When small pockets that bulge outwards are formed in the wall of the large intestine they are called diverticula and the condition is called diverticulosis; it becomes diverticulitis only when those pockets become inflamed due to infection. Diverticulosis is mainly caused by the typical western diet that is low in fiber. But lifestyle also has a part to play because when not enough exercise is undertaken regularly that contributes to poor regularity and the stool is more likely to then become lodged in these pockets.
Many people have diverticulosis without knowing it since there are no or few symptoms. It is only when stool becomes lodged in the pockets and causes inflammation and infection that there are any symptoms. The symptoms of diverticulitis include pain in the lower right side of the abdomen, gas and bloating, diarrhea alternating with constipation, rectal bleeding, fever, nausea and vomiting. Not all of these symptoms may be present during an attack of diverticulitis; it depends on how serious it is. Other diseases can also cause the same symptoms, so it is important to be properly diagnosed.
To diagnose diverticulitis, the doctor will need to take a comprehensive medical history, finding out all about the patient’s regularity, symptoms, medication, diet and lifestyle – for example what kind of exercise is taken and how often. A rectal examination will be needed to feel for tenderness in the area and to see if blood is present. The patient may need to supply a stool sample that will also be tested for the presence of blood. Blood samples will need to be taken to detect the presence of infection. Other test or x-rays may also be ordered.
If the presence of serious diverticulitis is discovered, an operation to cut out the infected portions of bowel may be needed. In some cases a temporary colostomy will be done. This is the construction of an alternative outlet for elimination. Once the area operated on has healed, the colostomy can be closed and normal function returned to.
If an operation is not necessary, the patient may be given antibiotics and prescribed bed rest and a liquid diet to rest the colon. If the pain is acute, a stay in hospital may be needed, with antibiotics injected rather than given orally.
In some cases, an abscess may form when there is diverticulitis. This can be healed with antibiotics, but if it has burst and the infection spreads into the abdominal cavity, an operation will probably be needed to prevent peritonitis.
If the infection spreads outside the colon, a fistula may result. This is, an abnormal connection between the skin and the organ or between two organs. This will need to be corrected by surgery to prevent ongoing infection.
Generally, the doctor will also prescribe a fiber product such as Metamucil to aid the function of the bowel and keep the stool moving through. Once the attack has been controlled and life appears to be normal again, the patient should control and minimize further attacks by making sure he takes a diet that is high in fiber. And while rest is necessary, so is exercising more regularly.
With care, further acute attacks can almost certainly be prevented or minimized and this will reduce the likelihood of surgery being necessary in the future.