The condition that results in the inflammation or infection of the pouches in the colon wall is called diverticulitis. Learn about its symptoms, causes, diagnosis, treatment, and more.
Formation of small, bulging pouches in the lining of the digestive system is called diverticula, and is seen especially after 40 years of age. When it gets inflamed or infected, it is known as diverticulitis, and may present with various symptoms. Though it was rare before 20th century, now it has become one of the most common conditions encountered.
The symptoms can be categorized from mild to severe and can be either immediate or rapid in onset. The following signs and symptoms can be seen associated with diverticulitis:
1. Constant chronic pain, usually in the left side of the abdomen.
2. Vomiting or nausea.
5. Tenderness in the abdomen.
6. Diarrhea or constipation.
Among all these, abdominal pain is the most common which is experienced in lower left abdomen. But chances are there it may develop on the right side. You need to immediately contact your physician in case you observe vomiting or blood in the stool as it may indicate some serious complication.
When there is excessive pressure application on weak areas of colon, this may develop as protrusion through colon wall.
The risk factors include the following:
1. Increases with age.
4. No or less exercise.
5. High fat and low fiber diet.
6. Medications like non-steroidal anti-inflammatory drugs, steroids, opioids, etc.
The diagnosis usually happens during an acute attack. Abdominal pain has various causes and proper examination is required to rule out the possible causes. The physician will initially take a detailed case history followed by physical examination where the abdomen will be examined for tenderness. Then, the following tests will be done for confirmation:
1.Blood and urine tests: This will help to check for infection.
2.Pregnancy test: As abdominal pain can be associated with pregnancy also.
3.Liver enzyme test: To check for liver disorders.
4.Stool test in patients with diarrhea.
5.CT scan to check for severity and location of the condition along with treatment plan.
6.Colonoscopy to examine the gastrointestinal tract.
It can be noted that more than 75% of patients with diverticulitis are uncomplicated, whereas the rest may have some complications.
The physician decides the treatment based on the severity of the condition related with signs and symptoms.
1. Uncomplicated diverticulitis:
Mild symptoms can be managed at home and you will be prescribed with antibiotics to cure the infection, a liquid diet for a short duration till the bowel heals, and over-the counter analgesics.
2. Complicated diverticulitis:
A severe attack or association with other health issues will need hospitalization and the treatment usually involves antibiotics given intravenously, and drainage of abdominal abscess (if present) by inserting a tube.
3. Surgical management:
This might be required when there is a severe complication like formation of fistula, frequent episodes of diverticulitis, or an immunocompromised patient.
The two types of surgery followed are primary bowel resection where in the damaged or infected segments of the intestine are removed and the healthy segments are joined, or bowel resection with colostomy in which the colon is removed and an opening in the abdominal wall is joined to the healthy part of the colon.
Almost 25% of the patients tend to develop complications which are as follows:
1.Abscess: It is a cavity filled with pus due to infection.
2.Colon blockage, small intestine blockage.
3.Fistula. It is a connection between two organs or an organ and skin. It is an abnormal condition.
4.Peritonitis. It has to be noted that peritonitis is an emergency condition and needs immediate medical attention.
Prevention of diverticulitis is possible using the following methods:
1.Regular exercise. It helps in maintaining normal functioning of the bowel and thus, leads to reduction in pressure within the colon.
2.Fibrous food consumption. Fresh fruits and vegetables and other fibrous foods helps in softening the waste material and assists in easy passage of it through the colon.
3.Consumption of adequate fluids.
4.Intake of adequate vitamin D.
5. Avoid smoking.
Presence of diverticula without any infection or inflammation is called as diverticulosis.
In most of the cases, diverticulosis does not show any symptoms, and in that case, treatment is not required. Although, in some cases, it may show some symptoms like abdominal pain and bloating sensation. This condition is called as symptomatic uncomplicated diverticular disease. Facts show that a few of people suffering from symptomatic uncomplicated diverticular disease eventually may develop diverticulitis.
Infection or swelling (inflammation) of the pouches that are present in the colon is called diverticulitis. It can be quite painful, with symptoms like fever, abdominal pain, bloating, diarrhea or constipation, nausea, vomiting, and fatigue.
The primary cause of diverticulosis can be a muscle spasm or strain during bowel movements, which creates pressure inside the colon and may push it against the lining. It can also be due to poor intake of dietary fibers. It is more common in people over the age of 60.
The best treatment for diverticulosis is modifying the diet through a high fiber diet and a liquid diet. The treatments also include antibiotics and antispasmodic drugs for mild symptoms. And for severe complications, hospitalization might be required with intravenous fluids and antibiotics. Sometimes, colostomy might be necessary in case of an infected abscess, later on with surgical removal of the diverticula.
The foods which should be avoided when you have diverticulitis include:
- Low fiber diet.
- Fried foods.
- Fatty diet.
- Foods rich in sugar and carbohydrates.
- Red meat.
- Processed foods.
- Canned food.
Foods rich in high fiber content are helpful to treat diverticulosis. Therefore, bananas that are rich in fiber are good for diverticulosis. These will soften the stools and prevent constipation, which in turn will avoid flare-ups of diverticulitis.
A high fiber diet helps treat diverticulitis. Fibers are not useful without the role of water. Water gets absorbed by the fibers and will soften the stools, which will allow it to pass freely through the digestive tract. It helps to prevent constipation, which will reduce the symptoms of diverticulitis. Therefore, it is necessary to drink about eight glasses of water every day.
A high amount of caffeine in coffee may increase bowel movements. Therefore, in a patient with diverticulosis, when he or she drinks coffee, it may cause increased stimulation of the bowels, irritating your intestine and causing severe pain. So drinking coffee while having diverticulosis is not advisable.
High levels of vitamin D in serum can lower the risk of diverticulitis. Therefore, vitamin D should be maintained at a proper level to prevent diverticulitis.
Diverticulitis, when it is mild, can be treated at home with bed rest, oral antibiotics, a high fiber diet, and drinking enough water. But, when the symptoms are very severe, like constant pain, fever, chills, and blood in your stool, which cannot be handled at home, in that case, hospitalization may be required.
Eggs contain protein that can be easily digested, and it will not irritate your digestive tract. Therefore, scrambled eggs can be taken during diverticulitis.
Usually, two days of stay might be required with IV antibiotics in the hospital. In case of severe complications, surgery is done, and it may require 2 to 7 days of stay.
To get fast relief from diverticulitis:
1. The bowels should be flushed using a special elemental liquid diet.
2. All the disease-causing bacteria in the gut should be killed.
3. Inflammation and ulceration in the stomach should be healed.
4. Problem of constipation should be resolved.
Mild diverticulitis can heal independently without any effective treatments, but it needs proper care and hospitalization in the case of severe symptoms.
Diverticulitis surgery requiring affected colon or bowel to be resected and reconnected to the healthy part might result in life-threatening complications for patients who are obese, over the age of 60 years, diabetic, hypertensive, and those with poor health.
In diverticulitis surgery, the infected part of the bowel is resected, and the two healthy parts are connected. The resection of the infected part is called a colectomy, and the reconnection of the healthy parts is called anastomosis.
Diverticulitis can recur after surgery because even though the infection and the inflammation are treated and resolved, the pockets remain the same. However, the risk of getting diverticulitis is less than 10 to 15%, and making some changes in your lifestyle can also lower the risk of recurrence.
Last reviewed at:
11 Dec 2019 - 3 min read
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