Diverticulitis

Question: Dr. Kiskila, what is diverticulitis?
Answer: Diverticulitis is the inflammation of small pouches in the intestine, called diverticula. It can be associated with infection, obstruction, bleeding, or perforation of the bowel. Sometimes, diverticulitis is minor. But it can also be severe, with a massive infection or perforation (your doctor will call it a rupture) of the bowel. 

Question: How do you get diverticulitis?
Answer: Doctors believe that a low-fiber diet contributes to diverticulitis.  This condition becomes more prevalent with age. Doctors aren’t sure. Some studies suggest that your genes might play a role. The pouches on your intestines get inflamed or infected when they tear or become blocked by feces. If you have more bad germs than good ones in your gut, that might cause it, too. Your chances of getting diverticulitis rise with age. It’s more common in people over 40. Other risk factors include:

• Being overweight
• Smoking cigarettes
• Not getting enough exercise
• Eating lots of fat and red meat but not much fiber
• Taking certain kinds of drugs, including steroids, opioids, and nonsteroidal anti-inflammatories like ibuprofen or naproxen

Question: What are the symptoms of diverticulitis?
Answer: The typical presentation is abdominal pain on the left lower side with belly distention and fever.  Patients may also experience nausea, weight loss, or bowel changes such as constipation or diarrhea.  You can have the pouches and not know it. The diverticula are usually painless and cause few symptoms, if any. But you might notice:

• Cramping on the left side of your abdomen that goes away after you pass gas or have a bowel movement
• Bright red blood in your poop

Question: How do you diagnose diverticulitis
Answer: When the bowel is inflamed, the white blood cell count may be elevated.  Doctors can measure a patient’s white blood cell count by a simple blood test in the office.  A CAT-Scan captures an image of the bowel and can be used to establish the diagnosis, assess the severity of the disease, and exclude any complications.

Question: How do you treat diverticulitis
Answer:  Antibiotics are sometimes used for infection.  If there is a complication such as tear or perforation then hospitalization may be required.  Approximately 15-30% of admitted patients require surgery.  Increasing dietary fiber, exercise, weight loss (if obese), and smoking cessation may help to prevent recurrences of diverticulitis.  Sometimes a colonoscopy may be needed 4-6 weeks after resolution of symptoms for individuals with complicated disease or age appropriate screening.

Question: Can diverticulitis be prevented?  If so, how?
Answer: You can prevent diverticulosis and diverticulitis and their complications by eating plenty of fiber, drinking lots of water, and exercising regularly.

Also, diverticulitis can be acute or chronic. With the acute form, you may have one or more severe attacks of infection and inflammation. In chronic diverticulitis, inflammation and infection may go down but never clear up completely. Over time, the inflammation can lead to a bowel obstruction, which may cause constipation, thin stools, diarrhea, bloating, and belly pain. If the obstruction continues, abdominal pain and tenderness will increase, and you may feel sick to your stomach or throw up. If you have any questions or think you or a loved one has diverticulitis, speak to a healthcare professional right away.