Treating diverticular disease and diverticulitis 6. Complications of diverticular disease and diverticulitis 7. Preventing diverticular disease and diverticulitis. About diverticular disease and diverticulitis Diverticular disease and diverticulitis are related digestive conditions that affect the large intestine colon.
Symptoms of diverticular disease include: lower abdominal pain feeling bloated The majority of people with diverticula will not have any symptoms; this is known as diverticulosis. Symptoms of diverticulitis tend to be more serious and include: more severe abdominal pain, especially on the left side high temperature fever of 38C Diverticulosis, diverticular disease and diverticulitis Diverticula "Diverticula" is the medical term used to describe the small bulges that stick out of the side of the large intestine colon.
Diverticular disease 1 in 4 people who develop diverticula will experience symptoms, such as abdominal pain. Having symptoms associated with diverticula is known as diverticular disease. Diverticulitis Diverticulitis describes infection that occurs when bacteria becomes trapped inside one of the bulges, triggering more severe symptoms.
Diverticulitis can lead to complications, such as an abscess next to the intestine. Treating diverticular disease and diverticulitis A high-fibre diet can often ease symptoms of diverticular disease, and paracetamol can be used to relieve pain — other painkillers such as aspirin or ibuprofen are not recommended for regular use, as they can cause stomach upsets. Who is affected Diverticular disease is one of the most common digestive conditions.
Symptoms of diverticular disease and diverticulitis Symptoms of diverticular disease and diverticulitis include abdominal pain, bloating and a change in normal bowel habits. Diverticulosis If diverticula have been discovered during a camera test for another reason colonoscopy or during a CT scan, you may be worried about what this means.
Diverticular disease The most common symptom of diverticular disease is intermittent stop-start pain in your lower abdomen stomach , usually in the lower left-hand side. Other long-term symptoms of diverticular disease include: a change in your normal bowel habits, such as constipation or diarrhoea , or episodes of constipation that are followed by diarrhoea — a classic pattern is multiple trips to the toilet in the morning to pass stools like "rabbit pellets" bloating Another possible symptom of diverticular disease is bleeding dark purple blood from your rectum back passage.
Diverticulitis Diverticulitis shares most of the symptoms of diverticular disease see above. Other symptoms of diverticulitis can include: a high temperature fever of 38C When to seek medical advice Contact your GP as soon as possible if you think you have symptoms of diverticulitis. If you have not been diagnosed with the condition, contact your GP so they can rule out other conditions with similar symptoms, such as: a stomach ulcer pancreatitis cholecystitis bowel cancer Irritable bowel syndrome IBS can also cause similar symptoms to diverticular disease.
Causes of diverticular disease and diverticulitis Diverticular disease is caused by small bulges in the large intestine diverticula developing and becoming inflamed. Diverticular disease It is not known why only 1 in 4 people with diverticula go on to have symptoms of diverticulitis.
However, factors that appear to increase your risk of developing diverticular disease include: smoking being overweight or obese having a history of constipation use of non-steroidal anti-inflammatory drugs NSAIDs painkillers, such as ibuprofen or naproxen having a close relative with diverticular disease, especially if they developed it under the age of 50 Exactly how these lead to developing diverticular disease is unclear. Diverticulitis Diverticulitis is caused by an infection of one or more of the diverticula.
Diagnosing diverticular disease and diverticulitis Diverticular disease can be difficult to diagnose from the symptoms, alone because there are other conditions that cause similar symptoms, such as irritable bowel syndrome IBS.
In some cases, you may be offered treatment for IBS and diverticular disease at the same time. Colonoscopy To make sure there is not a more serious cause of your symptoms, your GP may refer you for a colonoscopy, where a thin tube with a camera at the end a colonoscope is inserted into your rectum and guided into your colon.
CT pneumocolon or colonography Another technique for confirming the presence of diverticula is a computerised tomography CT scan. Diverticulitis If you have had a previous history of diverticular disease, your GP will usually be able to diagnose diverticulitis from your symptoms and a physical examination.
Further tests will be needed if you have no previous history of diverticular disease. Treating diverticular disease and diverticulitis Treatment options for diverticular disease and diverticulitis depend on how severe your symptoms are.
Diverticular disease Most cases of diverticular disease can be treated at home. Signs that you may be experiencing heavy bleeding aside from the amount of blood include: feeling very dizzy mental confusion pale clammy skin shortness of breath If you suspect that you or someone in your care is experiencing heavy bleeding, seek immediate medical advice.
Diverticulitis Treatment at home Mild diverticulitis can often be treated at home. Treatment at hospital If you have more severe diverticulitis, you may need to go to hospital, particularly if: your pain cannot be controlled using paracetamol you are unable to drink enough fluids to keep yourself hydrated you are unable to take antibiotics by mouth your general state of health is poor you have a weakened immune system your GP suspects complications your symptoms fail to improve after two days of treatment at home If you are admitted to hospital for treatment, you are likely to receive injections of antibiotics and be kept hydrated and nourished using an intravenous drip a tube directly connected to your vein.
