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Diverticulitis – Causes, Symptoms and Treatment

 

Diverticulitis is a common digestive disease particularly found in the large intestine. Diverticulitis develops from diverticulosis, which involves the formation of pouches (diverticula) on the outside of the colon. Diverticulitis results if one of these diverticula becomes inflamed.

What are the symptoms?

Most people with diverticulosis do not have any discomfort or symptoms. However, symptoms may include mild cramps, bloating, and constipation. Other diseases such as irritable bowel syndrome (IBS) and stomach ulcers cause similar problems, so these symptoms do not always mean a person has diverticulosis. You should visit your doctor if you have these troubling symptoms.

If a doctor knows that the person already has diverticulosis, a diagnosis of diverticulitis may be based almost entirely on the symptoms. However, many other conditions involving the large intestine and other organs in the abdomen and pelvis can cause symptoms similar to diverticulitis, including appendicitis, colon or ovarian cancer, a pus-filled pocket of infection (abscess), and noncancerous growths on the wall of the uterus (uterine fibroids).

Diverticular bleeding occurs when the expanding diverticulum erodes into a blood vessel at the base of a diverticulum. Rectal passage of red, dark or maroon-colored blood and clots occur without any associated abdominal pain. Rarely, blood may be black from a diverticulum of the right colon. Bleeding may be continuous or intermittent, lasting several days.

Diverticulitis Causes

Diverticulosis is thought to be caused by increased pressure on the intestinal wall from inside the intestine.

As the body ages, the outer layer of the intestinal wall thickens. This causes the open space inside the intestine to narrow. Stool (feces) moves more slowly through the colon, increasing the pressure.

How is diverticulitis diagnosed?

Your doctor will ask about your symptoms and will examine you. He or she may do tests to see if you have an infection or to make sure that you don’t have other problems. Tests may include:

Blood tests, such as a complete blood count (CBC).

Imaging tests, such as an X-ray, a CT scan, or a colonoscopy.

Treatment of Diverticulitis

An initial episode of acute diverticulitis is usually treated with conservative medical management, including bowel rest (ie, nothing by mouth), IV fluid resuscitation, and broad-spectrum antibiotics which cover anaerobic bacteria and gram-negative rods. However, recurring acute attacks or complications, such as peritonitis, abscess, or fistula may require surgery, either immediately or on an elective basis.

The involved portion of the colon may need to be removed with surgery if you have:

Abscess

Hole (perforation)

Fistula

Repeated attacks

After the acute infection has improved, diverticulitis is treated by increasing the bulk in the diet with high-fiber foods and bulk additives, such as psyllium.

Increased pressure in the colon can lead to breakdown of the wall of the diverticula leading to infection. A small tear or perforation can also develop in an infected pouch, which in turn can cause an infection within your abdomen (peritonitis). If the infection is limited to an area around the wall of your colon where the diverticula are inflamed, you may develop a localized collection of pus known as an abscess.

Initial treatment

Treatment for diverticulitis depends on the severity of your symptoms. If the pain is mild, you are able to drink liquids, and you have no signs of complications, treatment may include:

Medicines such as antibiotics and pain relievers.

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