Diverticulitis: Causes, Symptoms, Types, Risk Factors, Diagnosis, Treatment, Prevention and Complications

Diverticula are small pouches with protruding edges that can develop in the lining of your digestive tract. The bottom portion of the large intestine (colon) is where they are most frequently found. Diverticula are common, particularly after the age of 40, and rarely create issues.

Diverticulosis is the medical term for the existence of diverticula. 

Diverticulitis, which affects one or more of the pouches, is a disorder in which they become inflamed and infected.

 Excruciating stomach pain, fever, nausea, and a marked alteration in bowel habits might be symptoms of diverticulitis. Mild diverticulitis can be treated with rest, diet changes, and antibiotics. Surgery might be required for diverticulitis that is severe or repeatedly recurring.

What Are The Causes Of Diverticulitis?

Diverticula typically forms when pressure is applied to naturally weak areas of your colon. Marble-sized pouches begin to protrude through the colon wall as a result.

When diverticula tears, inflammation and, occasionally, infection follow, which is known as diverticulitis.

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What Are The Symptoms Of Diverticulitis?

Diverticulitis can cause the following signs and symptoms:

• Pain may be ongoing and last for several days.  Usually, the lower left side of the abdomen is where the pain is felt.
• However, occasionally, especially in those of Asian heritage, the right side of the abdomen hurts more.
• Vomiting 
• Nauseous.
• Fever.
• Tenderness in the abdomen.
• Diarrhea or constipation.

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What Are The Types Of Diverticulitis?

Diverticulitis is categorized by medical professionals as acute, chronic, complicated, or uncomplicated.

Acute/chronic

Diverticulitis is a chronic disease that first manifests as an acute condition, meaning it appears suddenly and goes away rapidly following therapy. Diverticulitis can occur repeatedly in certain persons, and some people experience chronic inflammation. Various explanations exist for why this occurs. It can be a symptom of a more serious chronic problem in your colon or it might be a result of an injury that didn't heal completely.

Complicated/uncomplicated

Diverticulitis is typically uncomplicated, meaning that the sole signs and symptoms are most likely inflammation and infection. It can quickly mend if the right care is given. When subsequent problems are triggered by the inflammation, diverticulitis becomes difficult. As an illustration, a diverticulum, which is the singular form of diverticula, may rupture as a result of extremely acute inflammation.

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What Are The Risk Factors Of Diverticulitis?

The following symptoms and indicators may be caused by diverticulitis:

• Aging. Diverticulitis is more common in older age.
• Obesity. Being overweight makes diverticulitis more likely to develop.
• Smoking. Smokers are more likely than non-smokers to get diverticulitis.
• Lack of physical activity. Vigorous exercise seems to lower the risk of diverticulitis.
• The diet heavy in animal fat and poor in fiber. Although the effect of low fiber on its own is unclear, a low-fiber diet coupled with a high intake of animal fat appears to raise the risk.
• Certain medicines. Steroids, opioids, and nonsteroidal anti-inflammatory medicines including ibuprofen (Advil, Motrin IB, and others), naproxen sodium (Aleve), and others are all linked to a higher incidence of diverticulitis.

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How Can We Diagnose Diverticulitis?

Diverticulitis is often only found during sudden attacks. Since stomach discomfort can be a sign of a variety of different conditions, your doctor will need to rule out other causes of your symptoms.

Your doctor will first do a physical examination, during which they will feel abdominal pain. Women often also get a pelvic examination to rule out pelvic illness.

The following tests are then likely carried out:

• Blood and urine tests to detect infection signs.
• Women of reproductive age should perform a pregnancy test to rule out pregnancy as the cause of their abdominal pain.
• A liver enzyme test can rule out liver-related causes of stomach pain.
• A stool test to rule out infection in diarrhea
• By identifying inflamed or diseased pouches, a CT scan helps confirm the diagnosis of diverticulitis. A CT scan can also identify diverticulitis and recommend a course of treatment.

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What Is The Treatment Of Diverticulitis?

Your indicators and symptoms' severity will determine your course of treatment.

Uncomplicated diverticulitis

You might be treated at home if your symptoms are not severe. Your doctor may advise you to:

• Antibiotics to treat infections, while updated recommendations say they may not be necessary in extremely mild cases.
• Drink just liquids for a few days until your bowels recover. After your symptoms improve, you can gradually increase the amount of solid foods you eat.
• The majority of patients with simple diverticulitis respond well to this treatment.

Complicated Diverticulitis

If you have a serious attack or other medical problems, you'll probably need to be admitted to the hospital. Treatment typically includes:

Intravenous antibiotics

inserting a tube within the abdomen to drain any existing abscesses

Surgery

If You have diverticulitis, surgery to treat it is probably necessary.

• You have a complication, such as a bowel abscess, fistula, obstruction, or a hole (perforation) in the bowel wall.
• You've experienced uncomplicated diverticulitis on several occasions.
• Your immune system is compromised.

There are two primary categories of surgery:

• Primary intestinal resection. Your intestine is divided into healthy and unhealthy segments, which are then anastomosed back together by the surgeon. You are able to have typical bowel movements as a result. You might undergo open surgery or a minimally invasive (laparoscopic) procedure, depending on the severity of the inflammation.
• Colostomy with Bowel resection. In the event that your inflammation prevents the reattachment of your colon and rectum, the surgeon will conduct a colostomy. A hole (stoma) in your abdominal wall is where the healthy part of your colon is connected. The perforation allows waste to enter a bag. Once the discomfort has passed, the colostomy can be reversed and the colon can be rejoined.

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Prevention Of Diverticulitis

Diverticulitis can be avoided by:

• Get frequent exercise. Normal bowel movements are encouraged by exercise, which also lowers colon pressure. Try to work out for at least 30 minutes most days.
• Take in more fiber. Diverticulitis risk is reduced by a high-fiber diet. Fresh produce, whole grains, and other fiber-rich diets help soften waste and speed up transit time through your colon. Diverticulitis is not correlated with eating nuts and seeds.
• Be sure to stay hydrated. Fibre works by absorbing water and causing your colon's soft, bulky waste to increase. However, fiber might cause constipation if you don't consume enough liquid to offset what is absorbed.
• Prevent smoking. Diverticulitis is more likely to occur when you smoke.

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Complications Of Diverticulitis

The following problems may occur in about 25% of patients with acute diverticulitis:

• Pus builds up in the pouch and develops into an abscess.
• Scarring that causes an obstruction in your bowel.
• a pathological opening between intestinal segments or between the gut and other organs (fistula).
• When the infected or inflamed pouch bursts, intestine contents leak into your abdominal cavity, causing peritonitis to develop. Medical attention must be given right away for peritonitis.

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