What is diverticulitis?
The digestive system is essential in breaking down food and eliminating waste. Food passes through the stomach into the small intestine where the nutrients are broken down into absorbable carbohydrates, fats, and protein. The substance not absorbed in the small intestine goes through the large intestine where fluid is absorbed and solid waste moves into the rectum for elimination.
Along the muscular lining of the digestive system, particularly in the colon, herniations can develop. These small pouches of mucosa are called diverticula. The bulging sacs that are formed extend into the peritoneum. Those with such herniations in their gut suffer from diverticulosis. Diverticula usually develop in the left colon, although they can be found anywhere in the large or (more rarely) small intestines. They develop at weaker areas along the colon wall where arteries are usually found.
When these outpouches become inflamed, the condition is known as diverticulitis. When inflamed, these sacs have the ability to cause abscesses, fistulas, GI obstruction, and perforation (resulting in peritonitis). Fortunately, these serious complications are rare.
Figure 1. Diverticular Disease (https://www.onhealth.com/content/1/diverticulitis_diverticulosis, 2016)
The exact cause of diverticular disease is currently unknown, but risk factors include:
- Increased colon pressure
- Decrease in dietary fiber
- Alterations of intestinal motility
- Advanced age
- Abnormal neuromuscular function
Consuming a high-fiber diet is essential in reducing diverticular risks. Dietary fiber decreases intracolonic pressure by increasing fecal bulk and reducing elimination time. As pressure increases in the colon, weak spots along the muscular wall are more at risk to become herniated. Dietary fiber can reduce this pressure within the colon.
Clinical Manifestations
Many individuals with diverticula remain asymptomatic. In fact, no more than 30% of people with the diverticular disease ever exhibit any specific symptom. However, those who develop diverticulitis often exhibit conditions such as:
- Cramping pain
- Constipation or diarrhea
- Nausea and vomiting
- Abdominal distention
Unfortunately, diverticulitis has the potential to become complicated by obstruction, abscesses, and infection. Signs of more serious obstruction or perforation include:
- Fever
- Increased white blood count
- Lower left quadrant tenderness (if the diverticula is in the left colon)
WebMD. (2017). Diverticulitis [computer rendering] Retrieved from https://www.onhealth.com/content/1/diverticulitis_diverticulosis