What is Diverticulitis?

A diverticulum (plural: diverticula) is a small sac or an outward pouch-like structure that is present within the large intestine. It is formed through points of weakness within the muscular wall of the intestine. Diverticulitis is a medical condition in which one or more diverticula becomes inflamed and swollen.

1. How Common is Diverticulitis?

Presence of diverticula is a common condition and it increases with age. In the United States, more than half of people over the age of 70 have diverticula. It is estimated that 1 in 5 people with diverticula develop diverticulitis at some stage.

2. Symptoms of Diverticulitis

Diverticula do not cause symptoms. They are present in the half of people over 70 years. When these diverticula get inflamed (diverticulitis), then you will experience one or more of the following symptoms:

Severe abdominal pain (mostly in the left lower abdomen)
Fever
Feeling of illness
Bloating, nausea, or vomiting
Constipation
Diarrhea
Blood in the stool

3. Causes of Diverticulitis

Diverticula are formed within the muscular wall of the intestine through the weakened points. This condition is common with old age and low-fiber diets. In old age, the muscle walls naturally become weak. With a low-fiber diet, the constipation occurs. When you are constipated, the repeated straining and the presence of hard stool within the intestine will increase the pressure within the intestine, it will result in the formation of the outward sac or pouch (diverticula) within the weakened muscle walls.

4. Risk Factors of Diverticulitis

Risk factors for Diverticulitis include:

Elderly persons
Chronic constipation
Straining to have the bowel movements
Western diet
Obesity
Smoking

5. Complications of Diverticulitis

Diverticulitis may lead to one or more of the following complications:

Peritonitis – infection involving the lining of abdominal cavity
Abscess – a localized collection of pus
Fistula – an abnormal tunnel-like tract between two areas
Obstruction – a blockage of the intestine
Sepsis

6. Diagnosis of Diverticulitis

Your doctor will first take a detailed history and will perform the relevant physical examination. Your doctor will suggest various medical tests to confirm the diagnosis. Tests may include:

Barium enema – specialized x-ray study to view the outline of the lower intestine. Barium is used in this testing. Barium is a contrast medium that highlights the lining.
Flexible sigmoidoscopy – thin, flexible tube that contains a camera to directly view the sigmoid colon.
Colonoscopy – thin, flexible tube that contains a camera to directly view the entire colon.
Computed tomography (CT) scan.

7. Treatment of Diverticulitis

People with diverticula who do not have symptoms do not require treatment. They are only diagnosed when specialized tests, such as barium enema or colonoscopy, are done for other reasons. People with diverticulitis need treatment. If you have symptoms of diverticulitis, you should consult a doctor and needs management. Untreated cases of diverticulitis will result in complications. You may be admitted in hospital till your symptoms improve. The management includes:

A fluid-only diet for a few days until your symptoms improve.
In severe cases, your doctor may also advise you to not eat and prescribe an intravenous diet to rest your digestive system.
Antibiotics
Pain killers
Surgical Management of Diverticulitis
Surgery is not the first-line treatment for the patients with diverticulitis. Surgery is only helpful if medicines are not effective enough to control your symptoms or complications have occurred. Surgery is performed to:
Remove the diseased part of the colon
Re-open parts of the colon that have become blocked
Close fistulas and drain abscesses

Your doctor may sew the colon to an opening in the skin on the abdomen (called colostomy). You will wear a bag over the colostomy to collect bowel movements. The colostomy is usually temporary. Your doctor will perform a second surgery to connect the two ends of the colon.

8. Diet and Exercise

The main goal of diet and exercise is to prevent diverticula formation. It may be achieved by

Increasing physical activity including aerobics.
Dietary changes including increasing dietary fiber and using stool softeners.
Avoiding low-fiber foods, such as ice cream, cheese, white bread, and meat.
Drinking plenty of fluids. You should drink at least eight to ten glasses of water daily.
Reduce weight, if you are obese.
Quitting smoking.

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