DIVERTICULITIS

15 Jun 2019

ABSTRACT –

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 Diverticulitis:
  1. Medications
    • Antibiotics
    • Analgesics
  2. A liquid diet
For complicated Diverticuliti’s:
  1. Surgery
    • Primary bowel resection
    • Bowel resection with colostomy
  2. Intravenous Antibiotics
  3. 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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