The Surgeons of The Surgical Clinic want everyone to know the signs and symptoms of a flare-up in your colon called acute diverticulitis.
Diverticula are small pouches or bulging sacs that most commonly form in the lower wall of the large intestine (colon) and can sometimes be found in the small intestine. These pouches often develop near your rectum, mainly in a part of the colon called the sigmoid colon. Having these pouches is called diverticulosis, which is quite common and usually doesn’t cause problems.
WHAT IS DIVERTICULITIS?
Diverticulitis occurs when one or more of these pouches become inflamed or infected. This can happen if the pouch gets blocked or obstructed, often by stool, which puts pressure on the surrounding tissues.
HOW COMMON IS IT?
Diverticulosis (having the pouches) is very common as people age. Most individuals with diverticulosis never experience any issues. However, about 10-25% of those with diverticulosis (inflamed or infected pouches) will develop diverticulitis at some point.
What Causes Acute Diverticulitis?
Acute diverticulitis develops when colonic wall herniations become inflamed and infected. This herniation is usually due to a blockage of the lumen or obstruction from stool, which can cause pressure on nearby tissues. Inflammation in the peritoneal cavity often occurs.
The most common causes of acute diverticulitis are fecal impaction, diarrhea, appendicitis, or obstruction by colon cancer. In the past, some foods were thought to cause diverticulitis, like nuts and seeds, beans, and fried foods. There has been no evidence that these foods can become lodged in diverticula and create inflammation.
The Surgical Clinic provides expert management for treating any type of case involving an inflamed and infected hernia in the abdominal cavity.
What Are Signs and Symptoms?
The most common symptoms of diverticulitis are left lower quadrant abdominal pain, fevers, chills, rectal bleeding, urinary urgency, and altered bowel habits. Acute diverticulitis can present in various ways, from mild intermittent pain to chronic severe unrelenting abdominal pains. Fever and a change in bowel movements are common, along with constipation and diarrhea.
The symptoms of diverticulitis can also look like other problems.
Acute diverticulitis can look like a bladder infection or appendicitis. In some cases, diverticulitis can be mistaken for irritable bowel syndrome or Crohn’s colitis disease.This is why it’s essential to see a doctor and rule out other intestinal diseases to ensure you are getting proper treatment.
When to Go to the Hospital
Most of the time diverticulitis can be handled without a hospital stay. But there are some red flags that mean you need to get to the ER immediately.
Head to the hospital if:
- Your belly pain is off the charts, and Tylenol or Advil aren’t helping.
- You’re running a fever over 102°F.
- You can’t keep anything down – even water’s coming back up.
- Your stomach feels hard as a rock, or it hurts like crazy when you touch it.
- There’s blood in your stool when you go to the bathroom.
- You start feeling confused or just not yourself mentally.
Any of these could mean your diverticulitis has taken a serious turn – It could be a sign of abscesses, holes in your gut, or an infection spreading in your belly. This needs immediate medical attention.
How Do You Diagnose Acute Diverticulitis?
The most accurate way to diagnose diverticulitis is by performing a computerized tomography (CT scan). CT scans give us a clear picture of what’s going on inside the abdomen and pelvis, showing not only if diverticulitis is present but also how severe it is and if there are any complications.
The CT scan takes detailed cross-sectional images that let doctors see the inflamed pouches in the colon wall, check how thick the colon wall has become, and spot any abscesses or perforations that might have developed. This kind of detailed information is crucial for deciding how to treat the patient—whether they need antibiotics and rest or if surgery might be necessary.
Your doctor will also do a physical exam and run some blood tests. These are important and can point towards diverticulitis, but they can’t give the same level of detail as a CT scan. That’s why even if your doctor strongly suspects diverticulitis based on your symptoms and blood work, they’ll likely still order a CT scan to confirm it and rule out any other issues that might be masquerading as diverticulitis.
Risk Factors for Colon Inflammation
Risk factors for acute diverticulitis are varied and can be different for men and women.
- Age: The risk of developing diverticular disease increases with age. Around 50% of individuals over 60 years old have this condition.
- Gender: Men between 40 and 50 years old may be at a higher risk due to prostate enlargement. Older women are more affected than men. Hospitalization from the disease is more common in women, as well.
- Diet: People who consume high levels of meat produce more intestinal gas than others in their diet, leading to constipation and fecal impaction that leads to diverticulitis. Low fiber intake hasn’t been shown to prevent diverticulosis but may play a role in preventing diverticular disease from forming in the first place.
