Diverticulitis is inflammation of an abnormal pouch (diverticulum) in the intestinal wall. The condition of having diverticula is called diverticulosis. Sometimes, however, one or more pouches becomes inflamed or infected, causing severe abdominal pain, fever, nausea and a marked change in your bowel habits. Sometimes inflamed diverticula can cause narrowing of the bowel , leading to an obstruction . The sigmoid and transverse colon and the anterior surface of the ascending and descending colon are intraperitoneal. Disease is frequently mild when pericolic fat and mesentery wall-off a small perforation. A patient suffering from diverticulitis will have abdominal pain and tenderness, and fever. More extensive disease leads to abscess formation and rarely, with rupture, to peritonitis. These marble-sized pouches usually occur where blood vessels run through the intestinal wall. Diverticulitis can lead to some very serious conditions (see Outlook ) if it is not detected and treated promptly. About one-quarter of people with diverticulitis have complications, such as an abscess, fistula, or obstruction of the colon, that require surgery.
Most patients can be managed with conservative measures. Patients with mild symptoms and no peritoneal signs may be managed initially as outpatients on a clear liquid diet and broad-spectrum oral antibiotics with anaerobic activity. Reasonable regimens include amoxicillin and clavulanate potassium (875 mg/125 mg) twice daily, or metronidazole, 500 mg three times daily, plus either ciprofloxacin, 500 mg twice daily, or trimethoprim-sulfamethoxazole, 160/800 mg twice daily orally, for 7–10 days or until the patient is afebrile for 3–5 days. Symptomatic improvement usually occurs within 3 days, at which time the diet may be advanced. Patients with increasing pain, fever, or inability to tolerate oral fluids require hospitalization.
Patients with severe diverticulitis (high fevers, leukocytosis, or peritoneal signs) and patients who are elderly or immunosuppressed or who have serious comorbid disease require hospitalization acutely. Patients should be given nothing by mouth and should receive intravenous fluids. If ileus is present, a nasogastric tube should be placed. Intravenous antibiotics should be given to cover anaerobic and gram-negative bacteria. Single-agent therapy with either a second-generation cephalosporin (eg, cefoxitin), piperacillin-tazobactam, or ticarcillin clavulanate appears to be as effective as combination therapy (eg, metronidazole or clindamycin plus an aminoglycoside or third-generation cephalosporin [eg, ceftazidime, cefotaxime]).
Symptomatic improvement should be evident within 2–3 days. The antibiotics should be continued for 7–10 days, after which time elective evaluation with colonoscopy or barium enema should be performed.
Many people have small pouches in their colons that bulge outward through weak spots, like an inner tube that pokes through weak places in a tire. Although diverticula can form anywhere, including in your esophagus, stomach and small intestine, most occur in your large intestine. Diverticulitis develops from diverticulosis , which involves the formation of pouches ( diverticula ) on the outside of the colon . However, an earlier description in an editorial comment by Sir Erasmus Wilson (1840) can be found. About 10 percent of Americans over the age of 40 have diverticulosis. If the infection spreads to the lining of the abdominal cavity , ( peritoneum ), this can cause a potentially fatal peritonitis . Sometimes, however, one or more pouches becomes inflamed or infected, causing severe abdominal pain, fever, nausea and a marked change in your bowel habits. The rupture results in infection in the tissues that surround the colon. Most of the time, diverticulitis can be treated with dietary changes and if there is an infection with antibiotics Disease is frequently mild when pericolic fat and mesentery wall-off a small perforation. More extensive disease leads to abscess formation and rarely, with rupture, to peritonitis. In women, the uterus is interposed between the colon and the bladder, and this complication is only seen following a hysterectomy. This happens in 10 to 25 percent of people with diverticulosis. Also the affected part of the colon could adhere to the bladder or other organ in the pelvic cavity , causing a fistula , or abnormal communication between the colon and an adjacent organ.
Causes of Diverticulitis
Common causes of Diverticulitis :
Symptoms of Diverticulitis
Some common symptoms of Diverticulitis :
Treatment of Diverticulitis
Disclaimer : All information on www.healthatoz.info is for educational purposes only. It is not a substitute for professional medical advice. For specific medical advice, diagnoses, and treatment, please consult your doctor.