Subdiaphragmatic Colon Implantation Syndrome

　　The cause of subdiaphragmatic sigmoid volvulus syndrome is not in the intestinal tract itself. The downward and abnormal position of the liver is the basis for the formation of the disease. It is often due to developmental abnormalities such as long, thin, or absent liver ligaments, causing the liver to descend and the gap between the liver and the diaphragm to widen, leading to the sigmoid colon being inserted between them. In addition, the congenital weakness of the diaphragm or diaphragmatic palsy is a triggering factor for the disease. Moreover, in some patients with liver cirrhosis, due to significant atrophy of the right lobe of the liver, the liver-diaphragm gap may also be large, and this symptom may also be seen.

　　When the sigmoid colon involved in the volvulus becomes obstructed, sudden and severe upper abdominal pain may occur, accompanied by a feeling of breathlessness and back pain. Subdiaphragmatic sigmoid volvulus syndrome is prone to complications such as intestinal obstruction, intussusception, and diaphragmatic hernia.

　　Subdiaphragmatic sigmoid volvulus syndrome can occur in both males and females, and is often asymptomatic in daily life. Some may manifest as upper abdominal discomfort, mild bloating, particularly in the upper right abdomen, which worsens after meals. Clinically, it is often misdiagnosed as cholecystitis or gastritis. When the sigmoid colon involved in the volvulus becomes obstructed, sudden and severe upper abdominal pain may occur, accompanied by a feeling of breathlessness and back pain. Symptoms may disappear after several hours to several days, and most of them disappear suddenly after activity.

　　The prevention of subdiaphragmatic sigmoid volvulus syndrome mainly focuses on early detection, early diagnosis, and early treatment to prevent the disease from worsening. The specific preventive measures are as follows.

　　1. More physical activities should be carried out to enhance immunity.

　　2. Maintaining a good attitude is very important. Keeping the mood pleasant, having an optimistic and open spirit, and a strong belief in overcoming the disease. Do not be afraid, only in this way can one mobilize the subjective initiative and improve the body's immune function.

　　3. Appropriate nutrition supply should not overemphasize high sugar, high protein, high vitamin, and low-fat diet under the current living conditions. However, the nutrition should be balanced, with a mix of meat and vegetables, fruits, meat, dairy products, etc., and the intake should be determined according to the person's body size. Smoking and drinking are strictly prohibited.

　　The diagnosis of subdiaphragmatic sigmoid volvulus syndrome mainly relies on auxiliary examinations in addition to clinical manifestations and signs. X-ray and ultrasound can show the sigmoid colon with gas accumulation between the diaphragm and liver (spleen) and shadows of colonic folds.

　　Patients with diaphragmatic colon entrapment syndrome should avoid eating foods that cause too much air swallowing and gas production. The specific dietary precautions are described as follows.

　　Firstly, dietary recommendations for patients with diaphragmatic colon entrapment syndrome

　　1. Abstain from food in the early stage of the disease.

　　2. Eat foods that promote bowel movement and emptying of the gastrointestinal tract.

　　3. Eat foods rich in calcium.

　　Secondly, dietary taboos for patients with diaphragmatic colon entrapment syndrome

　　1. Avoid eating heavy, rich foods.

　　2. Avoid eating rough, hard-to-digest foods.

　　3. Avoid eating high-starch foods.

　　4. Avoid eating fried foods.

　　5. Avoid eating foods that cause too much air swallowing and gas production. Foods like sweet potatoes, red beans, potatoes, taro, radishes, pumpkins, and chestnuts are all easily gas-producing foods in the gastrointestinal tract; side dishes such as taro and lean meat stew, braised beef with potatoes, braised chicken with chestnuts, and braised spareribs, while staple foods like the newfangled 'pumpkin cake', 'persimmon cake', or 'sweet potato cake' are also easy to produce gas in the gastrointestinal tract. These foods rich in starch, sugars, and fiber, when entering the gastrointestinal tract along with high-fat meats, are fermented by intestinal bacteria under the action of alcohol, producing a large amount of hydrogen sulfide and ammonia, accumulating in the intestines, causing symptoms such as gastrointestinal bloating, belching, heartburn, acid regurgitation, and abdominal pain. Particularly worth mentioning is the sweet potato, which contains a special 'gasification enzyme' that can produce acid and gas in the gastrointestinal tract, causing discomfort in many people after eating.

　　Mild cases of diaphragmatic colon entrapment syndrome usually do not require treatment. For those with more severe symptoms, active treatment is required. The specific treatment methods are described as follows.

　　1. Avoid swallowing too much air and eating foods that produce too much gas.

　　2. Lie flat to relieve pain symptoms during an attack.

　　3. Never take aspirin or other anesthetic painkillers for abdominal pain. Aspirin is harmful for abdominal pain, and anesthetic painkillers can mask symptoms and interfere with diagnosis.

　　4. For those with severe symptoms and progressive, persistent worsening, especially in children when symptoms are severe, affecting appetite, and hindering growth and development, consider radical surgical treatment. The prognosis for fixing the liver and colon is good.