Diverticulitis of the colon: Causes, symptoms and treatment methods

This is an automatically translated article.

The article is expertly consulted by MSc Duong Xuan Loc - Gastroenterologist - General Surgery Department - Vinmec Danang International General Hospital.
Diverticulitis is the presence of one or more inflammatory colonic diverticula. If there is a lot of infection, the diverticulum wall can be destroyed, perforated and the infection spreads beyond the colon wall, forming a pocket of pus at the site, or very dangerous peritonitis, which can be fatal if not treated promptly. .

1. What is diverticulitis?

Colonic diverticula are small sac-like structures that develop in the wall of the colon. Diverticulitis is a condition when one or more diverticula are inflamed. When a colonic diverticulum becomes infected, it can cause diverticulitis, which can become inflamed in or around the diverticulum.
Colonic diverticulum often contains trapped stool, which gradually solidifies into a fecal stone (fecalith), suffocating the diverticulum lumen and compressing the diverticulum wall, allowing bacteria (often abundant in stool in the colon) to develop. proliferate in the diverticulum causing diverticulitis.

2. Symptoms of diverticulitis and diverticulitis

People with diverticular disease often have no symptoms and do not need specific treatment, while the symptoms of diverticulitis are more obvious, such as abdominal pain, especially the lower left abdomen, accompanied by diarrhea. , chills and mild fever.
Complications from diverticulitis Diverticulitis, which causes a tear in the bowel wall, can leak pus into the abdomen, leading to peritonitis (infection of the abdomen), abscess, bowel obstruction, and fistula from the intestine to the intestine. urinary tract, or other organs in the abdomen or pelvis.

3. Causes of diverticulum formation

Currently, there is still no completely clear explanation for the cause of colonic diverticulum. Doctors believe that diverticula form in naturally weak places in the wall of the large intestine under the influence of pressure. The most common location for a diverticulum is the lower part of the large intestine (sigmoid colon).

3.1 Diverticulitis and diverticulitis Diverticulitis is a common condition, and most people with diverticulitis do not know they have it. About half of people in their 60s develop diverticulitis, but of those, only 10% to 25% develop diverticulitis.
Colonic diverticulum often contains trapped stool, which gradually solidifies into a fecal stone, suffocating the diverticulum lumen and compressing the diverticulum wall, allowing bacteria (often a lot in stool in the colon) to thrive in the colon. diverticulum causes diverticulitis.
3.2 Diverticular bleeding A ruptured diverticulum blood vessel can cause diverticular bleeding. Bloody stools can be a sign of a bleeding diverticulum. Usually, bleeding from the diverticulum is painless and will go away on its own. However, in rare cases, blood transfusions or surgery are necessary due to excessive bleeding. Patients with bloody stools should immediately contact their doctor for advice.
3.3 Link between fiber and colonic diverticulum A low-fiber diet can lead to diverticulosis, although researchers have yet to find a definite cause for this condition. To prevent constipation and reduce the risk of painful colonic diverticula, add more fiber to your daily diet.

4. Foods rich in fiber

Dietary sources of fiber are diverse, including fruits, vegetables, whole grains, and legumes. Brown rice has a higher fiber content than regular white rice. In addition, should add green vegetables in daily meals. According to the American Dietetic Association, women should get about 25 grams of fiber per day, and men should get about 38 grams.

5. Diagnosing diverticular disease

Diverticulosis often has no symptoms, so people often discover colonic diverticulum when going to the doctor for other health reasons. The diverticulum can be found on an X-ray or colonoscopy. When diverticulitis causes abscesses and pain, on ultrasound and computed tomography scans of the abdomen and pelvis, pus will appear.

6. Treatment of diverticula

Most people with diverticulitis have few or no symptoms, and do not need specific treatment. To prevent constipation as well as diverticula from forming, each person is advised to have a high-fiber diet, and to supplement with fiber.
When diverticulitis symptoms - abdominal pain, fever, ... if mild, oral antibiotics are usually sufficient. When pain is worse, a liquid diet to allow the colon and intestines to recover may also be indicated. When the pain gets worse, or when you have a high fever or you can't drink fluids, you may need to stay in the hospital, with intravenous antibiotics, and not eat or drink for several days.
When do I need surgery?
When medical treatment fails, diverticulitis has complications of perforation and bleeding. Surgery usually includes drainage of the pus and resection of the colon with the diverticulum. In addition, patients with prolonged bleeding or intestinal obstruction due to diverticulitis also need surgery.

7. Prevention of diverticulitis

The diverticulum, once formed, is permanent. Currently, there is no treatment to prevent complications of diverticulosis. However, a diet rich in fiber can help laxatives, prevent constipation, thereby preventing diverticular disease symptoms. There is no evidence that nuts cause diverticulitis, however, listen to your body and eat fiber instead of nuts if you have symptoms. Drink plenty of water and exercise regularly.
Master. Doctor Duong Xuan Loc has more than 12 years of experience as a Gastroenterologist and is currently a Gastroenterologist at the Department of General Surgery - Vinmec Danang International General Hospital.

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Article referenced source: Webmd.com