Diverticulosis happens when pouches (diverticula) form in the wall of the colon. If these pouches get inflamed or infected, it is called diverticulitis.
The exact cause of diverticulosis is unknown, however some theories include chronic constipation with repeated bouts of straining to defecate. Also, diverticulosis is thought to occur more often in those who follow a low-fiber diet. Without fiber to add bulk to the stool, the colon has to work harder than normal to push the stool forward. The pressure from this may cause pouches to form in weak spots in the musculature of the colon. Diverticulitis happens when feces get trapped in the pouches (diverticula) which allows bacteria to overgrow and lead to inflammation or infection.
- Tenderness, cramps, or pain in the abdomen (usually in the lower left side but may occur on the right) that is sometimes worse when you move.
- Fever and chills.
- A bloated feeling, abdominal swelling, or gas.
- A change in bowel habits, diarrhea or constipation.
- Nausea or vomiting.
- Loss of appetite.
Your doctor will take a history and do a physical exam if diverticulitis is suspected. Depending on your symptoms, you may have one or more tests to rule out other medical problems that could be causing your symptoms.
These tests may be done any time you see your doctor about abdominal pain or other symptoms.
- Blood tests to evaluate for infection or anemia to suggest blood loss
- Urinalysis to evaluate for a urinary tract infection.
- Abdominal X-ray
- The digital rectal exam
- The fecal occult blood test looks for blood in your stool.
- A computed tomography (CT) scan
- Flexible sigmoidoscopy and colonoscopy. However, endoscopic exams are not usually done while you are having an attack of diverticulitis because of the risk that the scope could tear the lining of the colon (perforation) and could cause a more serious infection.
You may have a brief (acute) bout of diverticulitis that goes away after treatment with antibiotics and a liquid diet. But in some cases the condition occurs off and on over a long term (chronic) period. Treatment is the same in both cases, unless complications occur.
Treatment for diverticulitis depends on how bad your symptoms are. If the pain is mild, treatment may include: Medications (antibiotics and pain relievers) and changes in diet, starting with a clear-liquid or bland diet that is low in fiber. Once the pain is resolved diet is centered around slowly increasing the amount of fiber.
If your case is more severe, ie You are not able to remain hydrated, bleeding occurs, etc, a hospital stay may be needed. Treatment may then include antibiotics given intravenously (IV), IV hydration and pain medications.
Surgery is sometimes considered for either complications of diverticulitis ,or if you have had repeated attacks that are not helped by andtibiotics and changing your diet. Overall, fewer than 6 out of 100 people who have diverticulitis need surgery.
Most cases of promptly treated diverticulitis will improve in 2 to 3 days. If your doctor prescribed antibiotics, take them as directed. Do not stop taking them just because you feel better.
Treatment after recovery from an attack of diverticulitis is aimed at preventing another attack. Treatment may include:
- Gradually increasing the amount of fiber in the diet through fruits, vegetables, wheat bran, and possibly the regular use of a fiber supplement.
- Getting plenty of fluids daily.
- Having regular doctor visits to monitor your condition. A colonoscopy may be recommended several weeks after symptoms are under control and treatment is completed. This is to look for resolution of inflammation, as well as, for any other problems such as inflammatory bowel disease or colon cancer.
