon, such as viral sigmoiditis, bacterial sigmoiditis, or amoebic sigmoiditis. Additionally, infection with Mycobacterium tuberculosis in the sigmoid colon may manifest as paroxysmal abdominal pain (relieved after defecation), alternating diarrhea and constipation, fever, night sweats, and other symptoms.
3. **Immune factors.** Immune imbalance may also be a key factor in the onset of sigmoiditis. Inflammation of the sigmoid colon mucosa due to various reasons can further induce ulcerative sigmoiditis or Crohn's disease.

What are the types of sigmoiditis?

Sigmoiditis can be divided into two types: specific sigmoiditis (e.g., viral, bacterial, protozoal infections) and non-specific sigmoiditis.

1. **Specific sigmoiditis.** Main symptoms include abdominal pain and diarrhea.

   • **Viral sigmoiditis:** Inflammation of the intestinal mucosa in the sigmoid colon caused by viral infection.
   • **Bacterial sigmoiditis:** Bacterial infection in the sigmoid colon leading to local mucosal damage and inflammatory reactions.
   • **Protozoal colitis:** Colitis caused by protozoa such as Giardia, Toxoplasma, or hookworms, related to dietary habits and personal hygiene.

2. **Non-specific sigmoiditis.** Includes ulcerative sigmoiditis and Crohn's disease, which may be related to genetic, immune, or infectious factors. This type of sigmoiditis not only presents significant intestinal symptoms but also varying degrees of extraintestinal symptoms and signs.

Who is at high risk for sigmoiditis?

High-risk groups for sigmoiditis include those with poor diets, irregular lifestyles, a family history of non-specific sigmoiditis, and individuals with weak constitutions.

1. **Poor diet.** Long-term consumption of high-fat, high-protein, spicy, or irritating foods, heavy smoking, excessive alcohol intake, and frequent consumption of fried foods can irritate the sigmoid colon mucosa and easily induce sigmoiditis.
2. **Irregular lifestyle.** Frequent late nights and irregular routines leading to excessive fatigue can cause gastrointestinal dysfunction and weaken the protective barrier of the sigmoid colon mucosa, triggering the disease.
3. **Family history of non-specific sigmoiditis.** Including ulcerative sigmoiditis and Crohn's disease, family members with these conditions significantly increase the likelihood of offspring developing sigmoiditis compared to the general population.
4. **Weak constitution.** Frequent overexertion, chronic illness, or physical weakness can make individuals more susceptible to bacterial or viral infections, thereby inducing sigmoiditis.

Is sigmoiditis hereditary?

Whether sigmoiditis is hereditary depends on its type. Non-specific sigmoiditis may be hereditary, while specific sigmoiditis is not.

1. **Non-specific sigmoiditis.** Includes Crohn's disease and ulcerative sigmoiditis, which have a certain hereditary tendency. Patients with a history of these conditions may pass them on to their offspring, with a higher incidence in their descendants compared to the general population^[3].
2. **Specific sigmoiditis.** Caused by infections such as bacteria, viruses, Mycobacterium tuberculosis, Rickettsia, or Mycoplasma, it is not hereditary, and the likelihood of offspring developing the disease is not significantly different from others.

Patients with sigmoiditis are advised to seek early medical attention, visit reputable healthcare institutions for tests such as stool analysis and colonoscopy, identify the cause, and receive targeted treatment.

DIAGNOSIS

Under what circumstances should patients with sigmoiditis seek medical attention promptly?

Sigmoiditis primarily manifests as abdominal pain, diarrhea, mucus-filled stools, or bloody stools. Prolonged diarrhea may lead to electrolyte imbalances, acid-base disturbances, and in severe cases, dehydration, water-electrolyte imbalance, hypoproteinemia, fever, or even shock. Chronic diarrhea can impair nutrient absorption, potentially causing malnutrition and severe anemia.

If the above symptoms occur, it is advisable to seek medical attention at a正规医疗机构 promptly to identify the cause and initiate treatment as early as possible.

Which departments should sigmoiditis patients visit for medical care?

Patients with sigmoiditis may consult the gastroenterology department, digestive clinic, or general surgery department.

What examinations are generally required for sigmoiditis patients during a medical visit?

Depending on the condition, sigmoiditis patients typically undergo abdominal palpation, stool routine and occult blood tests, colonoscopy, blood tests,病理学检查, and imaging studies.

1. Abdominal physical examination: Mild cases may show no阳性体征 or only tenderness in the lower left abdomen; severe cases may present with abdominal pain, muscle rigidity, or a palpable, rigid sigmoid colon.
2. Stool routine and occult blood tests: To detect red/white blood cells or pathogens via stool culture.
3. Colonoscopy: Reveals mucosal充血,水肿, erosions, ulcers, or bleeding tendencies; biopsies may be taken if necessary.
4. Blood tests: White blood cell and neutrophil counts indicate infection; red blood cell and hemoglobin levels assess active bleeding or anemia.
5. Pathological examination: Biopsy samples determine malignancy,病变性质, severity, and extent.

What questions might doctors ask sigmoiditis patients during a visit?

Patients should prepare answers to the following for efficient diagnosis:

1. What abnormal symptoms are present?
2. Initial symptoms, triggers, duration, and severity of symptoms?
3. Recent consumption of contaminated food?
4. Prior similar episodes?
5. Recent antibiotic use?
6. Previous test results?
7. Family history of intestinal diseases?
8. Names of long-term or newly added medications?

TREATMENT

What treatments do patients with sigmoiditis generally need when they go to the hospital?

