It is estimated that 60 percent of Americans over the age of 60 will develop diverticulitis. The number of Americans over the age of 55 is expected to double by the year 2030. Unless a cure or means of prevention is found, diverticulitis will be a large issue in the United States. Diagnosing and treating the elderly can be more complex than with younger people, making the impact of diverticulitis more difficult for the aged.
Anatomy
The large intestine's job is to convert liquid waste into solid stool and expel it to the outside through the rectum. If solid waste stays in the intestine too long, it builds up and exerts pressure on the intestinal wall. Chronic pressure causes pouches to develop in the wall, which can become infected or rupture, spilling stool into the abdominal cavity.
Causes and Symptoms
This uncomfortable and potentially deadly disease of the large intestine is associated with a lifetime of eating refined foods that are low in fiber. Diverticulitis was first diagnosed in the early 1900s, just when refined foods began to appear in the American marketplace, according to the National Digestive Disease Information Clearinghouse. Symptoms of diverticulitis include abdominal discomfort, bloating, constipation, cramping, nausea, vomiting, fever, chills, or a change in bowel habits.
Aging Intestine
Age seems to have little effect on the large intestine, according to Merck. However, constipation becomes more common and hard stools lead to the development of pouches associated with diverticulitis.
Diagnosis
Diverticulitis may be more difficult to spot in geriatric patients. Older people lose sensitivity and are often unaware of abdominal cramping or bloating. Other pre-existing or new conditions may have similar symptoms as diverticulitis, masking the disease. Obtaining a definitive diagnosis through the use of endoscopy and other advanced radiology tests can be complicated when working with the elderly. Pre-existing conditions such as arthritis can make lying still for testing uncomfortable for the patient. A confused patient may be frightened or upset by testing.
Treatment
The first course of treatment for diverticulitis is antibiotics, which are given in lower doses to older patients. Kidney function diminishes as the body ages, and older kidneys may not be able to eliminate the antibiotics from the body. Surgery is sometimes necessary to repair the damage caused by diverticulitis. Although surgery is commonly performed on the elderly---more than one third of all operations are performed on people aged 65 or older---geriatric patients are more prone to surgical complications such as delirium, pneumonia, blood clots, and even death.
