Diverticulitis

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Diverticulitis is a condition that occurs when small, bulging pouches (called diverticula) in the digestive tract become inflamed or infected. These pouches typically form in the lining of the colon and are more common as people age. Diverticulitis can range from mild discomfort to severe complications requiring hospitalization.

Signs & Symptoms

Common symptoms include:

  • Abdominal pain, often severe and localized on the lower left side.
  • Fever and chills, indicating infection.
  • Nausea and vomiting.
  • Changes in bowel habits, such as constipation or diarrhea.
  • Bloating and a feeling of fullness.
  • In severe cases, complications like abscesses, perforations, or intestinal obstruction may occur.

Anatomy Affected

  • Colon (large intestine): The diverticula primarily develop in the sigmoid colon, the lower portion of the large intestine.
  • Peritoneum: If the diverticula rupture, it can lead to peritonitis, an inflammation of the abdominal lining.
  • Blood vessels: Inflammation or rupture can occasionally cause bleeding in the digestive tract.

Cause/Transmission

Diverticulitis is not contagious and is caused by several factors:

  1. Formation of Diverticula:
    • These pouches form when weak spots in the colon wall bulge outward, often due to increased pressure.
    • A low-fiber diet, which leads to harder stools and increased strain during bowel movements, is a common cause.
  2. Infection and Inflammation:
    • Trapped stool or bacteria in the diverticula can lead to infection and inflammation.
  3. Age and Genetics:
    • Incidence increases after age 40.
    • Family history may predispose individuals to the condition.

Treatments

Treatment depends on the severity of the condition:

  1. Mild Diverticulitis:
    • Antibiotics: For infection, though recent studies suggest antibiotics may not always be necessary for mild cases.
    • Dietary Modifications: Clear liquid diet initially, followed by a gradual reintroduction of low-fiber foods.
  2. Severe Diverticulitis:
    • Hospitalization: For intravenous antibiotics, fluids, and pain management.
    • Surgery: Required in cases of abscesses, perforation, or repeated episodes of severe diverticulitis.
      • Resection: Removal of the affected portion of the colon.
      • Colostomy: Rarely, if healing is required before rejoining the colon.

Prevention

  1. High-Fiber Diet:
    • Foods like fruits, vegetables, and whole grains can prevent diverticula formation.
  2. Regular Exercise:
    • Promotes healthy bowel function and reduces pressure in the colon.
  3. Hydration:
    • Adequate water intake softens stools.
  4. Avoid Straining:
    • Proper bowel habits, including not delaying bowel movements, reduce pressure in the colon.

Prognosis/Outlook

  • Mortality Rate: Rarely fatal when treated promptly. Severe cases involving complications, like perforation or sepsis, carry higher risks.
  • Recovery:
    • Most cases resolve with conservative treatment within a few weeks.
    • Recurrent episodes may require surgical intervention.
  • Long-term Outlook: With lifestyle changes, many individuals prevent recurrence or complications.

Timely intervention and adherence to preventive measures significantly improve outcomes for individuals with diverticulitis.

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