My digestive disorder: Diverticulitis by Alanna DeGroot

What is Diverticulitis and what are the symptoms to look for?

Diverticulitis is when the diverticula in the in the lower part of the large intestine become inflamed or torn. This often happens in older adults because the lower portion of the intestine can weaken causing the diverticula to protrude out to the outer side of the colon. Some symptoms may include: fever, nausea, constipation, vomiting, abdominal pain, and in some cases diarrhea. Abdominal pain could last for a number of days and remain constant. Typically the pain will affect the lower left portion, however it can present in the right side as well in those cases the right side tends to be more painful than the left. 

Diagnosis: 

Doctors can generally only diagnose Diverticulitis when a patient is having an acute attack. This is due to the fact that the main symptom is abdominal pain which could mean any number of things. Doctors will do a pelvic exam on women and an abdominal check on all patients. A patient would then have a urine and blood test run to make sure there is no infection. A liver enzyme test would also be ran, this is to make sure that the pain is not due to some sort of liver disease/infection. Women will typically be given a pregnancy test as well. If a patient presents with diarrhea a stool test will be performed to make sure there is no infection there as well. After all of these tests have been run, a patient would then have a CT scan which will show whether the diverticula are inflammed and if they are pushing out to the outer wall. The CT scan will be able to show the doctor how serious the Diverticulitis is and what the best course of treatment will be based on the severity. 

Treatment: 

There are few different courses of treatment based on how serious and complicated the Diverticulitis has become. If it is not complicated a doctor may recommend one or all of the following: 

• Antibiotics- taken via mouth at home per doctor instructions
• Liquid diet- until you are healed and then slowly add solid food
• Tylenol for pain relief 

If it is complicated then hospitalization will be recommend with the following treatment(s):

• Antibiotics- taken intravenously
• Drainage tube insertion- only if the Diverticulitis has caused an abscess to form 
• Surgery- see below 

In the case of severe Diverticulitis surgery may be required if an abscess, bowel obstruction, or if the bowel has been perforated, or if recurring instances of Diverticulitis. There are two different surgeries a primary bowel resection or a bowel resection with colostomy. The primary bowel resection is performed in the case of minimal inflammation and connects the healthy part(s) of the intestine back together after removing the inflamed section(s). The bowel resection with colostomy will only be performed in cases with sever inflammation that require a colostomy bag is used to collect waste while the colon heals. 

Statistics: 

• In the US, diverticulitis is the third most common disease seen my gastroenterologists.
• It costs roughly $2.1 billion dollars a year in outpatient services.
• 20% of people age 40 or younger are affected and 60% of people age 60 or older are affected.  
• Diverticulitis affects 180-100,000 people a year. 

References: 

https://www.mayoclinic.org/diseases-conditions/diverticulitis/symptoms-causes/syc-20371758

https://www.medscape.com/answers/173388-20364/what-is-the-incidence-of-diverticulitis-in-the-us

https://www.medicinenet.com/diverticulosis/article.htm