The large intestine or colon is subject to internal pressure. Sometimes, this pressure causes a part of the colon wall to stretch into a pouch or diverticula. Diverticulitis is the inflammation, often caused by infection, of one or more diverticula.
Symptoms may include:
- Pain in the left lower abdomen
- Elevated white blood cell count (leukocytosis)
Other digestive diseases share some of these symptoms, so they do not always indicate diverticulitis.
Causes and Prevention
It is believed that insufficient fiber in the diet can lead to higher colon pressures. Adding fiber to the diet, and cutting down on popcorn, seeds, and nuts, may help reduce the likelihood of diverticulitis. Obesity may be associated with diverticulitis in younger patients. In the general population, it is prevalent in older people.
A computed tomography (CT) scan is extremely effective in diagnosing diverticulitis. Images reveal thickening and increased blood flow in a portion of the colon wall.
Diverticulitis is initially treated by resting the colon with IV feeding (nothing by mouth) and antibiotics.
Patients are observed closely for signs of complications, such as peritonitis. Diet is advanced slowly, starting with clear liquids. After symptoms recede, patients should undergo a follow-up CT scan.
Approximately 20% of diverticulitis patients require surgery, either on an emergency basis if the diverticulum has ruptured, or, after several weeks after recovery from acute diverticulitis if symptoms persist.
Surgery entails removing the affected section and either connecting the two sections or performing a colostomy, in which opening of the upper section of the large intestine is brought to the skin so that waste can be collected in a bag. This surgery is usually performed laprascopically (through a few small incisions) to minimize postoperative pain and speed recovery.