Complications of Diverticulitis
Diverticulitis can become a chronic condition, with inflammation and scarring leading to bowel blockages. The chance of recurrent attacks after a second episode of diverticulitis is greater than 50% and increases with each episode.
It is vital to get a prompt diagnosis and treatment, or else the disease can lead to complications.
- The most common complication is a localized abscess, which can usually be treated successfully with percutaneous drainage and antibiotics.
- Acute complications include intestinal obstruction or perforation, which will require surgery to repair the damage done by either one.
- Other acute complications are related to infection such as abscesses (pus) and sepsis (blood poisoning). These may occur from blood clots traveling through the bloodstream and lodging themselves into other parts of the body like the lungs or brain. Septicemia has a 50% mortality rate if left untreated, so prompt medical attention is needed for these types of infections.
- Diverticulitis is the most common cause of fistula between the colon and bladder. Severe cases of perforation can present with generalized peritonitis; this requires immediate operative intervention. In cases like these, it’s generally unsafe to restore intestinal continuity because of the increased risk of anastomotic leak. The appropriate surgical treatment in the emergent setting often requires creating a temporary colostomy or diverting ileostomy.
What Are the Treatment Options?
The Surgical Clinic offers a variety of treatment options for diverticulitis – from conservative management to surgical intervention. The decision between one or another is based on your symptoms and medical history. You must be aware of all the potential outcomes before making any decisions about your care plan.
Uncomplicated cases can often be treated with oral antibiotics on an outpatient basis. Focal peritonitis or systemic symptoms usually indicate that hospitalization, intravenous antibiotics, and bowel rest are necessary. Patients who improve with antibiotics should be evaluated with a colonoscopy to exclude cancer which can mimic diverticulitis.
Treatment Options:
- Bowel rest is a technique to help the body recover from inflammation naturally.
- Antibiotics and IV fluids are often prescribed to reduce inflammation and infection. The infection can spread to the bladder or hip joint if left untreated.
- Surgical treatment may be necessary if the diverticulitis is severe or there are complications. Surgical treatment with elective colon resection should generally be considered for patients with recurrent diverticulitis or following recovery from complicated diverticulitis. Elective colon resection has a lower risk of morbidity compared to an urgent operation. It generally avoids the need for a colostomy and can usually be accomplished laparoscopically. Laparoscopic colon resection is associated with shorter hospitalization and more rapid recovery compared to open surgery.
WHAT SHOULD YOU NOT EAT OR DRINK WITH DIVERTICULITIS?
If you’re dealing with diverticulitis, your diet can make a big difference. Everyone’s a little different, so you’ll want to chat with your doctor before making any major changes. That said, there are some foods that tend to be troublemakers for a lot of folks with this condition:
- Seeds and nuts: They’re generally healthy, but they can easily get stuck in the pouches in your colon.
- Popcorn: Movie night might need a new snack. Those kernels are like trouble magnets for diverticulitis.
- Spicy food: Your favorite hot sauce? Might have to take a break from it. Spicy stuff can really irritate your gut.
- Fried foods: Greasy fries and onion rings are hard to digest and can lead to constipation.
- Red meat: It’s tougher to break down than chicken or fish, and some studies show it might even make you more likely to get diverticulitis in the first place.
- Dairy: If you and lactose don’t get along, milk and cheese can make you feel even worse.
- White bread and sugary foods: These can cause inflammation, and let’s be honest, you’ve got enough of that already.
So what can you eat? Aim for a mix of fruits, veggies, lean proteins, and healthy fats. And don’t forget to drink plenty of water!
The best approach is usually to figure out your own triggers. Keep track of what you eat and how it makes you feel. And try cooking more at home – restaurant food, especially fast food, often has a bunch of extras that might set off a flare-up.
Just remember, there’s no one-size-fits-all diet for diverticulitis. It might take some trial and error to find what works for you. But stick with it (and stick with your doctor’s advice), and you’ll get there. Your gut will thank you!
GET DIVERTICULITIS HELP IN TENNESSEE
For more information, please contact one of our Tennessee clinic locations if you have questions or concerns. The surgeons at The Surgical Clinic can help diagnose any intestinal discomforts you feel and create a custom treatment plan. Leaving acute diverticulitis untreated can be dangerous, so don’t wait. Visit our locations page to find a surgical center near you!