What is Diverticulitis?
Diverticulitis is a form of diverticular disease, which occurs when small pouches in the large intestinal (colonic) wall called diverticula, are present. These diverticula arise in the colon and push through weak spots in the colon’s outer muscle layers. Inflammation of the diverticula is called diverticulitis. Diverticular disease that is not inflamed is called diverticulosis.
What are Symptoms of Diverticulitis?
Symptoms of diverticulitis may include:
What Causes Diverticulitis?
The cause of diverticulitis in Western countries is believed to be due to a high-fat and low-fiber diet.
Other possible causes of diverticulitis include:
- Straining to have a bowel movement from constipation
- Lack of exercise
- Use of certain medications including nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, and steroids
There are no specific triggers for diverticulitis attacks. In the past, it was believed that foods such as nuts, popcorn, and seeds should be avoided by diverticulitis patients because it was thought these particles could enter or block the diverticula. More recent research indicates these foods are not harmful and since they are high in fiber, they may help some patients.
- Processed meats
- Red meats
- Fried foods
- Full fat dairy products
How is Diverticulitis Diagnosed?
Diverticulitis is diagnosed based on a medical history and physical examination.
Laboratory tests may also be ordered to aid in diagnosis, such as:
- White blood cell count
- Hemoglobin level
- Electrolyte assays
- Blood cultures
- Renal function tests
- Liver enzyme and lipase levels
- Urine culture
- Stool test for blood
- A pregnancy test for females of childbearing age with abdominal pain
Imaging tests that may be indicated include:
What is the Treatment for Diverticulitis?
Treatment for diverticulitis depends on the severity, complications that may be present, and other coexisting medical conditions.
Treatment for mild diverticulitis includes:
- Clear liquid diet for 2-3 days; progressing to a soft diet as tolerated
- 7-10 days of oral broad-spectrum antibiotics if needed, such as:
- Acetaminophen (Tylenol) and antispasmodics for pain
In severe cases hospitalization may be needed. If hospitalized, treatment for severe diverticulitis may include:
- Clear liquid diet; progress to a soft diet as tolerated
- Intravenous (IV) or oral antibiotics
- Abscesses less than 3 cm: Typically resolved with antibiotics
- Abscesses greater than 4 cm: Drain percutaneously
- Pain management
- Elective surgical resection
What are Complications of Diverticulitis?
Complications of diverticulitis may include:
How do you Prevent Diverticulitis?
The primary way to prevent diverticulitis is with proper diet and exercise. Diverticular disease can be due to a low fiber diet, so consumption of a high fiber diet with plenty of vegetables and fruits, whole grains, and other high fiber foods is the mainstay of prevention.
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