Diverticulitis

What is Diverticulitis?

Diverticulosis is the presence of bulges in the colon wall. When these bulges become inflamed and/or infected, the condition is known as diverticulitis. These bulges are more common after age 40 and in the descending colon. Other risk factors for diverticular disease are males, overweight, people who consume a low-fiber diet and one high in fats and red meats. The cause of diverticulosis is not completely known, but there may be a relationship between not eating enough fiber and the presence of bulges in the colon. Not eating enough fiber can produce constipation which can cause a strain on the walls of the colon creating these bulges. Then, diverticulitis is assumed to happen when the bacteria common in stool gets trapped in these bulges and causes infection.

What are the symptoms of Diverticulitis?

Diverticulosis, which is the presence of bulges, does not usually cause symptoms. Diverticulitis causes the following symptoms: 

  • Abdominal tenderness
  • Abdominal cramps and pain
  • Constipation
  • Bloating 
  • Fever
  • Nausea or vomiting

What are the complications of Diverticulitis?

  • An intestinal blockage caused by scarring
  • An abscess can occur when pus collects during the infection
  • Peritonitis: if the infected pouch ruptures, the infection can move the whole peritoneal cavity. This is a medical emergency¬†

How is Diverticulitis diagnosed?

Diverticulitis is commonly diagnosed when symptoms of an acute attack are present. A physical exam and patient history are required for diagnosis. A blood test to check for infection is usually ordered as well as a stool sample to look for bacteria and possible blood. A CT scan can also be used to check for inflammation and the presence of pouches in the colon wall. 

How is Diverticulitis treated?

Treatment is based on the severity of the diverticular attack. If symptoms are mild, the treatment is mainly outpatient with the use of antibiotics and a liquid-based diet.  After symptoms improved, it is recommended to start eating fiber-containing foods to avoid constipation. If severe symptoms are present, or an abscess or perforation is suspected which may need surgery, then inpatient treatment is recommended. To help prevent diverticulitis it is recommended to drink a lot of fluids as well as eat a diet rich in fiber. 

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What are the differential diagnoses of Diverticulitis?

  • Infectious colitis
  • Inflammatory bowel disease
  • Intestinal ischemia
  • Appendicitis 

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