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Diverticulitis
Diverticula are small outpouches of the bowel lining that protrude through the muscle layer of the bowel. They occur in areas of weakness of the bowel wall. Diverticula most commonly occur in the colon. The presence of diverticula in the colon is called diverticulosis. The incidence of diverticulosis increases with age and affects half the population in the U.S. by the age of 80. Diverticulitis occurs when diverticula become inflamed.
Diverticulitis occurs when diverticula become blocked with stool, become inflamed and get infected. Occasionally, when the inflammation is severe, a hole (perforation) may form in the wall of the intestine. Perforation may lead to an abscess, a localized collection of fluid. Peritonitis, which is inflammation of the lining of the abdomen, is a potentially serious condition that occurs when the infection spreads througout the abdomen.
Symptoms
Symptoms of diverticulitis may include:
• gastroenteritis
• alternating diarrhea and constipation
• severe, intermittent cramps in the lower left side of the abdomen
• tenderness in the lower left side of the abdomen
• chills or fever
• rectal bleeding.
Diagnosis
After a history and physical examination, the doctor may obtain bloodwork to look for signs of infection, and often a CT scan to look and see if there is any evidence of an abscess. Later on, after this has resolved, and examination of the colon with colonoscopy is usually undertaken to rule out any significant problems in the colon, such as narrowing (stricture), polyps or colon cancer.
Treatment
Minor episodes of diverticulitis can often be treated at home with a clear liquid diet, oral antiobiotics, and rest. More severe cases require hospitalization for intravenous antibiotics, fluids and bedrest. Occassionally, surgery is required. In most cases requiring surgery, the diseased section of the intestine is removed and the remaining sections are joined together. In some patients, especially when peritonitis has occurred, a temporary colostomy is required. A colostomy is an operation to bring part of the large intestine to the abdominal surface to form a new opening for bowel movements. This can often be reversed after the infection and inflammation have subsided.
Dietary considerations
During an acute attack of diverticulitis, you want to minimize the irritation of the colon by taking liquids or low residue, easily digestible foods. Fruits and vegetables need to be avoided in the early stages. Your doctor can give you guidance on this.
After the acute episode, your diet can return closer to normal, but you should remember to eat regular, nutritious meals containing high-fiber foods, such as fruits and vegetables. You should avoid constipation, and may want to avoid nuts and popcorn, although this is controversial. One way to help avoid constipation is to drink plenty of water, as much as 8 glasses a day.
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Please note: We do not answer questions regarding individual medical problems on this website. We advise you to contact your physician for your specific health related concerns.
©2007 Syracuse Gastroenterological Associates, P.C.
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