Diverticular disease and diverticulitis
Diverticula are small bulges or weaknesses that can develop in the lining of the large intestine (colon) as you age. Most people with diverticula have no symptoms and do not need any treatment. Most diverticula are discovered during colonoscopy or CT scan for other reasons. Diverticula that causes abdominal pain is called diverticular disease. Diverticula with infection/inflammation is called diverticulitis.
Symptoms of diverticular disease include:
• abdominal pain that tends to come and go and gets worse during or shortly after eating. Pain is relieved with passing motion or flatus.
• constipation, diarrhoea, or both
• occasionally, blood in stools
If your diverticula become infected and inflamed (diverticulitis), you may suddenly:
• get constant, more severe abdominal pain
• have a fever of 38C
• have diarrhoea or constipation
• get mucus or blood in your stools (rectal bleeding)
Tests to confirm diverticular disease or diverticulitis
The two tests commonly done to confirm the diagnosis is CT scan and colonoscopy or both.
Consequences of diverticulitis
About 25% of people with acute diverticulitis develop complications, which may include:
1. An abscess, which occurs when pus collects in the pouch.
2. A blockage (stenosis) in your bowel caused by scarring.
3. A fistula (abnormal connection) between sections of bowel or the bowel and other organs.
4. Peritonitis, which can occur if the infected or inflamed pouch ruptures, spilling bowel contents into your abdominal cavity. Peritonitis is a surgical emergency and requires immediate treatment
Treatment for diverticular disease and diverticulitis
1. Medical Treatment
In mild cases, starting on a high fibre diet with simple painkillers and oral antibiotics will help. However, in more severe cases, admission to hospital for intravenous fluid and antibiotics with stronger pain killers may be necessary.
2. Surgical Treatment
In rare cases, surgery may be needed to treat serious complications of diverticulitis. Surgery usually involves removing the affected section of your large intestine. This is called a colectomy. This is the treatment for rare complications such as fistulas, peritonitis or a blockage in your intestines.
The most common complication of diverticulitis is developing abscesses. Severe abscesses are drained with a technique known as percutaneous drainage, which is done by a radiologist. Often, after the abscess is successful drained, surgery can be planned electively.