Diverticulitis

Diverticulum (plural: diverticula) is the pouching of the wall of the large intestine and diverticulitis is the infection or/and inflammation of the diverticula. Diverticulum is believed to develop due to changes that occur inside the intestines, including high pressure, due to faulty contraction of the intestines.

The most common risk factors are:

• Incidence (measure of risk) increases with age.
• When one follows a low fibre diet and possess a high level of saturated fat
• A family history of diverticulitis
• Excess use of NSAIDs like Aspirin
• Lack of exercise – exercise decreases the risk
• Obesity – There is an increased risk in obese people and in cases of morbid obesity, it would increase the chances of more invasive treatment

The usual symptoms are:

• Pain in the left side of the abdomen. Rarely seen, but sometimes on the right side too. The pain is constant and is tender on palpation of the area.
• Nausea and vomiting
• Fever with or without chills
• Bloody stool
• Constipation or on rare occasions, diarrhea

 The investigations usually advised are:

• Complete blood count
• Fecal occult blood test
• Abdominal ultrasound
• Abdominal CT scan – considered to be the choice of investigation to confirm the condition

The treatment of this condition depends on the severity of the symptoms along with the presence of any complications.

Treatments for diverticulitis are:

In uncomplicated diverticulitis, the usual treatment is antibiotics, analgesics along with liquid diet to reduce the inflammation and to allow the colon to heal on its own. Once the symptoms are improved, gradual introduction of semi-solid and solid foods is done.

In complicated diverticulitis, if the pain is severe and one is not able to consume anything orally, then hospitalization is advised for intravenous antibiotics and fluids.

If any complication occurs, like perforation, fistula, abscess or obstruction of the colon, then the standard treatment would be primary bowel resection with or without colostomy.

Ways to prevent diverticulitis would be:

• Consumption of whole grain bread, oatmeal, bran cereals and fibrous fresh fruits and vegetables to increase the bulk in diet
• Try to keep refined foods such as white flour, white rice and other processed foods to a minimum
• Regular exercise can help the muscles in the intestine retain their tone, which encourages regular bowel movements
• Avoid using suppositories for constipation for a long duration of time without seeking medical advice
• Prunes, prune juice and psyllium seeds may help to keep the bowels function properly