ABSTRACT – Diverticulitis is the inflammation of the diverticula, small bulging pouches formed mostly in the lower part of...
Diverticulitis
Diverticulitis is the inflammation of the diverticula, small bulging pouches formed mostly in the lower part of large intestine due to pressure. Diverticula is common in people over the age of 40.
Stages:
Stage 1a – Uncomplicated Diverticulitis
Stage 1b – Diverticulitis with Phlegmonous Peridiverticulitis
Stage 2a – Diverticulitis with Concealed Perforation, and abscess with a diameter of one centimeter or less
Stage 2b – Diverticulitis with Abscess greater than one centimeter
Stage 3a – Diverticulitis with Symptoms but without complications
Stage 3b – Relapsing Diverticulitis without complications
Stage 3c – Relapsing Diverticulitis with complications
CAUSES –
It is caused when diverticula tears, resulting into infection or inflammation. The causes for the same are :
Environmental factors
Genetics
Obesity and hypertension
Immunosuppression
Vitamin D deficiency
SIGNS AND SYMPTOMS –
Pain in the right side of the abdomen
Fever and diarrhea
Nausea and vomiting
Constipation
Abdominal tenderness
Blood in the stool
Complications like blockage in small intestine or colon due to scarring, Peritonitis and fistula between sections of bowel or between bowel and the bladder
DIAGNOSIS –
Since abdominal pain is commonly found in many diseases, different diagnostic tests are done to rule out other problems like:
Physical examination to check the tenderness of abdomen
Pregnancy test in women of childbearing age
Blood and urine test for infection
Stool test
Liver enzyme test for liver disease
If the above tests show negative results, Computed Tomography (CT Scan) is done which confirms the presence of this condition.
TREATMENT –
For simple and uncomplicated disease:
Medications
Antibiotics
Analgesics
A liquid diet
For complicated disease:
Surgery
Primary bowel resection
Bowel resection with colostomy
Intravenous Antibiotics
Tube insertion to drain an abdominal abscess
RISK FACTORS –
Aging
Obesity
Lack of exercise
Smoking
Low fiber and high animal fat diet
Medications like steroids, opioids and NSAIDs
PREVENTION –
Drink more fluids
Consume healthy and fibrous food
Exercise regularly
EPIDEMIOLOGY –
Right side diverticular disease (involving the ascending colon) is common in Africans and Asians while the Left side diverticular disease (involving the sigmoid colon) is common in western countries.
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