Diverticulitis is the inflammation or infection of small or raised pouches or sacs that can form in the lining of the digestive system (diverticula). This disease causes severe abdominal pain, fever, nausea and produces a change in bowel habits. It usually appears after the age of 40 and generally has a good prognosis and can be treated with rest, drugs and a change in habits.
Causes of diverticulitis
Low fiber diet
Aging, obesity, smoking, lack of exercise, a low-fiber diet combined with high consumption of animal fats and some medications such as ibuprofen and naproxen sodium favor the development of diverticula. These sacs or pouches develop at weak points in the digestive tract, usually in the colon, and protrude through the wall. Diverticulitis occurs when a diverticulum tears, causing inflammation or infection, or both.
Symptoms of diverticulitis
Abdominal pain and tenderness
The main symptom of diverticulitis is constant pain in the abdomen for several days; mainly in the lower left part of the abdomen. Other signs are:
– Nausea and vomiting.
– Fever.
– Abdominal sensitivity.
– Constipation or diarrhea; the latter is less frequent.
The possible complications of diverticulitis if it is not treated early can be: the appearance of abscesses due to the accumulation of pus in the diverticula; the formation of an intestinal obstruction; the formation of a fistula or passage between sections of the intestines or between the intestines and the bladder; or peritonitis. Peritonitis is the rupture of a diverticulum that spills its contents into the intestinal cavity. It’s a medical emergency. If it occurs, you should go immediately to the hospital emergency room.
Diagnosis of diverticulitis
Various analyzes and imaging tests
The diagnosis of diverticulitis usually occurs after the manifestation of an acute attack of abdominal pain. Confirming a case will require a physical exam to check for abdominal tenderness and a pelvic exam for women to rule out pelvic disease.
Additionally, the following will be necessary: blood and urine tests; rule out a possible pregnancy; liver enzyme analysis; stool analysis; and imaging tests such as computed tomography (CT) to identify inflamed or infected diverticula.
Diverticulitis treatment and medication
From rest, antibiotics and changes in habits and diet to surgery
The treatment that can be proposed for diverticulitis depends on the severity of the symptoms in each case. In the case of mild symptoms, it is likely that rest at home, antibiotics in case of infection and following a liquid diet will be enough until intestinal normality is recovered and solid foods can be added to the daily intake in a planned and gradual manner. Analgesics are prescribed to relieve pain.
In a case of complicated diverticulitis, hospitalization is required with the administration of intravenous antibiotics and drainage of the abdominal abscess or abscesses is usually necessary.
Surgery will be required, an intestinal resection that can be primary or with a colostomy, in case of intestinal abscess, fistula or obstruction, or a perforation in the intestinal wall. In primary intestinal resection, if it is not complicated it can be done through laparoscopy, the surgeon removes the diseased segments of your intestine and then reconnects the healthy segments (anastomosis) which allows the intestines to be evacuated normally.
In intestinal resection with colostomy, in addition to the resection, a stoma is opened in the abdominal wall that connects to the healthy part of the colon through which waste passes to a bag. It is reversible as soon as the inflammation is overcome.
Diverticulitis requires follow-up; especially after surgery.
Diverticulitis prevention
Regular physical exercise, diet rich in fiber and hydration
The prevention guideline against diverticulitis is marked by regular moderate physical activity (30 minutes of exercise almost every day) to promote intestinal transit and reduce pressure, especially within the colon. It is also key to eat a diet rich in fiber such as whole wheat bread; fruit, vegetables and vegetables; and drink plenty of fluids. It is key to soften fecal waste to facilitate and accelerate its motility through the colon.
In addition, you should drink plenty of fluids to promote the absorption of fiber and create soft, bulky fecal matter in the colon, as well as avoiding the appearance of constipation.
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