A diverticulum is a small outcropping of the intestine. Such areas of swollen, bubblelike diversions in the intestine are a prevalent condition. Typically, these bulges occur in the large intestine (colon) in the lower (either descending or sigmoid) portion of the colon and are of no consequence; however, sometimes they can become irritated and inflamed. Much as with hemorrhoid formation, the force of passing stools (especially when hardened as a result of constipated) is thought to be the primary cause of pressure on the walls of the colon that contribute to diverticula formation. These locations may trap material moving through the intestine, causing bacterial growth and infectious inflammation called diverticulitis.
|Common outpouchings of the bowel may merely require conservative care, at the most. In other cases, Lourdes’ GI specialists identify diverticula that require direct intervention to relieve symptoms and prevent complications.|
Aging, lack of exercise, obesity, too little fiber in the diet and smoking all increase risk of developing diverticula. The condition of having diverticula is called diverticulosis. Most people have no discomfort from the simple presence of diverticula, although others may experience crampy pain or discomfort in the lower abdomen, bloating and constipation. Increasing the amount of fiber in the diet may reduce symptoms of diverticulosis and prevent complications such as diverticulitis. Probiotics may also help to prevent diverticulitis. Specific foods small enough to become entrapped in diverticula, such as seeds, were once thought a likely culprit for inflaming diverticula, but most physicians no longer support this theory.
Treating Symptoms While a Flare-Up Heals
Diverticulitis can bring all of the more-benign symptoms of diverticulosis but will usually also signal itself with pain or tenderness (typically in the lower left side of the abdomen). Diverticulitis can also sometimes bring on symptoms of infection and, in rare cases, blood in the stool. These inflammations can be brief, mild and passing, or they can be severe and require acute intervention. They may resolve permanently or prove episodic or chronic.
Lourdes’ gastroenterologists may use blood tests and barium x-rays in diagnosis; colonoscopy sometimes; and most often CT imaging to confirm the condition and the location of one or more diverticula. When treatment is needed, these experienced GI specialists pursue conservative care whenever possible, starting with rest, pain medications, and a temporarily liquid diet. Antibiotic treatment may be necessary.
Intervention for More Difficult Cases
If medical care proves inadequate, and symptoms are significant, the medical team must continue to pursue treatment to prevent complications. This can involve a hospital stay and IV antibiotics.
Surgical intervention involves resection and removal of the diverticula with repair of the intestine. Gastroenterologists confer with Lourdes’s accomplished general surgeons who can also perform this step laparoscopically or through an open surgical procedure. The surgery may or may not involve creating a temporary colostomy. Surgery may be necessary to prevent or treat a case where diverticulitis can cause a hole or stricture in the colon.
Patients may have multiple diverticula that can become inflamed at different times. This means diverticulitis can become arepeated problem for those who suffer from it in this way. Lourdes’s GI experts can help to evaluate and manage these conditions.