Diverticula are bulges in the wall of the esophagus, small intestine or large intestine. In case of diverticulitis, one or more diverticula are inflamed. This occurs when food particles remain in the diverticula to rot. Most people with diverticulitis may suffer from fever, nausea, abdominal distension and abdominal pain. The pain occurs suddenly or gradually.
Cause
Diverticula probably arise on weaknesses in the intestinal wall, that will bulge under increased pressure. Low-fiber diet can play a role in the development of diverticula, resulting in harder stool. Hard stool remains longer in the intestine and bowel movements will be more difficult because of constipation. Insufficient exercise can lead to constipation. Hard stools cause an increased pressure in the intestine. Diverticula can get infected when stools remain in the bulge. Bacteria can quickly multiply, increasing the chance of infection. Diverticulitis is not contagious.
Symptoms
Diverticulitis usually causes no problems. Some people have symptoms, such as vague abdominal pain, abdominal cramps and sometimes constipation and/or diarrhea and some mucus from the anus. When diverticula get infected, the following signs and symptoms may occur:
- Abdominal pain and abdominal cramps. The pain may be immediately severe or increase during some days.
- Fever.
- Abdominal distension.
- Altered bowel movement: severe diarrhea or severe constipation.
- Nausea, sometimes with vomiting.
- Sometimes blood loss and loss of mucus from the anus, sometimes even in large quantities. This may be the result of a bleeding diverticulum, in which a small blood vessel is ripped.
Diagnosis
Diverticula are often discovered by accident. Diverticula and diverticulitis are usually determined by means of one of the following examinations:
- Ultrasound of the lower abdomen. This examination enables the doctor to view the wall of the large intestine and to assess the severity of the inflammation.
- CT scan of the abdomen. This is done when the doctor thinks that the patient has acute, severely inflamed diverticula in the large intestine, in which sometimes an abscess can arise.
- Colonoscopy and sigmoidoscopy. During this examination, the doctor looks at the inside of the large intestine with an endoscope.
Treatment
It is normally not necessary to treat diverticula. Though it is important to ensure that the stools remains smooth. Then it’s less likely that the stools remain in the bulges. The treatment of diverticulitis includes a diet and sometimes medications. Severe cases require hospitalization or surgery.
- Nutrition. If a person has inflamed diverticula, he or she can basically continue to eat normally. In case of severely inflamed diverticula, the doctor sometimes advises a liquid diet. This allows the intestines to calm down, so the inflammation can heal better.
- Medication. In case of severe inflammation and fever, the doctor sometimes prescribes an antibiotic. The patient often also receives an agent to soften the stool and he or she can be given painkillers to reduce abdominal pain and cramps.
- Hospitalization. Severe symptoms and threatening complications may require hospitalization.
- Surgery. Diverticulitis sometimes leads to serious complications, such as a (dangerous) perforation or peritonitis. An operation in which a part from the colon is removed, is necessary then.
- Puncture. Another serious complication of diverticulitis may be the development of an abscess in the abdomen. This is an accumulation of pus. For this purpose, a drainage procedure can often be sufficient. By means of a needle, a tube is inserted into the cavity with pus, so this can be flushed clean.
Prognosis
The prognosis is often good. The earlier a person starts with a high-fiber diet, the better the forecasts. When diverticulitis is not (properly) treated, the intestine can burst at the site of the inflammation. This is called an intestinal perforation. The risk of an intestinal perforation is higher when a person has a lot of inflamed diverticula in the large intestine. Intestinal perforation can be very dangerous, because the stool can get into the abdominal cavity, resulting in peritonitis. An intestinal perforation and/or peritonitis cause acute, severe pain, usually in combination with high fever.
Considerations
- Eat healthy, varied and high-fiber, so that the stool remains smooth. Smooth, soft stools will less rapidly stay behind in the diverticula. Fibers are mainly found in whole grain products, vegetables and fruits.
- Drink sufficiently daily. In a high-fiber diet, it’s wise to drink enough. These fibers need moisture to work properly.
- Get sufficient exercise. Regular effort stimulates bowel movement and can prevent constipation.
- Quit smoking. Smoking has an adverse effect on the gastrointestinal tract.
