DIVERTICULOSIS AND DIVERTICULITIS

Diverticulitis is a common digestive disease particularly found in the large intestine. Diverticulitis develops from diverticulosis, which involves the formation of pouches (diverticula) on the outside of the colon. Diverticulitis results if one of these diverticula becomes inflamed.

Most people with diverticulosis do not have any discomfort or symptoms. However, symptoms may include mild cramps, bloating, and constipation. Other diseases such as irritable bowel syndrome (IBS) and stomach ulcers cause similar problems, so these symptoms do not always mean a person has diverticulosis.

The most common symptom of diverticulitis is abdominal pain. The most common sign is tenderness around the left side of the lower abdomen. If infection is the cause, fever, nausea, vomiting, chills, cramping, and constipation may occur as well. The severity of symptoms depends on the extent of the infection and complications.

Diverticulitis can lead to bleeding, infections, perforations or tears, or blockages. These complications always require treatment to prevent them from progressing and causing serious illness.

It is generally maintained (though not proven) that the main cause of diverticular disease is a low-fiber diet due to the consumption of processed foods which contain refined, low-fiber flour.

TREATMENT METHODS

The treatment for diverticulosis is to get on a high-fiber diet. Increasing the amount of fiber in the diet may reduce symptoms of diverticulosis and prevent complications such as diverticulitis. Occasionally, mild pain medications will help relieve symptoms in most cases.

Treatment for diverticulitis focuses on clearing up the infection and inflammation, resting the colon, and preventing or minimizing complications. An attack of diverticulitis without complications may respond to antibiotics within a few days if treated early. An acute attack with severe pain or severe infection may require a hospital stay. Most acute cases of diverticulitis are treated with antibiotics and a liquid diet. The antibiotics are given by injection into a vein. In some cases, however, surgery may be necessary.

Surgery becomes necessary if attacks are severe or frequent. The surgeon removes the affected part of the colon and joins the remaining sections. This type of surgery, called colon resection, aims to keep attacks from coming back and to prevent complications. The doctor may also recommend surgery for complications of a fistula or intestinal obstruction.

Emergency surgery may be required if antibiotics do not correct an attack. Other reasons for emergency surgery include a large abscess, perforation, peritonitis, or continued bleeding.

Emergency surgery usually involves two operations. The first surgery will clear the infected abdominal cavity and remove part of the colon. Because of infection and sometimes obstruction, it is not safe to rejoin the colon during the first operation. Instead, the surgeon creates a temporary hole, or stoma, in the abdomen. The end of the colon is connected to the hole, a procedure called a colostomy, to allow normal eating and bowel movements. The stool goes into a bag attached to the opening in the abdomen. In the second operation, the surgeon rejoins the ends of the colon.

In a nutshell:
•  Diverticulosis occurs when small pouches, called diverticula, bulge outward through weak spots in the colon (large intestine).
•  The pouches form when pressure inside the colon builds, usually because of constipation.
•  Most people with diverticulosis never have any discomfort or symptoms.
•  The most likely cause of diverticulosis is a low-fiber diet because it increases constipation and pressure inside the colon.
•  For most people with diverticulosis, eating a high-fiber diet is the only treatment needed.
•  You can increase your fiber intake by eating these foods: whole grain breads and cereals; fruit like apples and peaches; vegetables like broccoli, cabbage, spinach, carrots, asparagus, and squash; and starchy vegetables like kidney beans and lima beans.
•  Diverticulitis occurs when the pouches become infected or inflamed and cause pain and tenderness around the left side of the lower abdomen.
•  If attacks are severe or frequent, the doctor may advise a colon resection surgery in which the affected part of the colon is removed and the remaining sections of the colon are joined.

COST OF DIVERTICULITIS REMOVAL SURGERY

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