Diverticulitis

Diverticulitis: Inflammation of Diverticula in the Colon

Diverticulitis
Diverticulitis is a medical condition characterized by inflammation of irregular bulging pouches, known as diverticula, that form in the wall of the large intestine. Normally, the large intestine (or colon) has a smooth wall. However, these diverticula can develop and, when inflamed, lead to diverticulitis.

Diverticula and Diverticulosis

  • Diverticulum: A single bulging pouch in the colon wall.
  • Diverticula: Multiple such pouches.
  • Diverticulosis: The presence of diverticula, a common condition especially in individuals over the age of 50, typically found in the lower part of the colon. It is not considered a disease as it usually does not cause symptoms.

Diverticulitis

When the diverticula become inflamed, the condition is termed diverticulitis. Inflammation is the body's immune response, characterized by increased blood flow and fluid to a specific area to fight disease. In the case of diverticulitis, this inflammation can result in severe abdominal pain, fever, nausea, and changes in bowel habits.

Symptoms of Diverticulitis

The most common symptom of diverticulitis is abdominal pain, typically located in the lower left abdomen. The pain can be sudden and intense, though it may also start mild and gradually worsen or fluctuate in intensity. Other symptoms may include:

  • Nausea
  • Fever
  • Abdominal tenderness
  • Changes in stool habits, such as sudden diarrhea or constipation

When to Seek Medical Attention

It is important to seek medical care if you experience constant, unexplained abdominal pain, especially if accompanied by a fever and significant changes in bowel habits.

Causes of Diverticulitis

Diverticula develop gradually in the colon wall over time, particularly in older adults. Factors such as spasms or straining during bowel movements can increase pressure in the colon, leading to the formation of diverticula in weak areas of the colon wall. Diverticulitis occurs when these diverticula become inflamed, which can be due to bacterial infection or tissue damage within the diverticula.

Risk Factors for Diverticulitis

Several factors can increase the risk of developing diverticulitis, including:

  • Age (more common in individuals over 50)
  • Obesity
  • Smoking
  • Low-fiber diet
  • High intake of red meat
  • Heavy alcohol use
  • Lack of exercise
  • Low vitamin D levels
  • Certain medications, such as steroids, opioids, and nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Advil, Motrin) and naproxen sodium (Aleve)

Complications of Diverticulitis

About 15% of people with diverticulitis may experience complications, which can include:

  • Abscess: A pocket of pus resulting from bacterial infection.
  • Bowel obstruction: A blockage in the colon.
  • Fistula: An abnormal connection between the bowel and another organ.
  • Peritonitis: A severe infection of the abdominal lining due to a tear in the colon wall allowing waste to spill out.
  • Diverticular hemorrhage: Bleeding from ruptured blood vessels.

Prevention of Diverticulitis

To help prevent diverticulitis, consider the following strategies:

  • Exercise regularly: Regular, vigorous exercise can reduce the risk of diverticulitis.
  • Eat a high-fiber diet: Fiber-rich foods like fruits, vegetables, whole grains, seeds, and beans help improve waste movement through the colon and reduce the risk of diverticulitis. Limit intake of red meats and sweets.
  • Maintain a healthy weight: Consult with healthcare professionals or dietitians to set and achieve healthy weight goals.
  • Stay hydrated: Fiber absorbs water and increases the bulk of waste in the colon. Drinking plenty of fluids helps keep waste moving and prevents constipation.
  • Quit smoking and limit alcohol use: Both smoking and heavy alcohol consumption are linked to an increased risk of diverticulitis.

It was previously recommended that people with diverticulitis avoid nuts, seeds, and popcorn. However, studies have shown these foods do not increase the risk of diverticulitis. In fact, seeds and some nuts can be good sources of fiber.

Conclusion

Diverticulitis is a common but potentially serious condition characterized by the inflammation of diverticula in the colon. While most cases can be managed with dietary changes, rest, and possibly antibiotics, severe cases may require hospitalization or surgery. Awareness of symptoms, risk factors, and preventive measures can help manage and reduce the risk of developing diverticulitis.

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