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Overview
The colon, also known as the large intestine or big bowel, is a 6 foot long tube-like organ that houses and subsequently removes waste products that are left behind after food is digested in the small intestine. It is thought that as a person matures, pressure within the colon contributes to tissue sacs that protrude from the colonic walls. A diverticulum is a little sac with a protruding bulge that develops from the colon wall.Diverticula, or several bulging sacs, is the plural form of the word. Diverticula can be found everywhere in the colon, but in Western cultures they are most frequent in the left colon's sigmoid colon. Diverticula are most common on the right side of the colon in Asia.
Diverticula are frequent in the West but uncommon in places like Asia and Africa. Diverticula get bigger as you age. Before the age of 40, they are not prevalent, but more than 74% of Americans over the age of 80 have them. Diverticulosis patients typically have few or no symptoms. Abdominal pain, constipation, and diarrhea are the three most typical symptoms of diverticulosis. Irritable bowel syndrome (IBS) or anomalies in the sigmoid colon muscles' ability to perform their normal functions may be present along with diverticular illness in the majority of patients; uncomplicated diverticula should not result in symptoms. Diverticular bleeding is the term used to describe bleeding that occasionally comes from a diverticulum.
Symptoms
Diverticulosis patients typically have few or no symptoms. These people's diverticulosis is discovered by accident during examinations for other digestive issues. It has been thought as many as 20% of individuals with diverticulosis will develop symptoms related to the diverticulosis, primarily diverticulitis; however, the most recent study suggests that the incidence is closer to 5%.
Diverticulitis' most typical warning signs and symptoms are as follows:
Abdominal pain (left lower abdomen)
Abdominal tenderness (left lower abdomen)
Fever
Elevated white blood cell count in the blood
Constipation or, sometimes, diarrhea.
Treatment
Surgical intervention is necessary for diverticulitis that does not improve with medication therapy. In most cases, surgery entails resection—the surgical removal—of the sigmoid colon, the part of the colon containing the diverticula, as well as draining of any pus accumulation. For patients with ongoing bleeding, surgical excision of the bleeding diverticulum is also required. To help the surgeon in patients who require surgery to control recurrent bleeding, it's critical to identify the precise source of the bleeding.
Diverticula sometimes cause serious recurring urinary infections and the passage of gas during urination by eroding into the nearby urinary bladder. Surgery is also required in this circumstance.
For patients who experience frequent, recurrent diverticulitis bouts that result in many courses of antibiotics, hospital stays, and days away from work, surgery may occasionally be recommended. The purpose of surgery is to completely—or nearly completely—remove the diverticula-containing colon in order to stop further occurrences of diverticulitis. Resection of the sigmoid colon for diverticulitis has few long-term effects, and the procedure is frequently performed laparoscopically, which reduces post-operative discomfort and recovery time.
Diverticulitis acute attacks are indicated to be treated with liquids or low-fiber diets. In order to prevent the diverticulitis from getting worse, it is reduced how much material travels through the colon.
Patients with severe diverticulitis who have a high fever and intense discomfort are admitted to the hospital and given intravenous antibiotics. Patients who have an abscess, hemorrhage, or persistent intestinal obstruction that is not improving after receiving antibiotics require surgery.
Tests Required for Diagnosis
he presence of diverticulitis is typically suspected since the signs and symptoms are so prevalent and recognizable. Numerous tests can be used to confirm the diagnosis if it is suspected. To see the colon, barium X-rays (barium enemas) can be carried out. Diverticula are characterized by pouches filled with barium that protrude from the colon wall.
Flexible tubes that are introduced through the rectum and progressed into the colon can be used to directly visualize the inside of the colon and the apertures of the diverticula. To aid in the diagnosis and rule out other illnesses that can mimic diverticular disease, either small tubes (sigmoidoscopes) or longer tubes (colonoscopes) may be utilized.
In order to identify inflammation of the tissues surrounding the ruptured diverticulum or pus collections, ultrasound, CT, and MRI scans of the abdomen and pelvis might be requested in patients who are suspected to have diverticulitis.
