Sunday, January 15, 2006

diverticulitis

Diverticulitis is inflammation of the small blind pouches that form in the lining of the colon trapping bacteria and fecal material. Weakness of the muscles of the colon may be produced by chronic constipation. Diverticulitis is caused by perforations of the diverticula. An erosion occurs and the contents of the bowel escape into the surrounding tissue. In a small perforation the infection and inflammation are confined to a small area. The intestinal contents are prevented from entering the abdominal cavity by a small abscess that seals the leak. A large perforation can result in severe complications including peritonitis (swelling of the membrane that covers the wall of the abdomen).
Diverticulitis is very common in older people and is frequently asymptomatic. Symptoms of diverticulitis include constipation, diarrhea, fever, blood in the stool, tenderness of the left lower abdomen, abdominal cramps, and flatulence.
Intestinal obstruction or a perforation leading to peritonitis can also result from the inflammatory process.
Diverticula that are asymptomatic require no treatment. During acute episodes, however, the person may be placed on intravenous fluids with no oral intake for several days. Antibiotics are started and as the inflammation subsides oral foods and fluids are resumed. Efforts should be made to avoid constipation by encouraging good fluid intake and regular evacuation. A stool softener may be helpful. If the condition does not respond to treatment or if complications occur, such as perforation, intestinal obstructions, or severe bleeding, surgery is necessary. The portion of the colon containing the diverticula is removed. Depending on the location and extent of the disease, a temporary colostomy may need to be performed. At a later operation the continuity of the bowel is restored and the colostomy is closed.
See also BOWEL OBSTRUCTION; PERITONITIS; ULCERATIVE COLITIS.
Bockus, H. I. Gastroenterology. Philadelphia: W. B. Saunders, 1985.
Goldberg, M. and Rubin, J. The Inside Tract. Washington, D.C.: AARP, 1986.

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