Definition
Diverticulitis is inflammation or infection in a pouch that forms in the wall of the large intestine (colon). The pouch is called a diverticulum (multiple pouches are called diverticula). The presence of pouches without inflammation is called diverticulosis.
Diverticulitis
Causes
The reason why pouches form in the colon wall is not clear. Doctors believe a constant pressure is built up when food moves too slowly through the bowel. This pressure increases then pushes along the colonic side walls resulting in pouch formations. Digested food or stool becomes trapped in one of the pouches and leads to inflammation and infection.
The following may contribute to diverticulitis:
• Low-fiber diet – fiber softens stools and makes them pass through the bowel more easily
• Increased pressure in the bowel from straining to pass a hard stool
• Defects in the colon wall
• Chronic constipation
Risk Factors
A risk factor is something that increases your chance of getting a disease or condition.
• Eating a low-fiber diet
• Age: 50 or older
• Previous episodes of diverticulitis
• High meat or protein diet
• Chronic constipation
Symptoms
Diverticulitis symptoms can come on suddenly. They vary in intensity depending on the severity of the infection.
Symptoms include:
• Abdominal pain
• Tenderness, usually in the left lower abdomen
• Swollen and hard abdomen
• Fever
• Chills
• Poor appetite
• Nausea
• Vomiting
• Diarrhea
• Constipation
• Both diarrhea and constipation
• Cramping
• Rectal bleeding
Diagnosis
The doctor will ask about your symptoms and medical history, and perform a physical and rectal exam. Early diagnosis is important because the pouch can break, releasing stool into the abdomen. This is a surgical medical emergency.
Tests may include:
• Analysis of a stool sample to look for blood
• Blood tests to look for signs of infection, inflammation, and bleeding
• X-rays to look for a rupture
• CT scan or ultrasound to locate and determine the size of the inflamed pouch
Once the inflammation subsides, other tests may be performed, including:
Barium Enema – injection of a dye into the rectum that makes your colon show up on an x-ray so the doctor can see abnormal pouches in your colon
Flexible Sigmoidoscopy – a thin, lighted camera is inserted into the rectum to examine the rectum and the lower colon
Colonoscopy – a thin, lighted camera is inserted through the rectum and into the colon to examine the entire lining of the colon
Treatment
The goals of immediate treatment are to:
• Resolve the infection and inflammation
• Rest the bowel
• Prevent complications
