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  Diverticulitis

Diverticulitis is the inflammation of pocket hernias in the large intestine. These pocket hernias are referred to as diverticula. Diverticulosis is the process in which these pockets or pouches are formed on the outside of the colon and large intestine. The diverticula build up bacteria and infection results, which is known as diverticulitis.

Diverticulitis
Diverticulitis


Symptoms:

The symptoms of this disease are very similar to appendicitis. Pain however, is usually in the lower left side – not the lower right side of the abdomen as in appendicitis. The pain comes on quickly and is severe. At other times the pain may be fluctuating – worse for a few days and then better. Symptoms that occur during a diverticulitis attack are fever, nausea, constipation, diarrhea and abdominal pain.

Symptoms and signs of diverticulitis that are not as common or specific to just this disease, are frequent urination, vomiting, bloating, pain or difficulty while urinating, rectal bleeding and tenderness in the abdomen when bending over or wearing a belt or sash.

Diagnosis:

Diverticulitis is usual diagnosed incidentally when an examination is being conducted for other diseases such as colon cancer, IBD, IBS, gynecological conditions, urinary disease and ischemic colitis. At this point diverticula are detected, before an attack has occurred.

A CT scan can diagnose diverticulitis ninety-eight percent of the time. The imaging is also excellent for picking up an abscessed diverticula and guiding for drainage of the abscess.

Studies that can also determine diverticulitis are a barium enema with a lower GI or a colonoscopy. If the patient is having a severe attack of diverticulitis, these procedures are not performed as a perforation of the intestine may occur.

Diverticulitis can range from mild to severe and life threatening. A patient who suspects an attack should seek medical treatment immediately.

Cause:

Diverticula are the pouches or herniated portions of the intestine. They begin as marble sized pockets on weak places in the colon or intestine that push through the intestinal wall when under pressure. Straining during bowel movements over a number of years can cause diverticula to form. Diverticula are most often found in the descending colon and the sigmoid.

At times a bit of bowel movement or stool can become stuck in the diverticula leading to infection. The inflammation and infection is what causes diverticulitis. A tear in the pouch can lead to peritonitis, when the infection spreads to the abdominal cavity. An abscess, or collection of pus, can occur when the inflammation occurs around one portion of the diverticula.

Treatment:

Treatment depends on the severity of the attack of diverticulitis. If the attack is the initial attack and the symptoms are not severe, then a liquid, low-fiber diet with antibiotics may be the only treatment. A severe or recurrent attack may require hospitalization.

Half of all patients suffering from diverticulitis are hospitalized and possibly require intravenous antibiotics. Hospitalization is required if vomiting and fever over one hundred degrees is present.

Treatment for recurring diverticulitis may require surgery. There are two methods for surgical treatment of diverticulitis: primary bowel resection and bowel resection with colostomy. The former procedure is the standard approach for patients with acute, recurring diverticulitis. A primary bowel resection will involve removing the diseased section of the intestine and reattaching the healthy portions to the colon. Normal bowel movements will resume. Traditional surgery is required if the bowel is extremely inflamed, otherwise this procedure can be performed using laparoscopic surgery. A bowel resection with colostomy is performed when it is impossible to reconnect the colon to the rectum because of the extent of damage. A colostomy procedure will connect the colon to an opening in the abdominal wall that has been made by the surgeon. A bag is attached to the opening so that body waste may be collected. Colostomies may be permanent or temporary depending on the healing of the digestive tract.

Prevention:

Diverticulitis patients can make life style changes that will slow and maybe even stop the progression of the disease. The first recommendation is to eat more fiber in foods such as fruit and whole grains. This speeds up digestion and relieves pressure on the digestive tract. Absolutely stay away from nuts, seeds and popcorn as they can be lodged in the diverticula. Drink plenty of water to aid fiber digestion. Fiber needs water or it will become constipating. Respond to the need to have a bowel movement. Delaying this urge will lead to harder stools that will require extra force to have a bowel movement and therefore increase the stress on the colon. Regular exercise is also recommended as it encourages normal bowel movements, reducing colon pressure.

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