Diverticulitis together with diverticulosis make up a condition known as diverticular disease. Diverticulosis is the presence of diverticula in the digestive tract. Diverticula are small pouches in the lining of the digestive tract that are pushed out through weak spots, more commonly found in the large intestine. It sounds unnatural but according to the National Digestive Diseases Information Clearinghouse, around half of all people over the age of 60 and 10 percent of those over 40 have diverticulosis. Diverticulitis is the inflammation of diverticula, and develops in those who have already developed diverticulosis.
Symptoms
Common symptoms of diverticulitis are fever and chills if infection is present. Another common symptom is sudden, severe pain in the lower left side of the abdomen. A change in bowel habits including diarrhea and constipation can also occur. Other symptoms include nausea, vomiting, bloating and abdominal tenderness. Diverticulitis can also cause blood to appear from the rectum or in stools and indicates severity of the condition, so any noted blood should be discussed with a medical professional.
Causes and Risk Factors
As previously discussed, diverticulitis develops from the inflammation of diverticula in weak spots of the digestive tract. However, some conditions have been known to increase the risk for developing diverticular disease. As we age, our risk for developing diverticulitis and diverticulosis increases. The reason is not known, but according to the Mayo Clinic, it is thought that as we age the strength and elasticity of the digestive tract, and intestinal wall specifically, could contribute to diverticulitis. Eating a diet too low in fiber also increases the risk for developing diverticulitis as the stool becomes too hard and can strain the intestinal tract. Obesity and lack of exercise also increase the risk but specific reasons are not clear.
Complications
Rectal bleeding caused by diverticulitis is a complication that can occur. According to the NIDDC, it is thought that when diverticulitis is present, small blood vessels in the diverticula can weaken and burst, causing bleeding in the digestive tract. Another complication is perforation or tearing of the bowel. The inflammation associated with diverticulitis can sometimes be caused by a small tear in the diverticula. If the tear is large enough, stool can spill out into the abdominal cavity causing an abscess and infection in the abdomen. Another complication is the possibility of developing a fistula, which is an abnormal connection between the digestive tract and another part of the body, including other organs or the skin. The fistula could allow stools to travel to other areas of the body, causing serious complications. Obstructions can also occur, which could be a partial or total blockage of the intestines. Scarring from the diverticulitis infection can cause the obstruction and cause stools to back up in the intestines; surgery then may be necessary.
Diagnosis
Diagnosing diverticulitis can be difficult as some people can misread their symptoms for other conditions. Appendicitis, pelvic inflammatory disease, irritable bowel syndrome, colon cancer, ovarian cancer, ischemic colitis and inflammatory bowel disease have similar symptoms and need to be ruled out in order for diverticulitis to be diagnosed. Diagnosis usually includes an abdomen examination or ultrasound, blood sample to look for signs of infection, a CT scan, or colonoscopy.
Treatment and Prevention
Treatment for diverticulitis varies depending on severity but is usually centered on treating the inflammation and infection, if present. A hospital stay may be necessary if any other complications such as obstruction are present. Antibiotics will usually be prescribed for any infections, and pain-relieving medication may also be used. Resting the colon with a low fiber, liquid diet may be necessary with a gradual increase in fibrous foods. A high fiber diet is then prescribed for maintenance and prevention of diverticulitis from occurring again. Since aging cannot be controlled, drinking plenty of fluids, staying at a healthy weight, and exercising regularly are also beneficial in the prevention of the condition.
