Diverticulitis is a gastrointestinal disorder involving active inflammation of the diverticula. Diverticula are abnormal protrusions of pouches that jut out from the wall of a hollow organ. In the case of diverticulitis, diverticula are caused because of the protrusion of mucosa and inner bowel wall layers. Bulging in the large intestine wall is a result of a weakened bowel wall. Diverticulitis is usually not seen in the rectum.
Most people with diverticula do not get any symptoms, in such cases, the condition is called diverticulosis. When diverticula cause pain in the lower stomach, it is called diverticular disease. These little diverticula become inflamed into diverticulitis, which is when a piece of feces (faecolith) blocks the opening to the diverticula. This obstruction of the diverticulum lumen leads to replication of the bacteria and increased mucous secretion.
As a result, the intraluminal pressure increases. This rising pressure results in venous congestion, leading to the development of ischemia of the wall and subsequently perforation. The perforation, if it is small, will usually lead to inflammation of the colonic wall surrounding it. Typically, the perforations get sealed by pericolic fat. In cases where the perforations are large, however, this results in the formation of a pericolic abscess. In most severe cases, it causes peritonitis and even death. The sigmoid colon is one of the most common places where diverticulitis is seen to occur.
Types of Diverticulitis
There are two kinds of diverticulitis. The more common form of diverticulitis is presented with abdominal pain and bowel symptoms while the less common form of the disease presents itself through bleeding and fistulae.
Diverticulitis affects the distal colon, where 50% of the cases affect the sigmoid colon, 40% affect the descending colon, and 5-10% affect the proximal colon. It becomes more common as people age too. In the US, 30% of adults above the age of 59 and more than 70% of those people above the age of 80 have experienced diverticulitis. About 200,000 people in the US get hospitalized for diverticulitis each year, with 71,000 getting hospitalized for diverticular bleeding.
- Cramps and constant abdominal pain that worsens over a 24-48 hour period
- In certain groups, the pain is mostly suprapubic pain (in the right lower quadrant). If this pain persists for more than three days, it is likely that one has diverticulitis.
- Other associated gastrointestinal symptoms might be either constipation or diarrhea. Sometimes both symptoms can be seen. Also, nausea and vomiting might be seen because of an obstruction, happening when diverticula cause severe blockages that prevent smooth bowel movement.
- In some cases, fever is seen as an inflammation/infection of the diverticula that causes the fecal bacteria to escape into the sites near the large intestine.
- Urinary urgency, frequency, and dysuria are common. Inflamed diverticula can push the bladder and also might lead to burning sensations as well.
Diagnosis may involve blood tests, a colonoscopy, or a CT scan. Sometimes a combination of coloscopy and CT scan, called CT colonography, is performed to get the right information about the disease.
Treatment of Diverticulitis
Diet: Eating a high-fiber diet helps ease the symptoms of diverticulosis and prevents its development. It is advised that adults eat at least 30gm of fiber — including fresh fruits, vegetables, beans, nuts, cereals, and starchy foods. This increase in fiber content should be gradual to avoid probable side effects like bloating. In some cases of diverticulitis, a fluid-only diet is recommended as doctors advise eating a low-fiber diet to rest your digestive system.
Medicine: A doctor might prescribe antibiotics in case of infection. More severe diverticulitis may need hospital treatment, antibiotic injections, and an intravenous drip to keep the body hydrated and nourished.
Surgery: In rare cases, it might be necessary to remove the affected section of the large intestine.
Prevention of Diverticulitis:
- Quit smoking
- Maintain a healthy weight
- Eat a fiber-rich diet and keep the body well-hydrated to avoid constipation
- Avoid regular use of painkillers like ibuprofen or aspirin
- How many forms of diverticulitis exist? There are two main types. Simple/uncomplicated diverticulitis can be easily treated through lifestyle changes and medication while, complicated is more life-threatening and often requires surgery.
- Do I have to undergo surgery if I have one or two instances of diverticulitis? Surgery is only recommended if other treatments have not worked. If the instances are not going away or regularly reoccurring, then surgery would be recommended.
- Can I have diverticular disease even if I have no symptoms? Yes, but the symptoms may just be slight. If you notice strange inconsistencies while producing stool, it is worth having a conversation with your doctor.
- Is diverticulitis hereditary? It has been linked to hereditary patterns, however, it can still be prevented to reduce risk factors.
- Do young people get diverticulitis? Though rare, it is possible if risk factors are exasperated.
Healthier Me Today is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment, always consult with your healthcare professional. Stay healthy!