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Diverticulitis symptoms
are a common and account for a significant number of hospital admissions each year. Diverticulitis 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.
What is diverticular disease?
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.
What are diverticulitis symptoms?
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).
What is a diverticulitis diet?
A diverticulitis diet is 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. Foods that are acceptable include white bread, fruit juice, cakes, biscuits, rice, pasta, noodles, peeled fruits and vegetables. Meats, fish, eggs, tofu are all ok to have too.
Is there any treatment for diverticulitis symptoms?
Treatment of diverticulitis 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. Abscess formation can occur and this often needs drainage either radiologically or surgically.
Are there any complications of diverticulitis?
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.
Symptoms of diverticulitis are a common reason for hospital admission and the complications that arise as outlined.
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