Small pouches that develop on the intestines, called diverticula, can become infected, a condition known as diverticulitis. Around 50 percent of people over age 60 have diverticula, which most commonly affect the large intestine, the National Digestive Diseases Information Clearinghouse reports. Around 10 to 20 percent of people with diverticula develop diverticulitis at some point. Diverticulitis occurs suddenly, without warning.
Causes
At one time, it was believed that consuming small seeds and nuts could increase the risk of developing diverticulitis because they would become stuck in the pouches and create inflammation. MayoCinic.com states that this doesn’t appear to be the case. Trapped fecal material or decreased blood supply to the areas may cause diverticulitis.
Symptoms
Diverticulitis causes abdominal pain and tenderness in the lower left abdomen. Fever, chills, nausea, vomiting, cramping and a change in bowel habits may accompany diverticulitis. Bloating and rectal bleeding may also occur.
Diagnosis
Abdominal ultrasound and computerized tomography, or CT scan, can show if diverticulitis has developed in the diverticula. If diverticulosis has already been diagnosed, a doctor may make the diagnosis on the basis of the medical history. Colonoscopy or barium enema X-ray study may be done after an infection to assess severity of the disease, the Merck Manual states.
Treatment
Treatment for diverticulitis includes resting the bowel with a liquid diet, pain medication if needed and antibiotics to treat the infection. Hospitalization for intravenous antibiotics may be necessary in severe cases. Around 20 percent of people with diverticulitis require surgery because the infection doesn’t respond to treatment, Merck reports. A section of the intestine may require surgical removal if an area of the bowel develops an abscess, a walled-off area of infection. Abscesses can also be drained with a needle with ultrasound guidance.
If part of the bowel dies or becomes necrotic, removal and placement of a colostomy to divert waste products from the bowel via a stoma, an opening in the abdominal wall, may be necessary. Colostomies may be temporary, while the bowel heals, or permanent.
Complications
Diverticulitis can cause bowel complications, some severe. Fistulas, abnormal channels or openings, may develop between the large intestine and other organs, most often between the large intestine and the bladder, according to Merck. Peritonitis, inflammation of the abdominal cavity, can also occur if diverticula rupture, spilling bacteria into the abdominal cavity, the National Digestive Diseases Information Clearinghouse states. Scar tissue can cause intestinal obstruction, which requires immediate surgery for complete bowel obstruction.
