Diverticulitis

What is Diverticulitis 

Diverticulitis is when small pockets in your large intestine (colon) get infected or swollen. This causes stomach pain and watery poop (diarrhea).

These pouches are called diverticula. They form in people who have a condition called diverticulosis.

Clinical characteristics of diverticulitis

• Age older than 50 years

• Localized left lower abdominal pain (often for several days’ duration)

• Palpable mass in left lower quadrant

• Low-grade fever and leukocytosis (note 45% may have normal white blood cell count)

Right-sided diverticulitis occurs in only 1.5% of patients in Western countries but is more common among Asians. Up to 75% of these patients present with right lower quadrant pain, often misdiagnosed as acute appendicitis.

How is diverticulitis diagnosed?

What are the characteristic CT findings of diverticulitis? 

• • Increased soft tissue density within pericolic fat, secondary to inflammation (98%)
• • Colonic diverticula (84%)
• • Bowel wall thickening (70%)
• • Soft tissue masses representing phlegmon and pericolic fluid collections, representing abscesses (35%)
• • Sensitivity, specificity, and positive and negative predictive values of 97%, 100%, 100%, and 98%

Note: In 10% of patients, diverticulitis cannot be distinguished from carcinoma and a gentle and cautious endoscopic examination may need to be performed.

Follow these instructions at home:

Medicines

• Take over-the-counter and prescription medicines only as told by your doctor. These include:
  • Antibiotics.
  • Pain medicines.
  • Fiber pills.
  • Probiotics.
  • Stool softeners.
• Do not drive or use heavy machinery while taking prescription pain medicine.
• If you were prescribed an antibiotic, take it as told. Do not stop taking it even if you feel better.

General instructions

• Follow a diet as told by your doctor.
• When you feel better, your doctor may tell you to change your diet. You may need to eat a lot of fiber. Fiber makes it easier to poop (have bowel movements). Healthy foods with fiber include:
  • Berries.
  • Beans.
  • Lentils.
  • Green vegetables.
• Exercise 3 or more times a week. Aim for 30 minutes each time. Exercise enough to sweat and make your heart beat faster.

Keep all follow-up visits as told. This is important. You may need to have an exam of the large intestine. This is called a colonoscopy.

Contact a doctor if:

• Your pain does not get better.
• You have a hard time eating or drinking.
• You are not pooping like normal.

Get help right away if:

• Your pain gets worse.
• Your problems do not get better.
• Your problems get worse very fast.
• You have a fever.
• You throw up (vomit) more than one time.
• You have poop that is:
  • Bloody.
  • Black.
  • Tarry.

Summary

• Diverticulitis is when small pockets in your large intestine (colon) get infected or swollen.
• Take medicines only as told by your doctor.
• Follow a diet as told by your doctor.