Diverticulitis

What is Diverticulitis?

Diverticulitis is a common disease of the large intestine, which is part of your bowel. Diverticulitis is characterized by a protrusion of the inner layers of the large intestine through the outer layers of the wall of the colon, forming a pouch or a diverticulum. These pouches can become inflamed or infected. If they do become inflamed or infected, it results in diverticulitis. Diverticulitis results from inflammation of a colonic diverticulum with or without a rupture (perforation) of the diverticulum. An attack of diverticulitis can develop suddenly and without warning.

How is Diverticulitis Diagnosed?

The most common diagnostic test which can reveal diverticulitis is a CAT scan.

What are the Symptoms and Signs of Diverticulitis?

The following symptoms are seen in patients with diverticulitis:

• Abdominal pain focused in the left lower side with fever
• Elevated white blood cell count
• Bloating
• Nausea
• Vomiting
• Diarrhea
• Constipation
• Fever
• Tenderness on physical examination
• Rectal bleeding (rarely)

Who is at Risk for Developing Diverticulitis?

Although not proven, the dominant theory is that a low-fiber diet is the main cause of diverticulitis. The disease is common in developed or industrialized countries where low-fiber diets are common. Constipation makes the muscles strain to move stool that is too hard. This strain causes increased pressure within the colon. This excess pressure might cause the weak spots in the colon to bulge out and become diverticula (pockets).
Diverticulitis is most commonly found in middle-aged and elderly people. However it has been seen in younger patients as well. Obesity has been associated with diverticulitis in younger patients.

Are There Complications that can Result From Diverticulitis?

Complications may occur in diverticulitis. Sometimes the inflamed diverticula can cause a narrowing of the colon and lead to an obstruction. In addition, the infected portion of the colon could adhere to the bladder or other organs and cause a fistula (an abnormal connection between the colon and the other organ). In some cases, an inflamed diverticulum can burst and bacteria may infect the outside of the colon. If the infection spreads to the lining of the abdominal cavity it can cause peritonitis.

What Treatment Options Do I Have?

Normally diverticulitis is treated with rest of the bowel (liquid diet), IV fluids and broad spectrum antibiotics. However, recurring attacks of diverticulitis or complications from diverticulitis may require surgical treatment. In some cases surgery may require the removal of the area of the colon
with the diverticula.

What Else Should I Ask My Doctor?

• Are there any other tests that we need to perform?
• What treatment do you suggest?
• What are the benefits and risks of this type of treatment?
• What are the chances of recurrence after my treatment plan?

Where Can I Find More Information?

American Gastroenterological Association
American College of Gastroenterology
American Society for Gastrointestinal Endoscopy