Diverticulitis symptoms are common and accounts for a significant number of hospital admissions each year. Symptoms can be similar to IBS or the Irritable Bowel Syndrome too.
The symptoms occur when there is inflammation and infection of diverticular disease that occur in the large bowel, the most common being in sigmoid diverticular disease, although they can occur anywhere from the rectum to the cecum.
Diverticulae are common and said to be present in over 50% of 50 year olds. They are a common finding when having a colonoscopy or barium enema.
From the inside of the bowel, they look like holes, similar in appearance to 'mouse-trap cheese'. If you were able to look at the bowel from the outside, they would have a sack-like appearance.
They are thought to be caused by poor western diets that are high in refined sugars, fats and carbohydrates, but low in fiber.
Not everyone with the disease gets diverticulitis symptoms, but when they do occur, the main features are abdominal pain (often lower abdominal pain ), bloating and wind, sometimes with features of diarrhea and constipation. These features are also common to IBS or the Irritable Bowel Syndrome and the two can also coincide.
The main diverticulitis symptoms include fever, abdominal pain and diarrhea (which are often bloody). Muscle aches, nausea and vomiting can also occur.
Diverticular bleeding, usually from sigmoid diverticular disease, can be heavy and require hospital admission for investigation and treatment.
Diverticular bleeding often starts quickly and stops quickly too! It may be so heavy that blood transfusion is needed. It is a particularly common problem in the elderly.
Whilst most cases settle spontaneously, sometimes surgery or radiological embolization therapy is required (blood vessel blocked off with a platinum coil or glue-like substance).
Diets for diverticulitis comprise of a low residue diet consisting mainly of avoiding course fibre. Foods that should be avoided include nuts and seeds, high fiber breads such as granary bread and brown breads, raw fruits and vegetables.
Diets for diverticulitis that are acceptable can include white bread, fruit juice, cakes, biscuits, rice, pasta, noodles, peeled fruits and vegetables. Meats, fish, eggs, tofu are all ok to have too. Diverticulitis diets are actually very similar to an IBS diet.
Treatment of diverticulitis symptoms normally involves analgesic pain relief, antipyretics to keep fever down, adequate fluid intake to avoid dehydration and antibiotics to treat infection.
The main antibiotics used are Amoxicillin or Co-amoxiclav with Metronidazole to cover anaerobic infections. Cephalosporin’s are sometimes used, but less so these days due to their association with clostridium difficile infection (c.diff) or pseudomembraneous colitis, usually a hospital acquired infection that can give rise to significant morbidity and mortality.
Abscess formation can occur and this often needs drainage either radiologically or surgically. Diets for diverticulitis need to be low residue, low fibre in this situation.
Complications can occur including abscess, fistula formation, septicaemia and death. Fistulas are abnormal communications between to viscera (organs). Common ones include enterovesical fistula (between bowel and bladder), enterovaginal fistula (between bowel and vagina) and enteric fistula’s between two bits of bowel. Long term complications can also include stricture (narrowed bowel) and adhesions.
Diverticulitis symptoms are a common reason for hospital admission and the complications that arise as outlined. However diverticular disease symptoms are the most common and include symptoms including wind, bloating, constipation and occasionally diarrhea and bleeding.