Surgery In the past, surgery was recommended as a preventative measure for people who had 2 episodes of diverticulitis as a precaution to prevent complications. However, there are exceptions to this, such as: if you have a history of serious complications arising from diverticulitis if you have symptoms of diverticular disease from a young age it is thought the longer you live with diverticular disease, the greater your chances of having a serious complication if you have a weakened immune system or are more vulnerable to infections If surgery is being considered, discuss both benefits and risks carefully with the doctor in charge of your care.
Colectomy Surgery for diverticulitis involves removing the affected section of your large intestine. There are 2 ways this operation can be performed: an open colectomy — where the surgeon makes a large incision cut in your abdomen stomach and removes a section of your large intestine laparoscopic colectomy — a type of "keyhole surgery" where the surgeon makes a number of small incisions in your abdomen and uses special instruments guided by a camera to remove a section of large intestine Open colectomies and laparoscopic colectomies are thought equally effective in treating diverticulitis, and have a similar risk of complications.
Stoma surgery 'having a bag' In some cases, the surgeon may decide your large intestine needs to heal before it can be reattached, or that too much of your large intestine has been removed to make reattachment possible.
There are 2 ways this procedure can be carried out: An ileostomy — where a stoma is made in the right-hand side of your abdomen. Your small intestine is separated from your large intestine and connected to the stoma, and the rest of the large intestine is sealed. You will need to wear a pouch connected to the stoma to collect waste material poo. A colostomy — where a stoma is made in your lower abdomen and a section of your large intestine is removed and connected to the stoma. As with an ileostomy, you will need to wear a pouch to collect waste material.
Results of surgery In general terms, elective non-emergency surgery is usually successful, although it does not achieve a complete cure in all cases. Complications of diverticular disease and diverticulitis Complications of diverticulitis affect 1 in 5 people with the condition.
Some complications associated with diverticulitis are discussed below. Urinary problems Diverticulitis can lead to the inflamed part of the bowel being in contact with the bladder. This may cause urinary problems, such as: pain when urinating dysuria needing to urinate more often than usual in rare cases, air in the urine Abscess The most common complication of diverticulitis is an abscess outside the large intestine colon.
Fistula A fistula is another common complication of diverticulitis. Peritonitis In rare cases, an infected diverticulum pouch in your colon can split, spreading the infection into the lining of your abdomen perforation. Intestinal obstruction If the infection has badly scarred your large intestine, it may become partially or totally blocked.
In some cases, the blocked part can be removed during surgery. Preventing diverticular disease and diverticulitis Eating a high-fibre diet may help prevent diverticular disease, and should improve your symptoms. Sources of fibre Good sources of fibre include fruit vegetables nuts breakfast cereals — but check fibre content as some are very low starchy foods — such as brown bread, rice and pasta Once you have reached your fibre target, stick to it for the rest of your life, if possible.
More detailed information on sources of fibre is provided below. Fresh fruit Good sources of fibre in fresh fruit plus the amount of fibre that is found in typical portions include: avocado pear — a medium-sized avocado pear contains 4. Starchy foods Good sources of fibre in starchy food plus the amount found in typical portions include: crispbread — 4 crispbreads contain 4.
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Diverticulitis may cause acute symptoms such as. The pain caused by diverticulitis is typically severe and comes on suddenly, although the pain may also be mild and worsen over several days. The intensity of the pain may change over time.
Experts think the following factors may play a role in causing or increasing the risk for this disease. Research suggests that certain genes may make some people more likely to develop diverticular disease.
While it is recommended that we consume 20 to 35 grams of fiber daily, most people only get about half that amount. The easiest way to increase fiber intake is to eat more fruits, vegetables or grains. Apples, pears, broccoli, carrots, squash, baked beans, kidney beans, and lima beans are a few examples of high-fiber foods. As an alternative, your doctor may recommend a supplemental fiber product such as psyllium, methylcellulose or polycarbophil.
These products come in various forms including pills, powders, and wafers. Supplemental fiber products help to bulk up and soften stool, which makes bowel movements easier to pass.
Your doctor may also prescribe medications to help relax spasms in the colon that cause abdominal cramping or discomfort. Diverticulosis may lead to several complications including inflammation, infection, bleeding or intestinal blockage. Fortunately, diverticulosis does not lead to cancer. Diverticulitis occurs when the pouches become infected or inflamed. This condition usually produces localized abdominal pain, tenderness to touch and fever.
A person with diverticulitis may also experience nausea, vomiting, shaking, chills or constipation. Your doctor may order a CT scan to confirm a diagnosis of diverticulitis. Minor cases of infection are usually treated with oral antibiotics and do not require admission to the hospital.
Diverticulitis can cause severe pain in the lower left abdomen that starts as mild and worsens, or occurs suddenly with changing intensity. Diverticular bleeding is signaled by a sudden, large amount of red or maroon-colored blood in stool causing dizziness, light-headedness or weakness.
This is a sign of peritonitis, a dangerous infection. Complications are serious and require prompt or immediate medical attention. Some can be treated with intravenous fluids and antibiotics. A needle may be inserted into your abdomen to drain pus from an abscess. In more severe cases, surgery may be needed to drain an abscess, repair a fistula or remove infected segments of colon.
With a bowel resection, the surgeon removes infected colon and reattaches healthy segments.
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