Diverticulitis

Diverticulitis is a condition characterized by the infection and inflammation of one or more diverticula—small, pouch-like structures that can form in the lining of the gastrointestinal tract. It is important to distinguish diverticulitis from diverticulosis, which refers to the presence of these pouches without inflammation.

Diverticulitis is relatively common, particularly among older adults.

Symptoms of Diverticulitis

The symptoms of diverticulitis can include:

• Severe abdominal pain, often on the left side (and sometimes the right)
• Nausea
• Cramping in the lower abdomen
• Constipation
• Fever
• Chills
• Rectal bleeding
• Blood in stool
• Frequent, painful urination

Causes of Diverticulitis

While the exact cause of diverticulitis is not fully understood, it is commonly linked to a low-fiber diet. Insufficient fiber intake can lead to waste buildup in the colon, creating pressure on the colon walls. This pressure may lead to the formation of diverticula. When bacteria from stool enter these pouches, infection can occur, causing inflammation and diverticulitis.

Risk Factors for Diverticulitis

Several factors may increase your risk of developing diverticulitis, including:

• Obesity
• Aging
• Smoking
• Sedentary lifestyle
• A diet high in fats and low in fiber
• Use of NSAIDs (nonsteroidal anti-inflammatory drugs)
• Use of steroids or opioids

Diagnosing Diverticulitis

If you experience any symptoms associated with diverticulitis, it’s essential to consult a healthcare professional for a proper diagnosis. Your doctor will typically ask about your symptoms, medical history, dietary habits, urinary frequency, and any medications you may be taking.

To confirm a diagnosis of diverticulitis, the following tests may be conducted:

• Blood and Urine Tests: To check for signs of infection.
• Stool Sample Test: To identify atypical bacteria in your stool.
• CT Scan: Produces images of your intestinal area to detect inflamed diverticula and assess the severity of the condition.
• Sigmoidoscopy: Involves inserting a camera-equipped tube into your rectum to visualize the sigmoid colon and inflamed diverticula.
• Colonoscopy: Similar to a sigmoidoscopy, but examines the entire colon for inflamed diverticula and other potential issues like sores or cancer.
• Angiography: Conducted only in cases of severe rectal bleeding to identify the source of the bleeding.

Treatment for Diverticulitis

Treatment for diverticulitis varies based on its severity:

Mild to Moderate Diverticulitis
For mild to moderate cases, your doctor may prescribe antibiotics to treat the infection, along with pain relievers for abdominal discomfort. Dietary changes, such as a temporary liquid diet and increased fiber intake, are also recommended. Once symptoms improve, you can gradually return to solid foods, focusing on a fiber-rich diet.

Severe Diverticulitis
In severe cases or for individuals who have recurrent mild diverticulitis, hospitalization may be necessary for intravenous (IV) antibiotics. Surgical intervention may be required for complications such as:

• Abscess: An infected pus pocket, often located in the colon or abdominal region.
• Strictures: Scarring from previous infections that causes narrowing of the colon.
• Fistula: An abnormal connection between the colon and other organs.
• Peritonitis: A life-threatening condition caused by the leakage of stool or pus into the abdominal cavity, necessitating immediate medical attention.

Depending on the level of inflammation, surgical options may include:

• Primary Bowel Resection: Removal of the damaged intestine, reconnecting healthy sections to restore normal bowel function.
• Bowel Resection with Colostomy: If reconnection of the rectum and colon is not possible due to inflammation, a colostomy is performed. This involves creating an opening in the abdomen for waste collection in a colostomy bag. After inflammation subsides, the colostomy can be reversed.

Conclusion

Diverticulitis occurs when diverticula in the digestive tract become infected and inflamed, leading to severe abdominal pain, cramps, nausea, and rectal bleeding. If you experience these symptoms, it is crucial to consult a gastroenterologist for an accurate diagnosis and appropriate treatment.