Define Diverticulitis and its symptoms, causes, risk factors, treatment and prevention with diet

Define Diverticulitis and its symptoms, causes, risk factors, treatment and prevention with diet
Define Diverticulitis and its symptoms, causes, risk factors, treatment and prevention with diet

What is diverticulitis?

Diverticula are tiny pouches that form along the lining of your digestive tract, especially in the colon or large intestine. Diverticula are formed from ballooning of weak spots (under pressure) present in the walls of the intestine. Diverticulitis is characterized by infection and inflammation of these pouches or diverticula. Diverticulitis needs treatment as it causes various symptoms and may result in serious complications.

how does diverticulitis look like
How does diverticulitis look like?

Diverticulosis vs. Diverticulitis

The presence of diverticula that are not inflamed or infected is referred to as diverticulosis. There are no symptoms due to this condition and it does not require any treatment.

If symptoms are present due to diverticulosis, the condition is referred to as SUDD or symptomatic uncomplicated diverticular disease. The symptoms caused due to this condition are similar to symptoms of IBS (irritable bowel syndrome) and includes bloating and abdominal pain.

10-20% of people having diverticulosis progress to get SUDD; and out of those, around 4% gets diverticulitis.

What are the risk factors of diverticulitis?

Though multiple risk factors exist for diverticulitis, the key factor is age. The greater your age is the higher is your risk of getting the condition.

Diverticulosis, which is the precursor of diverticulitis, is quite common in the elderly particularly in adults over the age of 60 years. 60% of persons of age greater than 70 years have diverticulosis whereas, 75% of those who are of age 80 years and older suffer from the illness.

Diverticulitis pictures

What are the causes of diverticulitis?

According to physicians there is no one thing in particular that result in diverticulitis. They do believe that the main cause of the illness is the blockage of the diverticular opening by the fecal matter, which results in infection and inflammation. However, according to them why that blockage occurs can vary in different individuals.

Several factors seem to result in diverticulitis. Some of these factors are:

  • A diet low in fiber: A diet lacking dietary fiber has been considered a risk factor since long; however, there are conflicting results of research. However, it’s still believed to be a causative factor in the development of diverticulitis.
  • Heredity: There exists a hereditary link to the development of diverticulitis.
  • Obesity: Being overweight and obese increases your risk of developing diverticulitis. Furthermore, being morbidly obese increases your risk of requiring more invasive methods to treat diverticulitis.
  • Lack of physical activity: It’s not clear if leading a sedentary lifestyle is a risk factor for diverticulitis. However, doing vigorous physical activity reduces your risk of developing the disease.
  • Smoking: Smokers are more likely to get complicated and symptomatic diverticulitis in comparison to nonsmokers.
  • Certain medicines: Using certain medicines such as aspirin and other NSAIDs regularly increase your risk of developing diverticulitis. Using steroids and opiates increases the risk of perforation, which is a serious complication of the disease.
  • Lower levels of Vitamin D: In one study, levels of Vitamin D were found to be lower in people who have complicated diverticulitis in comparison to people who have uncomplicated diverticulosis. Hence, it is suggested by this study that levels of vitamin D are related to the complications of diverticulitis.
  • Sex: In individuals of age 50 years and less, the condition is more common in males than females. In individuals greater than 50 years, it appears to be more common in females.

What are the symptoms of diverticulitis?

The most common symptom of diverticulitis is pain in abdomen. It occurs in the left lower side of abdomen. Diverticulitis mostly affects the colon present in that area.

Other symptoms of diverticulitis are:

  1. Nausea
  2. Fever
  3. Vomiting
  4. Gas and bloating
  5. Constipation
  6. Diarrhea
  7. Tenderness in abdomen
  8. Increased urge to pass urine, passing urine more times than usual, or burning while passing urine

Presence of blood in stool and bleeding from rectum may be present in both diverticulitis and diverticulosis. According to research, up to 17% of individuals who have chronic diverticulitis suffer from bleeding.

When to visit your physician?

Visit your physician if you suffer from mild pain in abdomen that is not relieved after 24 hours. Call your physician immediately if pain in abdomen worsens or if it is accompanied by bleeding or severe symptoms including fever, vomiting, nausea or diarrhea.

