- Category: Gastroenterology
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Diverticula are small, bulging pouches that can form in the lining of your digestive system. They are found most often in the lower part of the large intestine (colon). Diverticula are common, especially after age 40, and seldom cause problems.
Sometimes, however, one or more of the pouches become inflamed or infected. That condition is known as diverticulitis. Diverticulitis can cause severe abdominal pain, fever, nausea and a marked change in your bowel habits.
Mild diverticulitis can be treated with rest, changes in your diet and antibiotics. Severe or recurring diverticulitis may require surgery.
Symptoms of the diverticulitis
The signs and symptoms of diverticulitis include:
- Pain, which may be constant and persist for several days. Pain is usually felt in the lower left side of the abdomen, but may occur on the right, especially in people of Asian descent.
- Nausea and vomiting.
- Abdominal tenderness.
- Constipation or, less commonly, diarrhea.
Causes of the diverticulitis
Diverticula usually develop when naturally weak places in your colon give way under pressure. This causes marble-sized pouches to protrude through the colon wall.
Diverticulitis occurs when diverticula tear, resulting in inflammation or infection or both.
Several factors may increase your risk of developing diverticulitis:
- Aging. The incidence of diverticulitis increases with age.
- Obesity. Being seriously overweight increases your odds of developing diverticulitis. Morbid obesity may increase your risk of needing more-invasive treatments for diverticulitis.
- Smoking. People who smoke cigarettes are more likely than nonsmokers to experience diverticulitis.
- Lack of exercise. Vigorous exercise appears to lower your risk of diverticulitis.
- Diet high in animal fat and low in fiber, although the role of low fiber alone isn't clear.
- Certain medications. Several drugs are associated with an increased risk of diverticulitis, including steroids, opiates and nonsteroidal anti-inflammatory drugs, such as ibuprofen (Advil, Motrin IB, others) and naproxen (Aleve).
Tests and diagnosis of the diverticulitis
Diverticulitis is usually diagnosed during an acute attack. Because abdominal pain can indicate a number of problems, your doctor will need to rule out other causes for your symptoms.
Your doctor will likely start with a physical examination, including checking your abdomen for tenderness. Women, in addition, generally have a pelvic examination to rule out pelvic disease.
After that, your doctor will likely recommend:
- Blood and urine tests, to check for signs of infection.
- Pregnancy test for women of childbearing age, to rule out pregnancy as a cause of abdominal pain.
- Liver function tests, to rule out other causes of abdominal pain.
- Stool test, to rule out infection in people who have diarrhea.
- CT scan, which can indicate inflamed or infected pouches and confirm a diagnosis of diverticulitis. CT can also indicate the severity of diverticulitis and guide treatment.