Diverticulitis is inflammation and infection of pouches in the digestive system, which can cause bowel obstruction or perforation. Diverticulosis involves the swelling of tissue pockets in the intestine, while fistulas are abnormal connections between organs. Treatment depends on the severity of the condition, ranging from a low-fiber diet and antibiotics to surgery.
Diverticulitis is a disease of the digestive system — most commonly the large intestine — in which diverticula, or pouches, that have grown in the digestive system become inflamed and possibly infected. Protrusion can lead to bowel obstruction or perforation, causing constipation, diarrhea, abdominal cramps, and other pain. There is really only one type of diverticulitis, although it can vary in intensity and can affect virtually any part of the digestive tract, including the stomach, bladder, and esophagus. It is one of three diseases – including diverticulosis and fistula – on a spectrum of diverticular diseases. Each is a separate condition, but one can switch to another.
Diverticulosis involves the swelling of tissue pockets, or diverticula, from the walls of the intestine, most commonly in the colon. The cause of diverticulosis is unknown, but it is believed to be related to pressure within the walls of the intestines. Some researchers and doctors speculate that this pressure comes from a low-fiber diet and lack of exercise. This condition can result in rectal bleeding when a small blood vessel in a diverticulum ruptures. If this occurs, the patient should consult a doctor, as surgery is sometimes required to stop the bleeding.
Diverticulitis occurs when the diverticula caused by diverticulosis become inflamed or infected. This infection can usually be cleared up with treatment with antibiotics. If the infection goes untreated and gets worse, it can lead to abscess formation in the colon wall.
Fistulas are abnormal connections between two organs or between an organ and the skin. This most commonly happens when damaged tissue connects during infection. Therefore, if diverticulitis causes an infection that spreads outside the colon, a fistula can develop between the colon and nearby organs such as the bladder, small intestine, and skin. This can be corrected surgically, but it can also result in a lifelong increase in urinary tract infections.
Diverticulitis can lead to scarring as the infected tissue heals. This scar sometimes causes a partial or complete blockage of the intestines. While partial blockage will benefit from treatment but is not an emergency, total blockage is a dangerous situation requiring emergency surgery.
Patients with diverticular disease can be treated in a variety of ways, although the recommended treatment usually depends on the severity of the condition. For mild diverticulitis, a low-fiber or liquid diet is prescribed to allow the colon to rest while the blockage clears up; antibiotics are also recommended. Once the condition has resolved, a high fiber diet will be prescribed to prevent its return. Recurring diverticular disease may require more advanced care, including a stricter antibiotic regimen and pain relievers.
For severe diverticulitis, hospitalization and surgery may be required. A perforation or fistula will also require surgery to correct the problem. In rare severe cases, bowel resection may be necessary.
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