Diverticular Disease
Diverticula are saclike mucosal pouches that protrude from a tubular structure. Diverticulosis is the presence of one or more diverticula, diverticular disease is characterized as symptomatic diverticulosis and Diverticulitis is inflammation and/or infection of a diverticulum.
Most people with diverticulosis (diverticular disease) have few or no symptoms, and the symptoms that may occur is abdominal pain, constipation and diarrhoea.
When a diverticulum ruptures and inflammation and infection sets in around the diverticulum, the condition is called diverticulitis. Patients have left lower quadrant abdominal pain and tenderness and often have a palpable sigmoid; pain is occasionally suprapubic. The pain can be accompanied by nausea, vomiting, fever, and sometimes even urinary symptoms as a result of bladder irritation. Peritoneal signs may be present, particularly with abscess or free perforation.
Fistula may manifest as pneumaturia, fecaluria (feces in the urine), feculent vaginal discharge, or a cutaneous or myofascial infection of the abdominal wall, perineum, or upper leg. Patients with bowel obstruction have nausea, vomiting, and abdominal distention. Bleeding is uncommon. Diverticulitis as well as diverticular disease can be diagnosed with barium X-rays, sigmoidoscopy, colonoscopy, or CT scan.
Treatment varies with severity; liquid diet for mild disease with antibiotics, a CT-guided percutaneous drainage of abscess and Surgery.
A patient who is not very ill is treated at home with rest and a liquid diet. Symptoms usually subside rapidly. Patients with more severe symptoms (e.g. marked pain, fever) should be hospitalized. Treatment is bed rest, IV antibiotics and IV fluids.
