Diverticulitis

What Is Diverticulitis?

Diverticula are small, swollen pockets that primarily form in weak spots of the lining of the large intestine (colon), resulting in a condition known as diverticulosis.

These pockets are fairly common and mostly harmless unless they tear and become infected or inflamed. This is then referred to as diverticulitis.

To confirm a diverticulitis diagnosis, the specialists at Digestive Healthcare Center (DHC) may recommend the following to rule out other potential conditions:

• Blood and urine tests to check for infection
• Computed tomography (CT) scan to indicate location and severity of infection or inflammation
• Liver function tests to eliminate other reasons for abdominal pain
• Pregnancy test (to women of a childbearing age) to ensure pregnancy is not the source of symptoms
• Stool test to dismiss any other conditions for patients with diarrhea

Risk Factors for Diverticulitis

Risk factors for developing diverticulitis include:

• Age (diverticulitis appears mainly in patients over 40 years old)
• High-fat and low-fiber diet (diets high in animal fat and low in natural fibers may increase the chances of diverticulitis emerging)
• Lack of exercise (an active lifestyle may reduce your risk of experiencing this condition)
• Medications (certain medications may increase the risk of diverticulitis, including steroids, opiates and over-the-counter anti-inflammatories, such as Advil^® and Aleve^®)
• Obesity (excessive weight increases the chances of developing this condition)
• Smoking (smokers are more likely to develop diverticulitis than patients who don’t smoke)

Symptoms of Diverticulitis

Symptoms of diverticulitis may last from several hours to several days, depending on the severity of the infection or inflammation. Symptoms include:

• Constipation
• Diarrhea
• Fever and chills
• Gas or bloating
• Nausea and vomiting
• Tenderness, pain or cramping, usually in the lower left side of the abdomen (may occur in the right for some patients)

Treatments for Diverticulitis

Treatments for diverticulitis are dependent upon the severity of the condition.

If symptoms are mild, patients are typically treated at home with:

• A liquid diet, followed by a slow graduation to solid food
• Antibiotics (if infection is the cause)
• Over-the-counter pain relievers

If symptoms are severe or there are other health complications, hospitalization may be required. When patients are hospitalized, treatment usually involves intravenous antibiotics and tube insertion to drain an abscess (if one has formed). 

Surgery for Diverticulitis

In some cases, surgery might be required to effectively treat diverticulitis. Patients who could potentially benefit from surgery may:

• Be immune compromised
• Have a complication, such as a fistula (an abnormal connection between two body parts), abscess, perforation or bowel obstruction
• Have had numerous attacks of mild diverticulitis

If surgery is deemed necessary, there are two types of surgical treatments for this condition:

Primary bowel resection: Diseased portions of the intestine are removed, and the healthy segments are reconnected. This procedure may be done as an open surgery or a minimally invasive one, depending on the amount of inflammation.

Bowel resection with a colostomy: Sometimes, due to the amount of inflammation, reconnecting the healthy segments isn’t possible. The surgeon will then perform a colostomy, connecting the healthy colon to an opening in the abdomen for waste to pass through and, ultimately, into a bag. The bowel sections may be reconnected once the inflammation has improved.