Diverticulitis

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WHAT IS DIVERTICULITIS? Diverticulitis is an inflammation or infection in one or more small pouches in the digestive tract. Diverticulitis is the most serious type of diverticular disease that has caused uncomfortable symptoms to people and, in some cases, serious complications.  Before the 20th century, the diverticular disease was a rare occurrence, but now diverticulitis […] Read More

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Diverticulitis

WHAT IS DIVERTICULITIS? Diverticulitis is an inflammation or infection in one or more small pouches in the digestive tract. Diverticulitis is the most serious type of diverticular disease that has caused uncomfortable symptoms to people and, in some cases, serious complications.  Before the 20th century, the diverticular disease was a rare occurrence, but now diverticulitis has become a most serious health problem, a group of conditions that can affect your digestive tract. If left untreated, the complication arising from this disorder can cause long-term health problems. RISK FACTORS
  • Genetics
Diverticulitis may be hereditary.
  • Age. 
The older you become, the more your risk developing diverticulitis.
  • Dehydration. 
Not drinking enough water makes digestion difficult and waste may not pass through your colon so easily.
  • Smoking.  
Nicotine and other chemicals in tobacco products can weaken the lining of your colon, resulting in the development of diverticulitis.
  • Medication. 
Certain drugs such as nonsteroidal anti-inflammatory drugs (NSAIDs), opioids, and steroids may weaken or irritate the large intestinal walls. Ibuprofen (ADVIL, Motrin IB, others) and naproxen sodium (Aleve) need to be avoided.
  • Obesity. 
People with extra weight can put more pressure on their colon.
  • Straining when pooing. 
This can put extra pressure on the wall of the colon.
  • Lack of exercise. 
Regular exercises tend to decrease the odds of developing diverticulitis.
  • Nutrition. 
Diet high in animal fat and low in fiber seems to increase the risk of diverticulitis. DIAGNOSIS Tell your doctor all the symptoms you have experienced. This will help then exclude other conditions and pinpoint the cause of your symptoms.
  • Your doctor will review your symptoms and your medical history
  • Your doctor will perform a physical exam
  • Your doctor will order a CT scan, to see inside your colon and identify the diverticula and their severity
  • A sample of your blood and urine will be taken to test for infection
  • A liver enzyme test will be done to check for liver disease
  • A pregnancy test will be conducted to zero out pregnancy as a  cause
  • A stool sample is taken to test for infection in people with diarrhea.
TREATMENT Mild diverticulitis can be treated with rest, changes in your diet, and antibiotics. Severe or recurring diverticulitis may require a surgical approach. In complicated cases, you’ll likely be hospitalized. Treatment can involve: 
  • Antibiotics for diverticulitis such as mesalazine [Asacol], rifaximin [Xifaxan], etc.
  • Intravenous antibiotics
  • Insertion of a tube to drain an abdominal abscess if any has formed
Your doctor may recommend surgery if you have:
  • Serious complications, such as a puncture (perforation) in the bowel wall, or a bowel abscess, fistula, or obstruction in the bowel wall.
  • A weakened immune system
  • Had multiple occurrences of uncomplicated diverticulitis.
Surgery There are two main surgery options:
  • Primary Bowel Resection
With it, diseased segments of your intestine are removed, and then the healthy segments are reconnected (anastomosis). This allows you to have normal bowel movements.
  • Bowel resection with colostomy
When you have so much inflammation that seems impossible to rejoin your colon and rectum, the surgeon will perform a colostomy.  How? An opening in your abdominal wall is connected to the healthy section of your colon, by which, waste passes through the opening into a bag. Once there is no inflammation the colostomy may be reversed and the bowel reconnected. HOW TO TREAT DIVERTICULITIS AT HOME When diverticulitis is mild, it can easily be handled at home, but when severe, it is advisable to be handled by professionals. Home remedies for diverticulitis include:
  • High fiber food which helps to control symptoms or problem in people who have diverticulitis.
  • Drink lots of fluid especially water.
  • Eat fruits.
  • Exercise often.
  • Make sure you stay away from alcohol and smoking.
COMPLICATIONS. About 25% of patients with acute diverticulitis develop complications which may include:
  • An abscess occurs when pus collects in the pouch
  • A blockage in your bowel caused by scarring
  • A fistula (an abnormal passageway) between sections of bowel or bowel and other organs
  • Peritonitis occurs if an inflamed or infected pouch ruptures spilling intestinal contents into the abdominal cavity.
PREVENTION Diverticulitis may be prevented through the following:
  • Eating more fiber. Food such as fresh fruits, vegetables, and whole grains, seeds, and nuts
  • Drinking of plenty fluids
  • Exercise regularly. Try to exercise at least 30 minutes a day.
  • Avoid alcohol and alcoholic beverages, or at least reduce.
  • Avoid smoking. Can have harmful effects on your digestive system
  • Healthy weight. Keep your weight in a healthy range.
  • Use a stool softener. If you often strain when pooing, an over-the-counter stool softener may help reduce the pressure on your colon.

