The diverticulum is a ridge similar to the tip of a gloved finger.
It may be located in different areas of the gastrointestinal tract, but more often, it manifests between the muscle fibers of the walls of the large intestine. The diverticulum can penetrate and be retained in a small amount of stool; in the same way, if the conditions are favorable can accommodate colonies of bacteria.
The diverticula are of two types: hypotonic and hypertonic. The hypotonic is installed due to the relaxation of the smooth muscles of the intestine, and the hypertonic is caused by the abnormal increase in muscle tone and the significant increase in pressure in the colon. The presence of numerous diverticula in the intestine is called diverticulosis. It is believed that a large part of the population over 60 years of age are asymptomatic carriers of this condition.
Diverticulitis is when diverticula become inflamed or infected and may have an abscess or perforation. In such cases, there is a greater risk that intestinal waste may escape into the abdominal cavity and cause a complication called peritonitis.
Among the causes of diverticulosis may include:
* Aging and the consequent loss of elasticity of the intestinal muscles.
* A diet low in fiber.
* The increase in pressure inside the colon.
* Genetic predisposition.
Symptoms of Diverticulitis
In most cases, diverticulosis is an asymptomatic disease that goes unnoticed and is only diagnosed under investigation. When the symptoms appear, they are non-specific discomforts of abdominal discomfort, more on the left side, constipation, and changes in bowel habits.
Diverticulitis acute is a sign of a complication of diverticular disease. Depending on the severity, the most important symptoms are pain below the navel, moving to the lower left quadrant of the abdomen, constipation, diarrhea, bloody stools, difficulty urinating, fever, nausea and vomiting, fistulas, and bleeding.
The diagnosis of acute diverticulitis must consider the patient’s clinical history, clinical examination, and computed tomography findings. Barium enema and colonoscopy should not be done in this first stage because the free transit of feces through the perforation of the diverticulum can cause abdominal infection and severe peritonitis.
Establishing the differential diagnosis of diverticulitis is essential to distinguish it from diseases such as appendicitis, colon cancer, and Crohn’s disease, among others.
Treatment of Diverticulitis
If there are no signs of severity, the initial treatment for mild diverticulitis is a liquid diet associated with analgesics and antibiotics. In general, within 72 hours, 80% of cases progress positively. If the answer is negative, there are two options: surgery to remove the affected part of the intestinal diverticulosis and drainage of the abscesses by percutaneous puncture if they are small. As relapses of acute diverticulitis are usually frequent, surgery can be scheduled according to the convenience and underlying conditions of the patients.
- Preferably Include high-fiber foods in your usual diet. Fruits, vegetables, whole grains, and beans are necessary for the digestive process and essential for proper bowel function for the prevention of diverticular disease.
- Drink at least two liters of fluid per day to facilitate stool formation.
- Do not take laxatives on your own to deal with constipation crises. Consult a doctor.
- Remember that physical activity helps increase metabolism and, consequently, intestinal transit.