Diverticulitis is a common disease of the large intestine generally characterized by constipation, abdominal cramping and fever. Aging, too little fiber in the diet, lack of exercise and obesity are among the risk factors, according to the Mayo Clinic. The clinic advises you to see your primary-care physician if you think you have this disease. He will probably refer you to a gastroenterologist. Antibiotics are a mainstay of treatment, although some complications require more aggressive treatment.
Causes
Diverticulitis is preceded by diverticulosis. Marble or coin-sized protrusions develop in the wall of the digestive tract, usually the colon. The protrusions are called diverticula and occur in places where the wall is weak. The condition of having diverticula is called diverticulosis, according to the Merck Manual. Diverticulitis is inflammation or infection of the diverticula. It is unclear exactly how the diverticula become inflamed, but theories include blockage of the diverticula by fecal matter, reduced blood supply and breakdown of the wall of the diverticula.
Symptoms
Most of the time diverticulosis is asymptomatic. In contrast, diverticulitis generally is symptomatic. The two most common symptoms are pain and fever. Abdominal pain and tenderness are usually localized in the lower left of the abdomen. Other symptoms can include chills, nausea, vomiting, loss of appetite and change in bowel habits.
Complications
There are generally five possible complications of diverticulitis. Rectal bleeding is a possible complication but is much more common with diverticulosis in the absence of diverticulitis. The development of an abscess is another possible complication. Scar tissue, another possible complication can cause an intestinal blockage. The inflamed diverticula can also rupture, which is a surgical emergency. Finally, a fistula can form. This is an abnormal passageway between two organs, such as from the colon to the small intestine or bladder.
Risk Factors
Risk factors for diverticulitis include being over the age over 40, a sedentary lifestyle, obesity and a diet poor in fiber.
Diagnosis
To diagnose diverticulitis, a physician will go over your medical history and assess your symptoms, such as abdominal tenderness and fever. Blood tests may show a high white blood cell count, indicating inflammation or infection. A CT scan or ultrasound can also be helpful.
Treatment
Treatment of diverticulitis is typically rest, a liquid diet and oral antibiotics, usually ciprofloxacin plus metronidazole, or amoxicillin plus clavulanic acid for seven to 10 days. More severe symptoms, such as a high fever, warrant admission to a hospital for observation and intravenous fluids and antibiotics. Primary agents for moderate disease may include ampicillin plus sulbactam, piperacillin plus tazobactam or ticarcillin plus clavulanate, with alternative agents available if needed. Primary agents for severe disease include imipenem or meropenem, with others available as needed. Surgery may be required to treat complications such as a perforation of the bowel. In addition, elective surgery may be done in some cases to remove the diseased part of the intestine.
