A B C D E F G H I J K L M N O P R S T U V W

DIVERTICULITIS

What is Diverticulitis ?

Diverticula are small outpouchings or pockets of the lower bowel (the colon). These may occur throughout the colon or just in one part. Usually diverticula cause no symptoms at all. After a period of time, there may be colicky pain and constipation, but this is uncommon before the age of 50. In acute diverticulitis, inflammation in a diverticulum produces pain in the abdomen, often with fever. There may also be altered bowel habit, either with constipation or diarrhoea. Blood may be present in the stools. Rarely an inflamed diverticulum may perforate (burst) and cause severe pain and illness.

How does Diverticulitis occur ?

Diverticula are actually weaknesses in the wall of the bowel. Undigested food residue can get stuck in these pockets. Inflammation occurs in the adjacent colon and in the pockets themselves. This causes a spasm, resulting in pain and bowel disturbance.

Why does Diverticulitis occur ?

One major theory is that a low-fibre diet causes the problem. It may do this by requiring your bowel to contract too hard in order to push the stools onward. The high pressure then allows the pockets to develop.

Treatment Involved for Diverticulitis

Diverticular disease is confirmed by a barium enema which usually shows the tell-tale pockets. If there is still doubt about the diagnosis, a narrow tube may be passed up through the anus to inspect the lining of the bowel (colonoscopy or flexible sigmoidoscopy). Unless acute diverticulitis is actually occurring, a high-fibre diet and sometimes laxatives are used to treat the condition. Fibrous fruits such as apples and pears are best, together with fresh vegetables and grains. Pain due to spasm in the colon is treated with anti-spasmodic drugs (such as mebeverine) and analgesics (such as paracetamol). When the bowel is inflamed and there is pain, it is best to rest the bowel. A low-fibre diet, or sometimes only fluids, are advised. Antibiotics are given to counteract any infection which may be in or around the diverticula. An operation to remove the main affected area of the colon may occasionally be necessary but this is usually for the small minority of patients with complicated infection or narrowing of the bowel.

During Treatment for Diverticulitis

High-fibre diets may at first cause bloating and increased flatulence. You will need to introduce the diet gradually over a few weeks. The diet should help relieve pain. Also the stools should become less solid and easier to pass. Antibiotics should cause the symptoms of acute diverticulitis to settle in a few days. They are never continued as a preventive. A very few patients develop serious complications. A diverticulum may perforate, spilling bowel contents into the abdomen cavity (peritonitis). This produces severe, constant pain. Immediate admission to hospital is essential. Rarely, the infected diverticulum can cause an abscess. This may ulcerate into adjacent organs.

After Treatment for Diverticulitis

The pain, constipation, or diarrhoea will often recur. Diverticular disease usually gives intermittent problems for many years.

If Diverticulitis is Left Untreated

Untreated diverticulitis is more likely to lead to the complications described above but this is not inevitable.

Effects on Family of Diverticulitis

The changes in diet need to be discussed with the persons responsible for food preparation. They, as well as the patient, often benefit from a discussion with a dietician.