About Diverticulitis

Overview

Diverticulitis is a condition where small pouches, called diverticula, in the colon become inflamed. These diverticula are formed when weak spots in the colon's wall push outward. Diverticulosis is the term used when someone has these pouches in the colon without inflammation. It is relatively common, affecting more than 30% of adults in the United States between the ages of 50-59 and more than 70% of those older than 80. However, less than 5% of people with diverticulosis develop diverticulitis. Symptoms of diverticulitis can include pain (usually in the lower left side of the abdomen), diarrhea or constipation, nausea or vomiting, fever, and chills. The pain can vary in intensity and may come on suddenly or worsen over several days. The exact cause of diverticulitis is not fully understood, but it is believed to be related to factors such as a low-fiber diet and increased pressure within the colon.

Causes and Risk Factors

The cause of diverticulitis is believed to be related to the obstruction of the diverticulum by fecal material, leading to inflammation of the mucosa and subsequent congestion, mucosal trauma, and ischemia. Complicated disease, which occurs in about 12% of patients with diverticulitis, is characterized by perforation, abscesses, obstruction, and/or fistulas. Genetic factors, environmental factors, changes in the intestinal microenvironment (including microbiota imbalance, mucosal inflammation, and neuro-immune alterations), and changes in the architecture of the colon wall (such as enhanced collagen crosslinking and reduced elasticity) all play a role in the pathophysiology of diverticulitis.

Non-modifiable risk factors for diverticulitis cannot be changed or controlled. These include:

• Older age
• Male sex
• Certain genetic syndromes (such as Marfan and Ehlers-Danlos)

Modifiable risk factors for diverticulitis can be influenced or changed. These include:

• Red meat consumption
• Certain medications (such as NSAIDs, steroids and opiates)
• Obesity
• Hypertension
• Hypothyroidism
• Type 2 diabetes
• Smoking.

These factors can be modified through lifestyle changes or medical interventions. However, it's important to consult with a healthcare professional for personalized advice on managing these risk factors for your specific situation.

Symptoms

Common early symptoms of diverticulitis include:

• Abdominal pain, usually on the lower left side
• Abdominal bloating and cramping

Other symptoms include:

• Loss of appetite
• Nausea
• Vomiting
• Not passing gas or stool

In some cases, diverticulitis can cause complications, leading to more severe symptoms such as:

• Increasing pain
• Fever
• Bloody stools

It's important to note that symptoms can vary from person to person, and not everyone will experience all of these symptoms. If you suspect you may have diverticulitis or if your symptoms worsen, it is crucial to seek immediate medical attention. Your doctor can diagnose the condition and provide appropriate treatment based on your individual situation.

Diagnosis

To diagnose diverticulitis, doctors commonly perform the following examinations, tests, and procedures:

• History and Physical examination: A doctor will conduct a physical exam and ask questions about your symptoms and medical history.
• Blood test: A blood test, such as a complete blood count, can detect signs of infection.
• Stool sample: A stool sample may be taken to check for blood, bacteria, and parasites.
• CT scan: This imaging test can show inflamed diverticula in the intestine and help determine the severity of diverticulitis.
• Barium enema: During a barium enema, a liquid is injected through the anus to make the colon visible on an X-ray.
• Sigmoidoscopy: This procedure uses an endoscope to capture images of the sigmoid colon.
• Colonoscopy: Similar to sigmoidoscopy, a colonoscopy can visualize the entire colon and take tissue samples for biopsy.

Remember to consult with your healthcare professional for personalized advice as they will determine which examinations, tests, and procedures are appropriate for your individual situation.

Treatment Options

The goals of treatment for diverticulitis are to clear up the infection, relieve symptoms, and prevent complications. The recommended treatments vary depending on the severity of the condition:

Medications:

• Antibiotics: These are commonly prescribed to treat diverticulitis and help clear the infection.
• Pain medication: Over-the-counter pain medication, such as acetaminophen, may be recommended to relieve discomfort.

Therapeutic procedures:

• Abscess drainage: If abscesses (pus-filled sacs) form, they may need to be drained by an interventional radiologist or surgeon.
• Surgery: In severe cases or if there are repeated episodes, surgery may be necessary. This involves removing part of the colon or creating a temporary colostomy.

Self-care and health behavior changes:

• Liquid diet: In mild cases, a liquid diet may be advised to give the colon a break and allow it to heal.
• Fiber supplementation: Increasing fiber intake: Consuming a high-fiber diet can help prevent future episodes of diverticulitis. Adding fiber to the diet can help soften stools and reduce strain on the colon.
• Hydration: Drinking plenty of fluids helps maintain regular bowel movements.

It's important to note that treatment should be individualized based on each person's specific situation. Consult with a healthcare professional for personalized advice.

Medication dosing may be affected by many factors. Check with your healthcare professional about dosing for your individual situation. Side effects can occur. Check with your healthcare professional or read the information provided with your medication for side effect information.