Diverticular Disease

Definitions

  • Diverticula: pouches in bowel wall (a defect in the bowel wall continuity), usually from 0.5 – 1cm
  • Diverticulosis: the presence of diverticula without symptoms
  • Diverticulitis: inflammation of diverticula
  • Often described to patients as “wear and tear of the bowel”

 

Diverticulosis

  • Very common as people age
  • Low fibre diets and obesity are risk factors
  • Often diagnosed incidentally on colonoscopy or CT scan
  • No treatment necessary, but advice regarding high fibre diet and weight loss is appropriate

 

Diverticulitis signs and symptoms

  • Left iliac fossa / lower left abdominal pain and tenderness
  • Fever
  • Diarrhea
  • PR blood / mucus
  • Nausea and vomiting

 

Diverticulitis management

  • Consider admission if unwell
  • Antibiotics
  • Analgesia
  • Fluid resuscitation
  • May require surgical resection if severely septic / peritonitic or develops complications

 

Diverticulitis complications

  • Haemorrhage
  • Perforation
  • Abscess
  • Fistula (e.g. between colon and bladder / vagina)
  • Ileus / obstruction
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