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diverticulitis

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Digestive system

Definition
Diverticulae are small, abnormal sacs in the wall of the intestine. These sacs can become infected and inflamed, a condition known as diverticulitis.

What is going on in the body? 
The term diverticulosis means the presence of many diverticulae in the bowel. A person's diet is thought to play a role in the formation of diverticulae. Diverticulae do not usually cause symptoms. But if diverticulae become inflamed, symptoms usually do occur.

What are the signs and symptoms of the disease? 
Diverticulitis, which may be mild or severe, can cause: What are the causes and risks of the disease? 
Diverticulitis can only occur in people who have diverticulosis. Both conditions are more common in people older than 50.

Diverticulosis is more common in people who have a low intake of fibre in their diets. Diverticula usually occur in the left side of the large bowel or colon. This may be due to higher pressure in this part of the bowel.

Once a diverticulum has formed, it may become infected. This infection causes the inflammation and symptoms of diverticulitis.

Severe cases may lead to serious complications. These include developing a hole in the bowel, abdominal infections such as peritonitis, life-threatening blood infections known as sepsis, and blockage of the bowel. Death may occur. Diverticulae can cause severe bleeding.

What can be done to prevent the disease? 
Eating a diet high in fibre, low in dietary fat and increasing water intake is thought to decrease the risk of diverticulosis. There are no other ways known to prevent the disease.

How is the disease diagnosed? 
Diverticulitis is suspected after a history and physical examination. A history of lower, left-sided abdominal pain is a clue. The physical examination often reveals a tender abdomen. Tightness of the abdominal muscles, called abdominal rigidity, suggests serious infection. The white blood cell count is often elevated. An X-test called a CT scan may be used to confirm the diagnosis, or a colonoscopy may be used to evaluate the diverticulae.

What are the long-term effects of the disease? 
Most people will recover without long-term health effects. The disease can occur more than once in the same person. If it happens many times, surgery may be needed to remove part of the bowel.

What are the risks to others? 
The disease is not contagious and poses no risk to others.

What are the treatments for the disease? 
Mild cases can be treated at home with a clear liquid diet and antibiotics for about a week. In more serious cases, the person must be treated in the hospital. In this setting, the bowel is allowed to rest. This means the person should not eat or drink anything. Fluids and antibiotics are given through an intravenous, or IV. Surgery may be needed if the bowel has holes, blockages, or abscesses. Some people may need surgery to remove part of the bowel.

What are the side effects of the treatments? 
Antibiotics can cause many side effects, including rashes, stomach upset, and allergic reactions. Surgery carries a risk of bleeding and infection.

What happens after treatment for the disease? 
Most people will recover completely. More studies of the inside of the bowel, may be done after recovery.

How is the disease monitored? 
Some people have repeated attacks of diverticulitis. If a classic symptom such as left-sided abdominal pain reappears, the person should see a doctor. Blood tests and X-ray tests may be used to monitor the disease.

Author: 
Reviewer: HealthAnswers Australia Medical Review Panel
Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia
Last Updated: 1/10/2001
Contributors
Potential conflict of interest information for reviewers available on request
 


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