Acute Diverticulitis: Causes, Symptoms and Treatments

Definition:

Diverticulosis or acute diverticulitis is defined as the inflammation that occurs in the colon. The colon (large intestine) is a long tube-like structure that stores and then removes waste material that remains after digestion of food.

Causes

It is believed that the pressure inside the colon bulges the tissues creating (sacs) that push out from the walls of the colon. When more than one protruding sac are referred to as diverticula.

Diverticula may occur throughout the colon, but they are more common near the end of the left colon, known as the sigmoid colon, in western countries. In Asia, diverticula are produced on the right side of the colon.

Diverticula are common in the western world, but are rare in areas such as Asia and Africa. The diverticula increase with age. They are rare before age 40, but are seen in more than 74% of people over 80 in the US.

A person with diverticulosis usually has few or no symptoms. The most common symptoms associated with diverticulosis are abdominal pain, constipation and diarrhea.

In some of these patients the symptoms may be due to the concomitant presence of irritable bowel syndrome (IBS) or abnormalities in the function of the muscles of the sigmoid colon (in which case it is known as diverticular disease).

Occasionally, bleeding originates from a diverticulum, and diverticular bleeding is referred to. When acute diverticulitis is associated with inflammation as well as diverticular disease, they can be diagnosed with barium X-rays, sigmoidoscopy, colonoscopy, or computed tomography.

The treatment of diverticulitis and diverticular disease may include high fiber diet, and anti-spasmodic drugs.

Foods can prevent outbreaks of diverticulitis include fruits and vegetables, legumes and whole grains. It has been suggested that people with diverticulitis avoid the consumption of seeds, nuts and corn; However, there is little evidence to support this recommendation.

Symptoms of Acute Diverticulitis

Rectal bleeding

The blood in the stool may be bright red, brown in color, black and tarry, or not visible to the naked eye. Rectal bleeding or blood in the stool should be evaluated by a health professional.

Rectal bleeding can also be caused by:

  • Anemia.
  • Anal fissures
  • Cancer.
  • Colon polyps
  • Diverticulitis.
  • Hemorrhoids.
  • Ulcers (for example, ulcerative or Crohn’s colitis)

Treatment of Acute Diverticulitis

Surgery and medications

Surgery usually involves draining the segment of the colon that contains the diverticulum, when the diverticulum is bleeding surgery is also necessary, especially for people with persistent hemorrhage.

In patients who need surgery to stop persistent bleeding, it is important to determine exactly where the bleeding is coming from.

Sometimes, surgery may be indicated for patients with frequent recurrent attacks of diverticulitis, leading to multiple cycles of antibiotics, hospitalizations, the goal is to prevent future episodes of diverticulitis.

Surgery can often be performed laparoscopically, which limits pain and post-operative time for recovery.