The large intestine (colon) is the last part of the digestive tract. Food passes through it just before waste leaves the body as a bowel movement (stool). In diverticular disease, parts of the colon wall are weak. These weak places can puff out like small sacs (diverticula). Each sac is called a diverticulum. These parts can become red and swollen (inflamed) and infected. Diverticulitis is the disorder when diverticula become inflamed and infected. Diverticulitis can be a minor inflammation or a serious infection.
Diverticulitis occurs in about half of people who have diverticuli. About 3 cases per 100 people occur each year. With treatment the prognosis is good, but relapses do occur. Complications include hemorrhage (bleeding), perforation (rupture), bowel blockage, and abscesses.
Diverticuli become inflamed and infected, and small abscesses form, which causes symptoms. This disorder can occur if breakdown products from food move too slowly through the colon. Pressure in the colon from feces and food by-products causes weak spots and sacs. Diverticulitis is not contagious or cancerous.
Symptoms are cramping and pain in the abdomen (belly) that stops and starts but then becomes constant. The pain is usually in the left lower abdomen. It’s usually severe and starts suddenly. Other symptoms are fever, chills, constipation or diarrhea, and loss of appetite and nausea.
The health care provider will make a diagnosis from a medical history, physical examination, blood tests, x-rays, and computed tomography (CT). Blood tests will check for infection. CT will show the inflammation and infection. Certain tests such as colonoscopy and barium enama shouldn’t be done during acute diverticulitis because they may cause the colon to burst at the place of diverticulitis.
Outpatient treatment is usual, unless symptoms are severe and widespread infection or complications occur. Rest, stool softeners, liquid diet, and oral antibiotics are used. If a hospital stay is needed, treatment is similar, but intravenous fluids and antibiotics are given, together with pain medicine. At first, eating may not be allowed. Then, high-fiber, low-fat foods are slowly returned to the diet.
For severe or complicated cases, surgical removal of the affected part of the colon is possible. Surgery is also used for frequent diverticulitis to remove the affected area of the colon.
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