diverticulitis
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What is diverticulitis?
Diverticulitis is a condition that arises when diverticula, small pouches in the colon, become inflamed or infected, often due to a tear. Symptoms include persistent abdominal pain, especially on the left side, fever, chills, nausea, and changes in bowel habits.
Risk factors for diverticulitis include a low-fiber diet, increasing age, obesity, smoking, lack of exercise, and certain medications. Diagnosis involves physical exams, imaging tests like CT scans, and possibly colonoscopies.
Mild cases are treated with rest, antibiotics, a liquid diet, and increased fiber intake. Severe cases may require hospitalization, intravenous medication, or surgery to remove the affected part of the colon. If left untreated, complications like abscesses or peritonitis can occur.
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Which part of the body does diverticulitis affect?
Diverticulitis primarily affects the large intestine, especially the sigmoid colon, which is located on the lower left side of the abdomen. Diverticula, or small pouches, form in the lining of the large intestine, and diverticulitis occurs when these pouches become inflamed. Symptoms of diverticulitis include pain and tenderness, usually on the left side of the abdomen, along with possible fever and chills. Diagnosis is typically confirmed through physical exams and imaging tests such as CT scans.
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What are the common symptoms of diverticulitis?
Diverticulitis symptoms include sudden and severe abdominal pain or tenderness, especially on the left side, that lasts for several days. Other symptoms that may occur are fever, chills, nausea, constipation, or diarrhea. Rectal bleeding can indicate a more advanced stage of the disease. In severe cases, intestinal scarring can cause a blockage or an abscess from pus buildup in an infected diverticulum. The rupture of diverticula can cause peritonitis, a serious condition caused by the contents of the intestines leaking into the abdominal cavity.
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How does diverticulitis develop in the digestive system?
Diverticulitis arises when diverticula, small pouches in the large intestine, become inflamed. These pouches are believed to form at weak points in the intestinal wall when exposed to high pressure. Low-fiber diets can cause constipation, increasing pressure on the intestinal walls. A tear in a diverticulum can lead to inflammation and sometimes infection. Trapped debris and bacteria in these sacs can cause them to enlarge, inflaming the intestinal wall, resulting in muscle spasms, abdominal pain, and fever. Severe cases may lead to rupture and require surgery.
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What causes diverticula in the intestine to become inflamed?
Diverticula, or small pouches in the large intestine, can become inflamed, leading to diverticulitis, when the narrow necks of diverticula become plugged with debris or undigestible food. This allows bacteria to proliferate in these sacs, causing the adjacent intestinal wall to become inflamed and irritated. A tear in a diverticulum can also lead to inflammation and sometimes infection.
Several factors contribute to this condition, including a low-fiber diet, which can cause constipation and high pressure on the intestinal walls. Advanced age, obesity, smoking, lack of exercise, and a diet high in animal fat are also risk factors. Certain medications like ibuprofen, NSAIDs, steroids, and opioids can also increase the risk.
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How is diverticulitis usually treated and prevented?
Diverticulitis treatment ranges from rest and dietary adjustments to more intensive medical interventions, depending on the severity of symptoms. Mild cases usually require increased dietary fiber intake and rest. In contrast, liquid diets are recommended until the symptoms subside. Healthcare providers may prescribe antibiotics, pain relievers, or probiotics.
More severe diverticulitis cases may require draining any abscesses that may be present or a colectomy to surgically remove the affected part of the colon. Hospitalization and intravenous medications may also be necessary.
A high-fiber diet can help prevent diverticulitis, as a lack of fiber can cause constipation, which puts pressure on intestinal walls.
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diverticulitis, inflammation of the diverticula, or small pouches, that form in the lining of the large intestine. Diverticula are thought to form when weak spots in the intestinal wall are exposed to high pressure, causing the wall to bulge outward. They often form in the colon, the longest part of the large intestine, most commonly in the S-shaped sigmoid colon, on the left side of the abdominal cavity.
Diverticula frequently are found in adults over age 40. Diverticulosis, which is the presence of diverticula without inflammation, develops in almost all individuals after age 80. It is unlikely to cause problems if diverticula are not inflamed or infected, although some affected persons report mild abdominal cramping, bloating, and constipation. Because it is often asymptomatic, diverticulosis is most often discovered during diagnostic exams for other conditions.
Causes and risk factors
A tear in a diverticulum that leads to inflammation and sometimes infection is the main cause of diverticulitis. Sometimes an abscess, a contained infection in a diverticulum, occurs. Various risk factors are associated with diverticulitis. For example, a low-fibre diet is often implicated in the formation of diverticula, since a lack of fibre can cause constipation, which exerts high pressure on the intestinal walls. Some individuals may be genetically predisposed to diverticulosis and diverticulitis. In addition, for persons under age 50, males are more likely than females to have diverticulitis, and the condition is more likely to occur with increased age and obesity. Smoking, lack of exercise, and a diet that is high in animal fat are other risk factors. Some common medications also increase risk, including ibuprofen and other nonsteroidal anti-inflammatory drugs (NSAIDS), steroids, and opioids. If a person has had diverticulitis previously, there is an approximately 20 percent chance that it will recur.
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Symptoms
Sudden and severe abdominal pain or tenderness, particularly on the left side, that persists for several days is a common symptom of diverticulitis. Fever, chills, nausea, constipation, or diarrhea may also occur. Rectal bleeding may be indicative of more advanced disease. In severe cases intestinal scarring may cause a blockage in the intestine or an abscess may develop from a buildup of pus in an infected diverticulum. An abnormal opening may also form between sections of the large intestine or between the intestine and other organs. The rupture of diverticula, causing the contents of the intestines to leak into the abdominal cavity, can result in a serious condition known as peritonitis.
Diagnosis and treatment
Diverticulitis is diagnosed primarily by physical exam and imaging tests. The abdomen is checked for tenderness, particularly on the left side. A digital rectal exam, testing for white blood cell levels, and fecal testing for pathogenic bacteria or parasites may also be carried out. An abdominal computed tomography (CT) scan can be used to determine whether diverticula are present and whether they are inflamed or infected. More detailed imaging may be performed by colonoscopy, sigmoidoscopy, or barium enema, which makes the colon more visible on X-rays. If rectal bleeding is present, an angiography, which uses injected dye to look for the source of bleeding, may be performed.
If symptoms are mild, treatment may simply require rest and increased intake of dietary fibre. Conversely, a liquid diet may be recommended until symptoms diminish. Antibiotics to treat infection, pain relievers, and probiotics may be prescribed. If an abscess is present, fluid may be drained with a needle or catheter. Severe cases of diverticulitis may require hospitalization, intravenous medication, and a colectomy, the surgical removal of the affected part of the colon.