What are the complications of diverticulitis?

Around 25% of individuals suffering from acute diverticulitis may develop complications including:

  • Abscess formation that occurs when there is collection of pus in the pouch.
  • Blockage of small intestine or colon due to scarring.
  • Fistula (abnormal passage) formation between bowel sections or bladder and bowel.
  • Peritonitis, which occurs due to rupture of inflamed or infected pouch, spilling the contents of intestines in the abdominal cavity. It is a medical emergency and needs immediate care.

What is the treatment of diverticulitis?

Treatment of diverticulitis depends on how severe your symptoms are.

Treatment for uncomplicated diverticulitis

For mild symptoms, you will be given treatment at home. Your physician will recommend:

  • Antibiotics to clear the infection.
  • A clear liquid diet for some days so that your digestive tract heals and recovers. As the symptoms improve, a diet low in fiber is recommended.
  • An OTC painkiller such as Tylenol.

Treatment for complicated diverticulitis

For a severe attack of diverticulitis or if you suffer from other medical illnesses, you may be hospitalized. Treatment involves:

  • Antibiotics are given intravenously.
  • If an abscess has formed, then a tube is inserted to drain it.

Surgery

Surgery is needed if:

  1. You have developed a complication including abscess, perforation, bowel obstruction or fistula.
  2. You have developed multiple episodes of diverticulitis (uncomplicated).
  3. Your immune system is compromised.

There are two kinds of surgeries performed:

Primary bowel resection: In this surgery the diseased portions of the bowel are removed and the healthy portions are reconnected. By this you will be able to have normal movements of bowel.

Resection of the bowel with colostomy: If the amount of inflammation is so much that the surgeon cannot reconnect your rectum and colon then they will do a colostomy. In this procedure an opening is made in the wall of your abdomen, which is connected to your healthy colon. Waste material is collected into a bag via the opening. Once the bowel inflammation is relieved the colostomy can be reversed and bowel can be reconnected.

Follow-up care

A colonoscopy is recommended 6 to 8 weeks after recovery from diverticulitis. This test is done to rule out other problems of the digestive tract such as colon cancer.
Prevention of Diverticulitis

To prevent diverticulitis:

Do regular exercise: Doing regular physical exercise promotes normal functioning of bowel and decreases pressure inside the large intestine. Aim to do at least 30 minutes of moderate intensity exercise on most days of a week.

Include more fiber in your diet: Foods high in fiber including whole grains and fresh vegetables and fruits soften fecal material and aids it in passing more easily through your large intestine. This decrease pressure inside the digestive tract.

what can i eat when i have a diverticulitis attack
What can i eat when i have a diverticulitis attack?

Drink lots of fluids: The work of fiber is to absorb water and increase the bulky, soft waste in your large intestine. However, if you are not drinking enough fluids to replace the absorbed quantity, fiber can lead to constipation.

Include probiotics in your diet: According to some experts, people suffering from diverticulitis may lack good bacteria in their intestines. Hence, taking probiotics-supplements or foods, which contain good bacteria-, are recommended as a method to prevent diverticulitis.

References

https://www.mayoclinic.org/diseases-conditions/diverticulitis/basics/definition/con-20033495
https://www.mayoclinic.org/diseases-conditions/diverticulitis/basics/symptoms/con-20033495
https://www.mayoclinic.org/diseases-conditions/diverticulitis/basics/causes/con-20033495
https://www.mayoclinic.org/diseases-conditions/diverticulitis/basics/risk-factors/con-20033495
https://www.mayoclinic.org/diseases-conditions/diverticulitis/basics/complications/con-20033495
https://www.healthline.com/health/diverticulitis#complications7
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5331592/
https://www.mayoclinic.org/diseases-conditions/diverticulitis/basics/alternative-medicine/con-20033495
https://www.mayoclinic.org/diseases-conditions/diverticulitis/basics/treatment/con-20033495
https://www.mayoclinic.org/diseases-conditions/diverticulitis/basics/lifestyle-home-remedies/con-20033495
https://www.webmd.com/digestive-disorders/tc/diverticulitis-topic-overview#1

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