Diverticulitis

Diverticula are tiny pouches with protruding edges that can develop in the lining of your digestive tract. The bottom portion of the large intestine is where they are most frequently detected (colon). Diverticula are typical, particularly after the age of 40, and rarely create issues.

Diverticulosis is the medical term for the presence of diverticula. Diverticulitis is a disorder in which one or more of the pouches become inflamed and, occasionally, infected. Diverticulitis can result in excruciating stomach pain, fever, nausea, and a noticeable change in bowel patterns.

Rest, dietary modifications, and antibiotics can all be used to treat mild diverticulitis. Diverticulitis that is severe or keeps coming back may need surgery.

Diverticulitis: Causes

Diverticula commonly form when naturally brittle areas of your colon buckle under the strain. Because of this, pouches the size of marbles poke through the colon wall.

Diverticulitis develops when the diverticula ripen, causing swelling and, occasionally, infection.

Diverticulitis: Symptoms

Ongoing pain that lasts for several days. The discomfort often occurs on the lower left side of the abdomen. The right side of the abdomen can occasionally be more uncomfortable, particularly in those with Asian ancestry.

• Vomiting and nauseous

• Fever

• Tenderness in the abdomen

• Diarrheal or, less frequently, constipation

When to Visit a Doctor?

Seek medical assistance anytime you experience chronic, unexplained stomach discomfort, particularly if you simultaneously have a fever and constipation or diarrhea.

Complications from acute diverticulitis can include any of the following for about 25% of patients −

• Pus accumulating in the pouch leads to an abscess.

• An intestinal obstruction brought on by scarring.

• A pathological opening (fistula) between intestinal segments or the colon and other organs.

• If the infected or inflammatory pouch ruptures and spills intestinal contents into your abdominal cavity, peritonitis may result. Peritonitis is a medical emergency that has to be treated right away.

Diverticulitis: Risk Factors

Several factors play an important role in the development of diverticulitis which includes −

• Aging. Diverticulitis is more common as people age.

• Obesity. The likelihood of acquiring diverticulitis rises if you are overweight.

• Smoking. Diverticulitis is more prevalent in smokers compared to non-smokers.

• Absence of exercise. The risk of diverticulitis appears to be reduced by vigorous exercise.

• A diet low in fiber and rich in animal fat. Although the effect of low fiber on its own is unclear, a low-fiber diet coupled with high consumption of animal fat appears to raise the risk.

• Certain medicines. Many medications, including steroids, opioids, and nonsteroidal anti-inflammatory medicines (NSAIDs), such as ibuprofen and naproxen sodium, are linked to an increased risk of diverticulitis.

Diverticulitis: Diagnosis

The diagnosis of diverticulitis is mainly done based on history and some of the tests may be required for confirmation and to rule out underlying causes −

It's crucial to consult your healthcare practitioner if you experience diverticulitis symptoms to receive the proper diagnosis.

Your healthcare practitioner will first inquire about your medical history, including your present symptoms, the kinds of foods you often consume, how frequently you urinate, and other bowel movement-related inquiries. They will also go over any medications you are taking at the moment. Your doctor will feel your abdomen for soreness and discomfort.

Other exams that may be carried out or prescribed to aid with condition diagnosis include −

• Blood test − Your blood is examined for infection-related symptoms such as an elevated white blood cell count.

• Stool sample − Your stool sample is examined for the presence of unusual bacteria or parasites that might be the reason why you are experiencing symptoms like diarrhea, blood in the stool, stomach discomfort, or an infection.

• A finger that has been gloved and greased is gently inserted into the rectum during a digital rectal exam to feel for any anus or rectum issues.

• CT scan − A CT scan may both diagnose the degree of diverticulitis and indicate infected or inflamed diverticula.

• Lower gastrointestinal tract radiography, generally known as a barium enema, involves injecting a liquid containing barium into your anus. Your colon is coated on the inside by the fluids, which makes any issues there easier to see on X-rays.

• A thin, flexible tube with a light on the end is put into your rectum and advanced into your sigmoid colon during a sigmoidoscopy examination. A video camera is attached to the tube. The camera enables a visual examination of your rectum and sigmoid colon, which is where the majority of diverticula originate.

• Colonoscopy − With this procedure, your whole colon may be inspected. A colonoscopy, also known as a thin, flexible, lighted tube with a camera, is introduced into your rectum and your colon. Your colon is examined during a colonoscopy to look for any abnormal growths, lesions, ulcers, bleeding, or other issues that might result in altered bowel habits or abdominal pain. Polyps can be cut out and tissue samples can be collected.

Diverticulitis: Treatment

The treatment is based on the severity of the symptoms. Your doctor may advise conservative or surgical treatment.

Conservative Treatment

Conservative treatment includes −

• Antibiotics to treat infections, while updated recommendations say they may not be necessary for extremely mild instances.

• For a few days, only consume liquids until your bowels recover. You can gradually increase your intake of solid foods after your symptoms become better.

The majority of patients with simple diverticulitis respond well to this therapy.

You'll probably need to be admitted to the hospital if you experience a severe attack or have other medical issues. Therapy often entails −

• Antibacterial intravenously

• Placing a catheter within the abdomen to drain any existing abscesses

Surgical Treatment

There are two primary surgical procedures −

• Resection of the main bowel. Your gut is divided into good and damaged segments, which are subsequently connected by the surgeon (anastomosis). You might have regular bowel motions as a result.

• Colostomy with bowel resection. The surgeon will perform a colostomy if your inflammation is too severe for your colon and rectum to be reattached. The healthy portion of your colon is attached to an opening (stoma) in your abdominal wall. Trash enters a bag through the aperture.

Diverticulitis: Prevention

Some of the measures that can help to prevent diverticulitis include −

• Regularly moving about. Activity encourages regular bowel movements and lowers colon pressure. On most days, try to get in at least 30 minutes of exercise.

• Consume more fiber. Diverticulitis risk is reduced by eating a diet high in fiber. Fresh fruits and vegetables, whole grains, and other fiber-rich diets help soften waste and speed up colon transit. Nuts and seeds don't increase your risk of getting diverticulitis.

• Drink a lot of water. Fiber works by absorbing water and causing your colon to produce more soft, bulky waste. But if you don't drink enough fluids to replace what's absorbed, fiber can be constipating.

• Don't smoke. Diverticulitis risk is enhanced when a person smokes.

Conclusion

Diverticulitis, or diverticula inflammation, is a painful illness that has a high fatality rate. Diverticulitis that is not problematic may occasionally be treated outside of the hospital with antibiotics and dietary restrictions.