Diverticulitis

What is diverticulitis?

Diverticula are small, protruding pouches that develop in weaknesses within the lining of the colon. They give way under pressure, creating a condition known as diverticulosis. The majority of patients live with the condition without issue.

Diverticulitis occurs when the diverticula split and result in inflammation or infection. It is a common condition, especially for patients over the age of 40.

It should be noted that as many as 80 out of 100 people who have diverticulosis never get diverticulitis.

What are the symptoms of diverticulitis?

Symptoms of diverticulitis include:

  • Abdominal tenderness
  • Constant pain that may persist for several days, usually in the lower left side of the abdomen
  • Constipation
  • Diarrhea (a less common symptom)
  • Fever
  • Nausea and vomiting

Diagnosing Diverticulitis

Diverticulitis is commonly diagnosed during the course of an acute attack. After performing a physical examination to check for tenderness (and to rule out pelvic disease in women), your physician may recommend testing such as:

  • Blood and urine tests to look for signs of infection
  • Computed tomography (CT) scan to point out inflamed or infected diverticula
  • Liver function tests to exclude other potential causes for the abdominal pain
  • Pregnancy test for women of childbearing age to rule out pregnancy

What are the treatment options for diverticulitis?

Treatment for this condition is dependent on the severity of the symptoms. Severity is broken down into two main types:

Uncomplicated Diverticulitis

In the mild form of the condition, patients with uncomplicated diverticulitis may be treated in the comfort of their home. Recommended treatments include:

  • Antibiotics in the event of infection
  • Liquid diet regimen until the colon heals, with a gradual introduction of solids following symptom improvement
  • Over-the-counter pain relievers such as naproxen or acetaminophen

Complicated Diverticulitis

If symptoms are severe or coupled with other health problems, hospitalization may be required. Treatments would then include intravenous (IV) antibiotics and insertion of a tube to drain an abscess in the event one has formed.

Surgery

Surgery may be a necessary treatment for diverticulitis if:

  • Numerous episodes of uncomplicated diverticulitis have occurred
  • Patient is immunocompromised
  • There is a complication such as an abscess or bowel obstruction

There are two types of surgery for this condition:

  • Primary bowel resection: A portion of the diseased intestine is removed and the two healthy ends are connected to one another (anastomosis). Depending on the amount of inflammation in the intestine, this procedure may be done laparoscopically.
  • Bowel resection with colostomy: If the intestine is too inflamed to reconnect the segments, a colostomy will be performed. During this procedure, an opening is cut into the abdominal wall and is connected to the healthy part of the colon. Waste will then be passed through and into a connected bag. When the inflammation subsides, the colostomy is reversed and the ends of the colon reconnected.

For more information on diverticulitis or to schedule an appointment with one of our specialists, contact us today.

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