What is Diverticulitis?

Diverticulitis is a condition that causes infection and inflammation of pouches that can develop in the large intestine (also known as the colon). These pouches are known as diverticula which are small protrusions forming along the colon's wall. The colon is part of the digestive system and helps break down food into waste. According to the Royal Australian College of General Practitioners, around 10% of over 45-year-olds and 65% of over 70-year-olds will have diverticula in their colon [1]. About 10-25% of these individuals will be diagnosed with diverticulitis [2]. The colon is a large organ that spans around the abdomen, and as a result, issues can occur in any part of the colon. Typically, Westerners will develop problems along the left side of the abdomen compared to people of Asian descent, who are more affected on the right side [2].

Complicated vs. Uncomplicated Diverticulitis

Diverticulitis can be separated into uncomplicated and complicated types. Complicated diverticulitis occurs when there is inflammation around the colon and damage around the organ (e.g. infection, holes along the organ walls, etc.) [3]. Although there are signs of inflammation in those with uncomplicated diverticulitis, signs of organ damage are less severe and more uncommon. Each form will require different medical treatment.
 

Diverticulitis Symptoms

Symptoms of diverticulitis will vary depending on the condition's type, severity and location. Common symptoms include [2]:

• Pain around the abdomen, particularly on the left side
• Vomiting
• Nausea
• Constipation (and less commonly diarrhoea)
• Tenderness around the abdomen
• Bloating
• Increased need to pass gas

 

Diverticulitis Causes

It is not fully understood why diverticulitis occurs [4]. Researchers believe that diverticula (small pouches) develop along the colon due to high pressure in areas of weakness [3]. Over time, these small pouches can worsen due to a combination of factors, such as lifestyle choices, genetics, inflammation, trapped particles, medications and changes within the gut environment (also known as the gut microbiome). Eventually, these changes can lead to severe complications, such as infection and tearing along the colon. Certain risk factors increase the chances of being diagnosed with diverticulitis. These include [4]:

• Eating a Western diet
• Red meat consumption
• Being overweight or obese
• Being a regular smoker\
• Not being physically active
• Having low vitamin D levels
• Taking certain medications (e.g. non-steroid anti-inflammatory drugs, corticosteroids, etc.)
• Having a sibling with diverticulitis

 

Diverticulitis Diagnosis and Testing

There are numerous tests that can be performed to help diagnose diverticulitis. It's essential to contact your GP as soon as possible to help receive the necessary treatment and prevent further complications. Examples of standard tests will be detailed below.

Medical Examination

Your GP may perform a medical examination to find signs of diverticulitis. This may involve detailed questioning of any symptoms and history of your current condition. Examples of questions that may be asked include your bowel movements, pain location, and diet. A physical examination may also be performed, such as assessing tenderness along the abdomen [1].

Imaging

Ultrasound and CT scans are the most common imaging tests that are used to check for any abnormalities along the colon. Trained professionals will operate machines to create 2D and 3D images inside the body. Doctors use these images to diagnose diverticulitis and other potential conditions [3]. Click here for more information about imaging tests.

Colonoscopy

A colonoscopy is a procedure that is used to examine the colon. Specially trained doctors will perform a colonoscopy to check for abnormalities inside the colon. It will involve placing a thin tube with an attached camera inside the body. Generally, you will be sedated and asleep for comfort. For more information about colonoscopy, you can read our guide here [3].

Blood Tests

Blood tests can be performed to look for signs of inflammation and infection. After your blood is drawn, it will be taken to the laboratory for further analysis. While blood tests alone are not enough to make a diagnosis, they may be able to assist with the severity of your condition [3].
 

Diverticulitis Treatment

Treatment for diverticulitis will vary depending on your symptoms and the severity of the condition. An assessment by a GP will be essential for guiding the most appropriate treatment for the best possible outcome. Complicated diverticulitis may require urgent treatment and hospital admission. On the other hand, uncomplicated diverticulitis can be treated by your GP. Please read our "What is diverticulitis?" section for more information about the differences between these two types.

Lifestyle Changes

Lifestyle habits play a role in developing diverticulitis. As noted earlier, factors such as weight, physical activity levels and diet can increase the risk of being diagnosed with the condition. Your GP may provide recommendations about how you can prevent and reduce its progression. Referrals to other healthcare professionals, such as dietitians and exercise physiologists, may also help.

Medications

Medications can be prescribed to help relieve symptoms and prevent the progression of the condition. Antibiotics are used to treat bacterial infections to stop the inflammation from spreading further. On the other hand, suitable pain-relief drugs can also help ease discomfort [1]. Always take your medications as guided by your doctor.

Temporary Diet Change

Some GPs may suggest temporarily changing your diet to help your gut recover. Depending on the findings, temporarily eating non-solid foods, such as soup and smoothies, may settle symptoms [5].

Percutaneous Drainage

Those with abscesses (pockets of pus) that develop in the colon may require percutaneous drainage. This process involves the removal of infected fluids from the organs, such as the colon. It may be performed when you are hospitalised or planned with a surgeon [1].

Operation

Surgery may be required for more severe and/or persistent cases of diverticulitis. A part of the infected colon will be removed, and the healthy areas will be re-connected by your surgeon. Those with complications, such as perforations (holes in the organ wall) and peritonitis (inflammation of the organ's lining), may require immediate surgery [1][3].
 

Recovery

Recovery will depend on the severity of the condition, age and general health of the individual. Those not seeking early treatment may experience long-term complications and/or death. Immunocompromised people, those with severely complicated diverticulitis and unsuspecting younger people can have poorer outcomes [2]. However, most people who recover from diverticulitis will not develop it again [6].
 

Complications

If diverticulitis is not managed appropriately or early enough, it can lead to severe complications, including:

• Formation of abscesses (collection of pus)
• Peritonitis (inflammation of the thin layer around the colon)
• Tearing and rupturing of the colon's wall
• Leaking along the colon
• Blockage in the gut
• Ongoing pain and discomfort
• Narrowing of the gut's passages
• Sepsis or infection spreading throughout the body

 
 

Receiving quality care from highly experienced doctors is essential for a prompt diagnosis and receiving the correct medical treatment. With 24-7 MedCare, you can experience telemedicine from the convenience of your own home. Our friendly online doctors will be available 24/7 for a consultation, anytime and anywhere in Australia.

To make a telehealth appointment booking, simply click on the button below.

 
 
 
 

References

1. McSweeney, W., & Srinath, H. (2017). Diverticular disease practice points. Australian Family Physician, 46(11), 829-832.
2. Linzay, C. D., & Pandit, S. (2017). Acute diverticulitis.
3. You, H., Sweeny, A., Cooper, M. L., Von Papen, M., & Innes, J. (2019). The management of diverticulitis: a review of the guidelines. Medical Journal of Australia, 211(9), 421-427.
4. Strate, L. L., & Morris, A. M. (2019). Epidemiology, pathophysiology, and treatment of diverticulitis. Gastroenterology, 156(5), 1282-1298.
5. InformedHealth.org [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. Diverticular disease and diverticulitis: Treating acute diverticulitis. 2018 May 17. Available from: https://www.ncbi.nlm.nih.gov/books/NBK506996/
6. Carr, S., & Velasco, A. L. (2019). Colon Diverticulitis.