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Diverticulitis

Definition: Diverticulitis is inflammation of an abnormal pouch (diverticulum) in the intestinal wall, usually found in the large intestine (colon). The presence of the pouches themselves is called diverticulosis.

Causes, incidence, and risk factors: Small protruding sacs of the inner lining of the intestine (diverticulosis) can develop in any part of the intestine. They are most common in the colon. These sacs, called diverticula, occur with increasing frequency after the age of 40. When they become inflamed, the condition is known as diverticulitis.

Diverticulitis is an inflammatory condition where the area around the diverticula becomes irritated and attracts immune cells. It affects 10% to 20% of those with diverticula at some time. These areas can become infected. Risk factors are older age and history of diverticula or prior episodes of diverticulitis. Eating a high-fiber diet and avoiding seeds and nuts may prevent episodes.

Symptoms:

  • abdominal pain, usually in the left lower abdomen but can be anywhere
  • possible constipation or diarrhea
  • chills
  • fever

Additional symptoms that may be associated with this disease:

  • bloody stools
  • nausea and vomiting

Signs and tests:

  • CT scan revealing thickening of the inflamed area
  • colonoscopy
  • sigmoidoscopy
  • barium enema
  • abdominal palpation showing left lower quadrant mass
  • stool hemoccult test revealing blood
  • elevated white blood cell count

Treatment: Acute diverticulitis requires antibiotic therapy.

Recurrent attacks or presence of perforation (hole), fistula (abnormal tube-like passage), or abscess requires surgical removal of the involved portion of the colon.

After the acute infection has stabilized, diverticulitis is treated by increasing the bulk in the diet with high-fiber foods and bulk additives such as Metamucil.

Expectations (prognosis): Usually, this is a mild condition that responds well to treatment.

Complications:

  • abscess formation
  • perforation of the colon leading to peritonitis
  • stricture or fistula formation

Calling your health care provider: Call your health care provider if symptoms of diverticulitis occur. Also call if you have diverticulitis and symptoms worsen or new symptoms develop.

Prevention: A high-fiber diet may prevent development of the disease.

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