Diverticulosis - An Overview

What Is Diverticulosis?

Diverticulosis is a condition that occurs when small pouches or sacs develop within the colon wall and protrude through weak spots in that wall. Diverticulosis can cause pain and discomfort in the abdomen. Diverticular disease is the term used by medical professionals to describe the condition that results when diverticulosis leads to signs, symptoms, bleeding, inflammation, or consequences.

What Are the Symptoms?

Diverticulitis is typically symptomless. However, when several diverticula (pouches) are present, regular bowel function can be compromised. This may lead to many different symptoms, including:

• Stomach discomfort.

• Swelling.

• Congestion and diarrhea are common digestive disorders.

• Flatulence.

• When a diverticulum becomes inflamed or is close to a blood vessel, it may bleed profusely and cause anemia.

• These symptoms are comparable to those of colon cancer. Diverticulosis is more prevalent than cancer, so these symptoms may be attributable to diverticulosis rather than the cancer.

What Is the Diagnostic Method?

• CT Scan of the Abdomen: An abdominal CT scan is the most accurate diagnostic method for diverticular illness. A CT scan offers cross-sectional, two-dimensional, and three-dimensional views of the digestive tract's components. It permits the identification of any abnormalities inside the colon and surrounding area, including an abscess or even a fistula, an irregular opening inside the intestines that leads to another organ.

• Colonoscopy: A colonoscopy would be a procedure that permits the entire lining of the colon and rectum wall, including the diverticula, to be examined for any issues. This test is performed to detect irritation or hemorrhage within the colon. Anyone with symptoms can utilize the test to detect diverticular illness. Colonoscopies are also routinely used as a colon cancer screening method. Many individuals are detected as having diverticular disease during routine colonoscopies. In the presence of signs of an illness, such as a fever, chills, or nausea, the practitioner is unable to perform this test until the symptoms have subsided. The blood test and CT scan of the abdomen are sufficient to confirm the diagnosis. In the process of performing a colonoscopy, the physician will administer a sedative. The colonoscope's camera feeds images to a video monitor, allowing the physician to observe the colon wall.

• Test of Blood Samples: An examination of the patient's blood can reveal indicators of illness, including an increase in the percentage of disease-fighting immune cells known as leukocytes.

What Is the Treatment Method?

No treatment has been shown to successfully stop the development of new diverticula in a person who already has diverticulosis. The primary objective of therapy is to provide relief to patients' distressing symptoms.

1. Diet: Altering the diet gradually to include more soluble fiber such as green vegetables, oat bran, and fiber supplements such as psyllium are all instances of meals falling within this group and typically result in an improvement in bowel regularity and mild symptoms. Some foods have been shown to exacerbate symptoms or possibly cause diverticulitis in some people. It is recommended that one stay away from nuts, seeds, and pips. Moreover, some people find that avoiding legumes (such as peas and beans) and sweet corn is beneficial.

2. Medication: Laxatives should be used for the shortest possible periods while treating or attempting to avoid constipation. Antibiotics are medications that combat bacterial infections, and if a person has diverticulitis that is not severe, the doctor may recommend a course of antibiotics.

3. Treatment in Hospital: When the symptoms of diverticulitis are severe, and there is a suspicion of perforation, bleeding, or an abscess, it is advised that the individual be hospitalized so that they can be monitored and subsequently treated if the symptoms do not improve or become worse. If diverticular disease produces a significant loss of blood, one may also require a transfusion, which is a medical treatment in which blood is given to the patient intravenously.

Individuals with a micro-perforation or perhaps an abscess may be prescribed bowel rest and antibiotics by a medical professional. Antibiotic treatment is typically given as an intravenous (IV) infusion, which is given through a vein. It could be necessary to drain an abscess. An interventional radiologist who specializes in gastrointestinal imaging techniques will introduce a needle into the abscess to drain the fluid that is contaminated with the infection. There is no requirement for surgical intervention in this condition.

4. Surgery: When symptoms are so severe that they prevent a person from living a normal life, elective surgery to remove parts of the colon that are severely damaged is undertaken very rarely. To prevent a recurrence, sigmoidectomy is an elective treatment in which the diseased portion of the colon is removed. To do minimally invasive colorectal surgery, which is performed using traditional laparoscopy or robotic-assisted surgery.

• Laparoscopic Method - During a laparoscopic operation, the surgeon makes multiple tiny incisions within the abdomen, into which the laparoscopic equipment is inserted. Using a two-dimensional image displayed on a television monitor to perform the surgery.

• Robotic-Assisted Surgery - Using a sophisticated surgical system, surgeons perform robotic-assisted surgery. It consists of miniature surgical instruments attached to individual robotic arms. To guide the surgeon, an additional arm holds a video camera that projects an enlarged, high-definition, three-dimensional image onto a computer monitor. The surgical instruments and camera are placed into the abdomen through minute incisions. The surgeon uses a console to operate the equipment and camera.

What Is the Complication?

Diverticulitis can result in inflammation, infection, bleeding, or intestinal obstruction. This condition is brought on by an inflammatory or infectious condition of the pouches. Typically, this illness causes localized stomach pain, touch sensitivity, and fever. Moreover, a person with diverticulitis may have nausea, vomiting, trembling, chills, and/or constipation.

• Abscess - If the diverticulitis is not treated, it might progress to an abscess with pus.

• Perforation - It refers to the rupturing of a weak spot in the wall of the bowel. It is, therefore, possible for the contents of the bowel to leak into the abdominal cavity. There is also a high body temperature and chills associated with this condition. A perforated gut is considered a critical medical condition.

• Peritonitis - The condition known as peritonitis can be caused by perforation with infection of the membranes that line the abdominal cavity and abdominal organs. This difficulty has the potential to endanger someone's life.

• Hemorrhagic Diverticulitis - It is rare and occurs when the intestinal wall is breached by the arteries. It leads to severe bleeding and necessitates hospitalization and blood transfusions.

Conclusion

Diverticulosis is a frequent illness that can lead to serious consequences and symptomatology. This is increasingly common in industrialized nations while also rising in the developing world. In recent years, the pathophysiologic explanation underlying diverticulitis has shifted. Constipation is no longer regarded as the primary cause of diverticulosis; nonetheless, one must take into account that the emergence of diverticulosis is likely due to several factors, ranging from structural modification of the colonic walls to microbial dysbiosis. However, the majority of the factors affecting its development remain to be defined, such as the incidence or duration of symptoms. Many explanations, ranging from bacterial overgrowth to the presence of low-grade inflammation, have indeed been postulated.