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Diverticulitis: Symptoms, Causes, Diagnosis And Treatment

Diverticulitis has become one of the most common conditions today. It is a problem of the digestive tract that affects the colon (large intestine). The condition develops when a part of the mucous membrane or mucosa pushes out through a weak muscle area of the large intestine and form small bulging pouches in the lining of the gastrointestinal tract [1] .

To mention, the mucosa is a moist tissue that lines the internal organs and the pea-like small pouches formed are called diverticula (diverticulum in singular). Diverticulitis mainly occurs in the lower left end of the colon. The condition affects both men and women, especially after 40.

In many people, diverticula are not infected or inflamed and thus, doesn't cause any pain. Researchers suggest that 80% of people experience no symptoms of diverticulitis and thus, won't need treatment. But in other cases, they can cause severe pain which might lead to surgery.

Symptoms Of Diverticulitis

The symptoms of Diverticulitis ranges from mild to severe. They can develop either suddenly or in several days depending on the severity of the disease.

  • Persistent pain in the abdomen [2]
  • Vomiting
  • Nausea
  • Constipation [3]
  • Fever
  • Stomach tenderness
  • Bloating [3]
  • Blood in the stool

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Causes Of Diverticulitis

The main cause of diverticulitis is still unknown but there are several factors which contribute to the formation of diverticulitis. The factors are as follows:

  • Low-fibre diet and high saturated fat
  • Red meat
  • Obesity [4]
  • Zero physical activity [5]
  • Ageing (men less than 50 and women between 50-70)
  • Smoking [6]
  • Medications like steroid and anti-inflammatory drugs [7]
  • Deficiency of vitamin D [8]
  • Genes [2]

Diagnosis Of Diverticulitis

To diagnose the symptoms of diverticulitis, a doctor will ask for the symptoms and medical history of a patient. They will perform other tests to rule out similar symptoms of other diseases. The tests can range from one or more.

  • Colonoscopy to determine issues in the inner regions of the GI tract
  • Urine and stool test for infections
  • Blood test for inflammation or kidney-related problems
  • Pelvic test to rule out some gynae issues in women
  • MRI, CT scan, ultrasound and X-ray for imaging of GI tract [3]
  • Pregnancy test to eliminate the symptoms of pregnancy

Treatment For Diverticulitis

After diagnosis, a doctor will go for its treatment depending on the severity of the condition. In some cases, the condition can be treated at home by making changes in your diet. For this, the doctors may suggest a clear-liquid diet and high-fibre foods [9] . Other modes of treatment include the following:

  • Antibiotic drugs like metronidazole and amoxicillin [10]
  • Needle drainage to drain out pus from the diverticulum [3]
  • Surgery to remove the infected diverticula.

Complications Of Diverticulitis

If diverticulitis remains untreated for a longer period, it can cause severe complications. A study says that in more than 75% of people, the condition is uncomplicated while the remaining 25% of people develop severe complications.

  • Phlegmon: A condition in which the soft tissues under the skin gets inflamed.
  • Intestinal perforation: This is a severe condition in which the intestinal walls develop a hole allowing the content to leak into the abdominal cavity [13] .
  • Scarring: A condition defined by blockage of the intestine.
  • Fistula: A condition in which the infection of the diverticula reaches other organs and make them infected.
  • Abscess: A condition in which pus is formed inside the diverticula

Foods That Can Help Prevent Diverticulitis

As discussed before, including high-fibre foods in your diet may prevent you from getting diverticulitis. The foods which will suit best to prevent the condition are as follows:

  • Beans and legumes like navy beans and kidney beans
  • Brown rice
  • Oats [11]
  • High-fibre fruits like apple and pears
  • Vegetables like peas and spinach
  • Ground Psyllium Seed
  • Low fibre animal proteins like fish and eggs

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Foods To Avoid

There are certain foods which should be avoided to reduce the risk of contracting diverticulitis. Some of the foods are as follows:

  • Red meat
  • Saturated fat
  • Fried foods
  • Nuts [12]
  • Popcorn
  • Refined grains
View Article References
  1. [1] Böhm S. K. (2015). Risk Factors for Diverticulosis, Diverticulitis, Diverticular Perforation, and Bleeding: A Plea for More Subtle History Taking. Viszeralmedizin, 31(2), 84–94. doi:10.1159/000381867
  2. [2] Rezapour, M., Ali, S., & Stollman, N. (2018). Diverticular Disease: An Update on Pathogenesis and Management. Gut and liver, 12(2), 125–132. doi:10.5009/gnl16552
  3. [3] Linzay, C. D., & Pandit, S. (2018). Acute Diverticulitis. In StatPearls [Internet]. StatPearls Publishing.
  4. [4] Strate, L. L., Liu, Y. L., Aldoori, W. H., Syngal, S., & Giovannucci, E. L. (2009). Obesity increases the risks of diverticulitis and diverticular bleeding. Gastroenterology, 136(1), 115-122.
  5. [5] Colditz, G. A., Cannuscio, C. C., & Frazier, A. L. (1997). Physical activity and reduced risk of colon cancer: implications for prevention. Cancer Causes & Control, 8(4), 649-667.
  6. [6] Wijarnpreecha, K., Boonpheng, B., Thongprayoon, C., Jaruvongvanich, V., & Ungprasert, P. (2018). Smoking and risk of colonic diverticulosis: A meta-analysis. Journal of postgraduate medicine, 64(1), 35–39. doi:10.4103/jpgm.JPGM_319_17
  7. [7] Kvasnovsky, C. L., Papagrigoriadis, S., & Bjarnason, I. (2014). Increased diverticular complications with nonsteriodal anti‐inflammatory drugs and other medications: a systematic review and meta‐analysis. Colorectal Disease, 16(6), O189-O196.
  8. [8] Maguire, L. H., Song, M., Strate, L. E., Giovannucci, E. L., & Chan, A. T. (2013). Higher serum levels of vitamin D are associated with a reduced risk of diverticulitis. Clinical Gastroenterology and Hepatology, 11(12), 1631-1635.
  9. [9] Oates, J. R., & Sharma, S. (2019). Clear Liquid Diet. In StatPearls [Internet]. StatPearls Publishing.
  10. [10] Carabotti, M., & Annibale, B. (2018). Treatment of diverticular disease: an update on latest evidence and clinical implications. Drugs in context, 7, 212526. doi:10.7573/dic.212526
  11. [11] Painter N. S. (1974). The high fibre diet in the treatment of diverticular disease of the colon. Postgraduate medical journal, 50(588), 629–635. doi:10.1136/pgmj.50.588.629
  12. [12] Strate, L. L., Liu, Y. L., Syngal, S., Aldoori, W. H., & Giovannucci, E. L. (2008). Nut, corn, and popcorn consumption and the incidence of diverticular disease. JAMA, 300(8), 907–914. doi:10.1001/jama.300.8.907
  13. [13] Onur, M. R., Akpinar, E., Karaosmanoglu, A. D., Isayev, C., & Karcaaltincaba, M. (2017). Diverticulitis: a comprehensive review with usual and unusual complications. Insights into imaging, 8(1), 19–27. doi:10.1007/s13244-016-0532-3
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