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Diverticular Disease: Diverticulosis & Diverticulitis

Assessed and Endorsed by the MedReport Medical Review Board


Diverticula are small pouches that bulge outwardly inside the colon/ digestive tract. The presence of diverticula is called Diverticulosis. Diverticulitis is the inflammation of the diverticula. These two go hand in hand and the conditions are known as diverticular disease.



Etiology

Doctors believe the main cause of diverticulosis is a low-fiber diet. Some more causes are

  • Lack of physical activity

  • Obesity

  • Smoking

  • Problems with the immune system

  • Certain medications

Risk Factors

Diverticula tearing resulting in inflammation and occasionally infection, causes Diverticulitis. As one ages, it becomes more prevalent as it affects half of those over 60. Hospitalization for diverticulosis is more likely to occur in those who consume red meat than in people who don't. Other risk factors include genetics and BMI.


Pathophysiology

The pouches aren’t generally harmful but they can become Diverticulitis once they become inflamed or infected. The pathophysiology of Diverticulitis is related to obstruction of the diverticulum by fecal material which then causes inflammation of the mucosa. This usually results in congestion, mucosal trauma, and ischemia.


Signs & Symptoms:

Diverticulosis is asymptomatic however it still affects the working of the bowel. Symptoms of Diverticulosis include:

  • Bloating or Abdominal pain

  • Constipation and diarrhea

  • Anemia

  • Blood in the feces

Symptoms of Diverticulitis include:

  • Sharp pain in the abdomen

  • Fever

  • Nausea and vomiting

  • Bloating of the abdomen.


Pertinent Diagnostic Tests

Diverticulosis and Diverticulitis are typically diagnosed using

  • Abdominal CT scan

  • Colonoscopy

  • Blood tests

  • Stool tests


Diverticulitis is most often diagnosed during an acute attack.

Treatment

Diverticulosis is treated by attempting to alleviate symptoms through modifying diet to include more fiber and avoiding nuts, seeds, and pips. Some more treatments are the use of short-term laxatives and in rare cases elective surgery.


Treatment for Diverticulitis which is a medical emergency is no eating or drinking, taking pain relieving medications, antibiotics, and surgery. Another is Colostomy, if it isn’t possible to rejoin the healthy sections of the bowel.


Brief description of surgical procedure that may be done


Colon resection is the most common surgery for Diverticulitis. It occurs when the surgeon cuts into the colon, removes the damaged pockets or pouches, and lastly reattaches the remaining colon. The surgeon may create a colostomy or reattach the colon to the rectum although it can fail and require another surgery.


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