Sigmoiditis is inflammation in a segment of the colon. It is a complication of diverticulosis of the colon which is an anatomical anomaly causing the formation of pockets on the surface of the colon. Diverticulosis of the colon is an abnormality that develops with age and is more common in industrialized countries.

Definition of sigmoiditis

Sigmoiditis, also called sigmoid diverticulitis or diverticular sigmoiditis, is inflammation of the sigmoid colon. The latter corresponds to a specific portion of the large intestine located before the rectum.

We often speak of acute sigmoiditis or acute sigmoid diverticulitis because this inflammation tends to appear suddenly and develop rapidly.

Cause of sigmoiditis

Sigmoiditis is a complication of colon diverticulosis (or colonic diverticulosis). It is an anatomical abnormality characterized by the formation of small pockets on the outer surface of the colon. Called diverticula, these pockets are hernias. They appear when the colonic lining (inner layer of the colon) pierces through the muscularis (outer layer of the colon).

While diverticulosis of the colon may remain asymptomatic (without clinical manifestation), inflammation of the diverticula may occur. This is called colon diverticulitis, and more generally sigmoiditis (or sigmoid diverticulitis).

Risk factors for sigmoiditis

The risk factors are those for diverticulosis of the colon. Mostly observed in industrialized countries, this anomaly is strongly linked to lifestyle:

• a diet low in fiber;
• excessive consumption of sugary foods;
• a lack of physical activity and a sedentary lifestyle.

People affected by sigmoiditis

Sigmoiditis can occur in people with diverticulosis of the colon. This is an acquired anomaly that develops with age. It is rare before the age of 30 and is present in more than 50% of individuals over the age of 70.

Among people with diverticulosis of the colon, it is estimated that about 70% will have no symptoms while the remaining 30% will develop diverticulitis, and mostly sigmoiditis.

Diagnosis is usually based on:

• a clinical examination;
• a blood test ;
• medical imaging exams.

Inflammatory signs

Sigmoiditis is manifested by inflammatory reactions:

• pain localized in the lower left of the abdomen (left iliac fossa);
• transit disorders with diarrhea or constipation;
• a feverish state with fever.

Possible complications

Sigmoiditis can sometimes become more complicated and lead to other problems:

• abscesses, that is, the local accumulation of pus;
• fistulas, the formation of an abnormal connection between two organs;
• peritonitis which is inflammation of the membrane covering the abdominal cavity;
• a stenosis which corresponds here to a narrowing of the colon;
• blood loss.

Conservative treatments

In the absence of complications, the management of sigmoiditis can be based on:

• the establishment of a liquid diet;
• antibiotic therapy;
• taking antispasmodics.

Management of complications

Other treatments may be necessary if there are complications. Drainage of abscesses can be done. Surgical sigmoid resection may also be considered in the event of complications or recurrence.

Prevention of sigmoiditis involves limiting the risk factors for diverticulosis. It is therefore recommended to:

• maintain a healthy and balanced diet, in particular allowing adequate intakes of fiber;
• limit sedentary lifestyle and maintain regular physical activity.