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Symptoms, Diagnosis, And Treatment For Diverticulitis

May 25

We can't avoid some of the inevitable negative effects of aging no matter how hard we try. Years of ingesting, digesting, and processing food cause years of wear and strain on our intestines. Muscles along the colon wall contract to drive digested food forward, producing pressure in a wavelike pattern over the whole length of the colon. This aids in the movement of waste to the rectum, which is our signal that we need to go to the toilet.

Constipation, for example, weakens the colon lining over time owing to frequent and often unequal strain. Diverticulosis is a disorder in which the lining of the colon bulges through the colon wall, producing a sac or pouch. (Diverticula is the medical word for these tiny pouches.) These pouches are seen in the majority of persons over 60, and they normally create no difficulties. If a problem develops in one of these sacs, it may lead to diverticulitis, a painful and severe infection.

Symptoms of diverticulitis include stomach discomfort, fevers, and nausea, among others. Diverticulitis is usually treated with simple measures such as short dietary adjustments and medications. Diverticulitis affects the majority of individuals. A pouch, on the other hand, may rupture open, pouring feces straight into a person's circulation. As a consequence, there is an immediate danger of getting sepsis, a life-threatening blood infection. Occasionally, surgery is required to repair a piece of the colon with a ruptured pouch or to treat a fistula—an improper connection—formed by a pouch with a neighboring organ.

The digestive disease specialists and surgeons at Yale Medicine can assist patients with diverticulitis decide the best course of therapy. When determining the optimal course of therapy for each patient, our gastroenterologists use the most up-to-date evidence. "We now know that antibiotics may not be needed to treat moderate bouts of diverticulitis, and that surgery may be required only in a small percentage of patients with extensive diverticulitis," explains Yale Medicine gastroenterologist Anil Nagar, MD.

Why does diverticulitis occur?

Diverticulitis occurs when a single sac (diverticulum) in the colon gets obstructed or filled with feces. Inside the sac, bacteria starts to thrive, causing irritation and infection. Researchers are baffled as to why this occurs and how dietary fiber contributes to or prevents the development of diverticulitis.

How can you know if you have diverticulitis?

Many patients complain of a strong ache in their lower left stomach, which is where sacs usually form (though they sometimes occur on the right, in which case the pain is felt there). Other signs and symptoms may include:

  • Cramps and acute abdominal soreness
  • Fever
  • Vomiting and nausea
  • Constipation

What people are at risk for diverticulitis?

After the age of 60, diverticulosis becomes more prevalent. While experts have yet to discover a technique to determine who is most at risk for diverticulitis, the following characteristics tend to enhance a person's chances of getting it:

  • Smoking
  • Low-intensity living
  • Steroids and opioids are two examples of drugs
  • Obesity
  • Marfan syndrome and Ehlers-Danlos illness, both of which alter connective tissue in the body, seem to enhance an individual's chance of acquiring the sacs at a younger age

Diverticulitis cases in young people may be on the rise, according to new study. "This might be linked to rising obesity rates, a lack of physical activity, and changes in our eating habits," Dr. Nagar explains.

What are the symptoms of diverticulitis?

Because its most prevalent symptom—severe stomach pain—can be caused by a variety of illnesses, diverticulitis is diagnosed by ruling out other possibilities. Your doctor will most likely begin with a physical examination and a review of your medical history. A diagnosis may also entail one or more of the following tests:

  • Test your blood
  • Sample of feces
  • Rectal digital examination
  • Abdominal ultrasound imaging, CT scan, and X-ray
  • Colonoscopy

What is the treatment for diverticulitis?

Allowing the colon to relax and cleaning out inflammation and infections are the main goals of treatment. Recent study reveals that, contrary to popular belief, not all instances of diverticulitis need antibiotic treatment. Some patients, but not all, need hospitalization.

Inpatient care (hospitalization). Patients with severe diverticulitis may need several days of intravenous antibiotics and fluids. This method gives the colon a chance to relax. If a patient's condition improves within a few days, he or she is frequently given a lengthier prescription of antibiotics to take home. If the patient's condition does not improve, colon surgery to remove diverticula-affected areas may be necessary.

Outpatient therapy. Some people may be treated safely without being sent to the hospital if they are given a clear liquid diet and, if needed, antibiotics.

A physician may suggest increasing the quantity of dietary fiber in a person's diet once they have recovered, although this is case-by-case.

"After an incident of diverticulitis, it's critical to get a colonoscopy to screen for colon cancer," Dr. Nagar explains. "Fruits and nuts are not need to be avoided, and probiotics do not seem to help prevent the condition."