Diverticula are small areas of weakness in the wall, usually of the large intestine and most often in an area known as the sigma, on the left side of the abdomen.
When there is an increase of pressure inside the intestine, due to this weakness, a kind of pouch is generated, as when a balloon is inflated. When there are one or several balloons in the intestine but they do not bother, the affected person is not aware that he/she has it, and we speak of “diverticulosis”. Therefore, the diverticula as such, have no function.
When do we talk about diverticulitis?
If any of these balloons becomes inflamed, even to the point of rupture, then we speak of “diverticulitis” and its different degrees, ranging from a small inflammation (phlegmon) around the diverticulum, to a major perforation with gas or even solid stool leaking into the abdomen, which we would call a generalized fecal peritonitis.
Causes of diverticulitis
As we have already mentioned, the origin of diverticulitis seems to be in an increase of pressure inside the intestine. Therefore, anything that increases this pressure, can cause diverticula to appear. The reasons may be:
- By ingestion of foods that cause gas and distension of the intestine.
- Increased contractility of the intestine. The intestine contracts more or less abruptly, in the irritable colon, in relation to stress or constipation, for example.
- Increased pressure from outside the intestine, when making a sudden effort, with a blow to the abdominal level, when doing sit-ups or wringing out a mop among others.
This means that avoiding these situations can prevent the appearance of diverticula and also prevent it from progressing to diverticulitis.
Signs and symptoms of diverticulitis
The symptoms of diverticulitis are similar to those of appendicitis but on the left side. In general, there is continuous pain, abdominal swelling, sometimes with fever and diarrhea or constipation depending on the severity of the picture, even the pain can evolve to the rest of the abdomen.
Diverticulitis as such is an urgent situation, so it is necessary to go to a medical center as soon as possible for an initial evaluation.
Another aspect is to live with diverticula (diverticulosis), which normally will not cause problems, and there is no possibility of them turning into anything “bad”, as long as we have ensured the diagnosis, which is usually done with a colonoscopy a few weeks after the acute episode.
Treatment of diverticulitis
Mild episodes can be treated on an outpatient basis, with or without antibiotics, depending on what your physician deems appropriate. In addition, probiotics and a residue-free diet will be recommended for the first few days. After the acute episode, the recommendation is the opposite, a diet rich in fiber, that is, fruit and vegetables. In certain situations, we may recommend antibiotics as a preventive measure for a few months.
In more advanced forms of diverticulitis, and in some at-risk patients, hospital treatment will be proposed for antibiotic therapy and other types of drugs. In the last case, for situations of extreme severity or that do not respond to treatment, emergency surgery is necessary to remove the diseased segment of bowel.
Scheduled surgery is relegated to specific clinical situations that your surgeon will indicate to you.
For more information, consult a specialist in Coloproctology.