Diverticulitis and Diverticulosis

Diverticular disease: Diverticulitis is an inflammation to a diverticulum, which is an inflammation of saclike bulges in the wall. Diverticulosis is the presence of diverticula.

Studies shows that diverticula probably result from high intraluminal pressure on areas of weakness in the GI wall, where blood vessels enter. Diet, such as highly refined foods, may be a contributing factor. The like of fiber reduces fecal residue, narrows the bowel lumen, and leads to higher intra - abdominal pressure during defecation.

In this disorder, bulging pouch like herniations in the GI (gastrointestinal ) wall push the mucosal lining through the surrounding muscle.  Diverticula occur most commonly in the sigmoid colon, but they may develop anywhere, from the proximal end of the pharynx to the anus.  Other typical sites are the duodenum, near the pancreatic border or the ampulla of Vater, and the jejunum.

Diverticular disease of the ileum is the most common congenital anomaly of the GI tract. Diverticular disease has two clinical forms. In Diverticulosis, diverticula are present but do not cause symptoms.  In diverticulitis, diverticula are inflamed and may cause potentially fatal obstruction, infection, or hemorrhage, in this disorder, undigested food mixed with bacteria also accumulates in the Diverticular sac, forming a hard mass ( fecalith ).  This substance cuts off the blood supply to the thin walls of the sac, making them more susceptible to attack by colonic bacteria.

Symptoms:

Diverticulosis - recurrent left lower abdominal quadrant pain is relieved by defecation or passage of flatus.  Constipation and diarrhea alternate.

* This disorder is usually asymptomatic ( without symptoms )

Diverticulitis - the patient may have moderate left lower abdominal quadrant pain, mild  nausea, gas, irregular bowel habits, low - grade fever, leukocytosis, rupture of the diverticuli can occur in severe diverticulitis, and fibrosis and adhesions may occur in chronic diverticulitis.

Treatment:

Asymptomatic Diverticulosis usually does not require treatment.

Patient with intestinal Diverticulosis who experience pain, mild GI distress, constipation, or have difficulty with bowel movement may respond well with  a liquid or bland diet, stool softeners, and occasional usage of mineral oil. These measures relieve symptoms, minimize irritation, and lessen the risk of progression to diverticulitis. After pain subsides, patients also benefit from a high residue diet and bulk forming laxatives.

Patient with mild diverticulitis without signs of perforation must prevent constipation and combat infection. It may include; bed rest, a liquid diet, stool softeners, a broad spectrum antibiotic, and antispasmodic to control muscle spasm, mild to moderate analgesic to control pain and relax smooth muscle.

* When diverticulitis is unresponsive to medical treatment requires a colon resection to remove the involved segment. Complications that accompany diverticulitis may require a temporary colostomy to drain abscesses and rest the colon, followed by later anastomosis

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