Patients with sigmoiditis who visit the hospital require general treatment, medication, or surgery depending on the cause and severity of their condition.

1. General treatment. Ensure adequate rest, avoid fatigue, consume nutritious, easily digestible, and light foods, and replenish fluids and electrolytes.

2. Medication. Different medications are selected based on the underlying cause:

   • Viral infection: Antiviral drugs (e.g., acyclovir, ganciclovir) may be used, combined with medications like smectite and bifidobacteria for treatment.
   • Bacterial infection: Antibiotics such as norfloxacin, levofloxacin, or amoxicillin may be prescribed.
   • Non-specific sigmoiditis: Immunotherapy drugs like mesalazine, azathioprine, or prednisolone may be used.

   Patients with severe diarrhea who cannot absorb nutrients normally may require temporary fasting and intravenous nutrition, such as amino acids, vitamins, fat emulsions, and electrolytes.

3. Surgery. Emergency surgery is necessary for patients with severe bleeding, intestinal perforation, or worsening symptoms.

What medications are generally effective for patients with sigmoiditis?

Patients with sigmoiditis should take appropriate medications based on the cause, such as antibiotics, smectite, probiotics, antifungal drugs, or aminosalicylates^[1].

1. For bacterial infections, antibiotics like norfloxacin or levofloxacin may be prescribed for anti-inflammatory treatment, combined with smectite to relieve diarrhea and probiotics like bifidobacteria or Saccharomyces boulardii to regulate gut flora.
2. For fungal infections, antifungal drugs like fluconazole or itraconazole may be used.
3. For ulcerative sigmoiditis or Crohn's disease, aminosalicylates such as sulfasalazine or olsalazine may be prescribed. Severe cases may require corticosteroids like prednisone or methylprednisolone.

Patients with sigmoiditis should consult a doctor for medication guidance and avoid self-medication.

Can sigmoiditis heal on its own?

Mild cases of sigmoiditis may resolve on their own, but severe cases require proper treatment.

If caused by a viral infection with mild symptoms, dietary adjustments may lead to self-recovery.

If caused by bacterial, mycoplasma, or tuberculosis infections, antibiotic treatment is usually necessary for a cure.

Non-specific sigmoiditis (e.g., ulcerative sigmoiditis or Crohn's disease) is difficult to cure completely and can only be managed symptomatically.

Therefore, patients with sigmoiditis should seek early medical attention to identify the cause and receive timely treatment to avoid worsening the condition.

DIET & LIFESTYLE

What should patients with sigmoiditis pay attention to in daily life?

Patients with sigmoiditis should focus on dietary adjustments, psychological care, maintaining a proper routine, and moderate exercise.

1. Dietary adjustments. Maintain food hygiene to avoid intestinal infections. Avoid spicy, irritating, raw, cold, or high-fiber foods, and refrain from alcohol. For severe cases, opt for semi-liquid, easily digestible, and nutrient-rich foods, consumed in small portions multiple times a day.
2. Psychological care. Due to its prolonged and recurrent nature, sigmoiditis may cause anxiety in many patients. Family members should communicate more with the patient to alleviate anxiety, avoid emotional agitation, and maintain a cheerful mood. A positive mental state aids in recovery.
3. Proper routine. Develop a regular schedule, ensure adequate sleep, avoid staying up late, and prevent excessive fatigue.
4. Moderate exercise. Rest more during acute phases, while light activities like walking, brisk walking, or jogging are suitable during remission periods.

What foods should patients with sigmoiditis avoid in their daily diet?

Patients with sigmoiditis should avoid raw, cold, spicy, and irritating foods. In severe cases, fasting is recommended, during which parenteral nutrition can be used to meet the body's energy needs, allowing the intestines to rest and reducing inflammation.

Daily meals should primarily consist of easily digestible, nutrient-rich liquids or semi-liquids, consumed in small, frequent portions.

PREVENTION

Can Sigmoiditis Be Prevented? How to Prevent It?

Sigmoiditis is a common and frequently occurring disease with multiple causes. Avoiding suspected pathogenic factors can reduce its incidence. Prevention can be achieved through a reasonable diet, regular routine, good bowel habits, exercise, and maintaining a positive mood.

1. Reasonable diet. Quit smoking and alcohol, avoid spicy, irritating, raw, cold, and fried foods. Eat regularly, consume small portions of easily digestible and nutritious foods multiple times a day.
2. Regular routine. Avoid staying up late, develop a regular sleep schedule, ensure adequate rest, and prevent overexertion.
3. Good bowel habits: Defecate at a fixed time daily to avoid diarrhea and constipation.
4. Exercise. Choose suitable activities such as jogging, brisk walking, badminton, yoga, or tai chi. Moderate exercise enhances physical fitness and boosts disease resistance.
5. Maintain a positive and cheerful mood, and avoid tension, anxiety, and depression in daily life.

Which Lifestyle Habits Easily Lead to Sigmoiditis?

Poor dietary habits, irregular routines, and bad bowel habits can easily cause sigmoiditis.

1. Unhealthy eating habits. Frequently consuming greasy, raw, cold, or irritating foods, excessive alcohol, smoking, or fried foods such as chili, mustard, curry, fried chicken, or icy drinks can irritate the sigmoid colon wall, causing local mucosal congestion, swelling, and inflammation.
2. Irregular routines. Frequently staying up late, having an irregular schedule, and lacking sufficient sleep can trigger gastrointestinal dysfunction, damaging the intestinal protective barrier and leading to sigmoiditis.
3. Poor bowel habits. Failing to develop regular bowel movements or deliberately holding in stool can easily cause constipation, which may negatively affect the intestines over time.