Symptoms

SYMPTOMS

Diverticulitis can cause symptoms ranging from mild to severe. This symptom can appear suddenly, but in most cases, they develop gradually over several days. 

Potential symptoms of diverticular disease include:

  • Bloating
  • Constipation
  • Diarrhea
  • Fever and chills
  • Nausea and vomiting
  • Constant or severe abdominal pain
  • Rectal bleeding
  • Blood in the stool
  • Crumpling on the left side of the abdomen, and may go after you pass gas or have a bowel movement
  • Attacks of infection
  • Inflammation
  • Bowel obstruction

Causes

CAUSES

Diverticular disease develops when pouches (sac-like swellings) form along your digestive tract (particularly the large intestine). These pouches (known as diverticula) form when a weak spot in your intestine wall bulges outwards.

Diverticulitis is a condition where diverticula become inflamed and perhaps infected. This is likely when feces or partially digested food blocks the opening of the diverticula. 

The health condition in which diverticula just flare up along the lining of our digestive tract is known as diverticulosis, but when the diverticula are inflamed or infected it is termed diverticulitis. In other words, diverticulitis is only associated with inflamed or infected diverticula.

FAQ

What does a diverticulitis attack feel like?

The most common symptom of diverticulitis a sharp cramp-like pain, usually on the left side of your lower abdomen. Other symptoms can include fever and chills, nausea, vomiting, and constipation or diarrhea.

Is diverticulitis hereditary?

In some cases, diverticulitis can be genetic, that is found in genes which is transferrable. That means that diverticulitis can be hereditary.

What triggers diverticulitis?

Diverticulitis usually develops when naturally weak places in your colon give way under pressure. This causes marble-sized pouches to protrude through the colon wall. Diverticulitis occurs when diverticula tear, resulting in inflammation, and in some cases, infection.

What foods trigger diverticulitis?

Avoid the following foods to divert from diverticulitis:

  • Certain fruits, such as apples, pears, and plums
  • Dairy foods, such as milk, yogurt, and ice cream
  • Fermented foods, such as sauerkraut or kimchi
  • Beans
  • Cabbage
  • Brussels sprouts
  • Onions and garlic

What is the best treatment for diverticulitis?

Your doctor may recommend the following treatment:

  • High fiber diet. Although a high-fiber diet may not prevent diverticulitis, it may help prevent symptoms or problem in people who already have diverticulosis
  • Fiber supplements, such as methylcellulose (Citrucel) or psyllium (Mechanical).
  • Medicines, such as mesalazine [Asacol], rifaximin [Xifaxan], etc.
  • Probiotics, such as yogurt.
  • Colon resection.
  • Abscess.
  • Perforation.
  • Peritonitis.

What causes diverticulitis to flare up?

As you get older, your colon wall can become weaker. This can cause small pockets or pouches to form in weakened areas of your colon. If these pouches get infected, it can cause a diverticulitis attack or flare-up.