Diverticulitis: What Is, Symptoms, Causes & Treatment

Diverticulitis is a bowel condition characterized by inflammation and/or infection of the diverticula, which are small pouches in the walls of the intestines, especially in the lower part of the colon.

Diverticula are usually present in adults over the age of 40, and they are more frequent in those who have chronic constipation or that do a diet that is poor in fiber. This causes the feces to get dry and get retained in the bowels, which leads to the formation and inflammation of the diverticula. Symptoms like nausea, vomiting, and stomach pain are signs of this condition. 

It's important that diverticulitis be identified and treated under the supervision of a gastroenterologist, to prevent serious complications such as perforation or intestinal obstruction.

Diverticulitis: What Is, Symptoms, Causes & Treatment

Symptoms of diverticulitis

In most cases, diverticulitis is asymptomatic and it is only identified through diagnostic tests, such as abdominal CT scan. However, some people do report signs and symptoms that are not very specific, such as:

  • Abdominal pain, especially in the inferior left-hand side, which may be constant and persist for several days;
  • Diarrhea or constipation;
  • Sensitivity on the left side of the abdomen;
  • Nausea and vomiting;
  • Fever;
  • Chills;
  • Blood in the feces;
  • Loss of appetite.

The intensity of the symptoms varies according to the severity of the inflammation, which, if light, will not produce noticeable symptoms. Meanwhile, if you have these symptoms it's important that you visit a gastroenterologist to assess the need to carry out imaging tests such as ultrasound or Abdominal CT scan, and blood tests.

Main causes of diverticulitis

The presence of diverticula in the lower part of the colon is called 'diverticulosis' and when those diverticula are inflamed the condition is called 'diverticulitis'. That inflammation can happen as a consequence of aging, as there is a loss of elasticity of the intestine muscles, which can lead to small parts of stool remaining in the area and the diverticula getting inflamed.

In addition, other situations that can cause these structures to get inflamed are diets poor in fiber and chronic constipation, which lead to dry feces which, in turn, increase pressure in the intestine and can cause the diverticula to get inflamed.

Due to small portions of feces being retained, it's also possible for there to be a small local infection, which causes the signs and symptoms of diverticulitis.

Treatment options

Diverticulitis treatment should be oriented by a gastroenterologist according to the intensity of the symptoms and the cause of the inflammation. The doctor may prescribe analgesic medication and/or anti-inflammatory medication to relieve symptoms, and antibiotics, such as Ciprofloxacin e Metronidazole, to treat or prevent the development of infections.

Additionally, the doctor may also indicate some dietary changes, being that the most important guideline is to only ingest fluids in the first three days of a diverticulitis crisis. Solids should be introduced gradually, in order not to increase the pressure inside the intestines. As the inflammation and the symptoms decrease, it's important to follow a fiber rich diet, such as fresh fruits, vegetables, or wholegrain cereals, in order to avoid the diverticula getting inflamed again. See how your diet should be during a diverticulitis flare-up.

In most cases, treatment for diverticulitis can be done at home, however, in the case of complicated diverticulitis, hospitalization is important as intravenous medication and assessment regarding a surgical procedure may be necessary. 

Possible complications 

When diverticulitis is not treated as soon as the first symptoms appear or when treatment is not done accordingly, some serious complications may appear:

  • Bleeding, which can be intense and noticeable through the presence of blood in the feces;
  • Formation of fistulas, which are connections of the intestine with other organs, which increases the risk of infection;
  • Perforation of the intestine, which is a serious complication of diverticulitis and causes intense inflammation in the abdominal region;
  • Intestinal obstruction, in which the inflammation stops the passage of feces through the intestine and this causes swelling, cramps, and vomiting.

To avoid complications it's important to follow all of the doctor's recommendations in order to decrease inflammation and avoid new crisis of diverticulitis.

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References

  • REGERT, REBECA; BERGMANN, GABRIELA A.; FILLMANN, LÚCIO S. Diagnóstico e manejo da diverticulite aguda. Available on: <https://docs.bvsalud.org/biblioref/2018/02/879424/diagnostico-e-manejo-da-diverticulite-aguda.pdf>. Access in 20 Jan 2021
  • CAMPOS, Fábio G. Diverticulite aguda. Available on: <https://cbcsp.org.br/wp-content/uploads/2016/aulas/Diverticulite.pdf>.
  • SOCIEDADE BRASILEIRA DE COLOPROCTOLOGIA. Diverticulite: Diagnóstico e Tratamento. Available on: <https://diretrizes.amb.org.br/_BibliotecaAntiga/diverticulite-diagnostico-e-tratamento.pdf>. Access in 20 Jan 2021
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