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Diverticulitis

What is Diverticulitis?

Diverticulitis is a condition characterized by the inflammation or infection of one or more diverticulum. Diverticula are tiny pouch-like structures that may be found in the intestinal wall, especially in older individuals.

Causes of Diverticulitis

The diverticula are weak spots within your intestinal walls that may balloon outwards. They become inflamed or infected when incompletely digested food or fecal matter blocks the opening into the diverticula, resulting in diverticulitis. Some of the common risk factors for diverticulitis include:

  • Advanced age
  • Obesity 
  • Lack of exercise
  • Smoking
  • Certain medications

Symptoms of Diverticulitis

The signs and symptoms of diverticulitis include:

  • Pain 
  • Nausea and vomiting
  • Fever
  • Abdominal tenderness
  • Constipation
  • Diarrhea
  • Rectal bleeding

Diagnosis of Diverticulitis

Your doctor will review your symptoms and medical history and perform a thorough physical examination including checking your abdomen for tenderness, and a digital rectal exam to identify any masses, bleeding, or other problems. Diagnostic tests to rule out other conditions include:

  • Blood tests: Your blood will be tested for signs of anemia, liver or kidney problems, or infection.
  • Stool sample: Your stool sample is checked for the presence of abnormal bacteria or parasite infection. 
  • CT scan: This test can detect the infected or inflamed diverticula and reveal the severity of the diverticulitis.
  • Barium enema: In this test, a liquid containing barium is inserted through the anus. The liquid coats the inside of the colon, which helps make any abnormalities more visible on X-rays.
  • Colonoscopy: In this exam, a tube-like instrument with a miniature camera and light source is inserted through the anus to detect changes and abnormalities of the large intestine (colon).
  • Sigmoidoscopy: This test is used to examine part of the colon and rectum. A thin flexible tube with a light and camera is inserted into your rectum and moved into your sigmoid colon. The camera allows a visual inspection of your sigmoid colon and rectum.
  • Angiography: This is an imaging test that uses X-rays to identify the source of rectal bleeding.

Treatment for Diverticulitis

Treatment depends on the severity of your signs and symptoms. Uncomplicated diverticulitis can be treated by medications and a liquid diet for a few days to improve the condition.

If you develop a complicated case of diverticulitis that cannot be treated with diet and medication alone, your doctor may advise you to undergo one of the following procedures:

  • Needle Drainage: In this procedure, a needle is inserted into the abdomen to drain pus from an abdominal abscess.
  • Surgery: If you have complications from the diverticulitis such as a bowel abscess, fistula, obstruction, bowel wall puncture, or weakened immune system, you may require surgery.
    • Primary Bowel Resection: In this procedure, the doctor removes the diseased part of your intestine and then rejoins the healthy parts. This allows you to have normal bowel movements.
    • Bowel Resection with Colostomy: In cases with a higher rate of inflammation, a bowel resection will be performed with the help of a colostomy (the healthy bowel is connected to an opening created in the abdominal wall for removal of waste), as the inflammation prevents the rejoining of the colon and rectum.

Prevention of Diverticulitis

Preventive measures for diverticulitis include:

  • Exercise regularly
  • Eat a healthy diet
  • Drink plenty of fluids
  • Avoid smoking 
  • American Board of Internal Medicine
  • American Medical Association
  • American College of Gastroenterology
  • Texas Medical Association
  • Memorial Hermann Foundation
  • HCA Healthcare
  • Methodist Church
  • Howard University College of Medicine
  • American Society for Gastrointestinal Endoscopy
  • UT Health San Antonio