Diverticulitis

GENERAL INFORMATION:

What is diverticulitis?

• Diverticulitis (die-ver-tik-u-li-tis) is an inflammation (swelling) of the small sac-like pouches in the colon (large bowel). These sacs are called diverticula. Diverticulitis occurs when stool or food that is not broken down get trapped in the diverticula. This can cause swelling, pain, and infection in your abdomen (stomach). Diverticulitis is most common in people over the age of 80.
  
  
• The colon is the long tube that connects the small bowel with the anus (opening through which stool passes). The colon absorbs water from digested foods and turns the digested food into stool. It stores the stool until it can be passed out through your anus.

What causes diverticulitis? It is not known what causes diverticulitis. The following may put you at a higher risk of having diverticulitis:

• Diet: Not eating enough fiber in your diet may contribute to small, hard stools that are difficult to pass. This may cause increased pressure in your colon.
  
  
• Age: You are 60 years or older. As you age, the wall of your colon thickens and narrows.
  
  
• Obesity: You weigh more than what is suggested by your caregiver.

What are the signs and symptoms of diverticulitis? The most common symptom of diverticulitis is a cramping pain. This is usually felt on the left lower side of the abdomen. You may also have any of the following:

• Bright red or maroon-colored blood in the toilet or on toilet paper. You may also see blood in the stool after a bowel movement (BM).
  
  
• Constipation (dry, hard stools) or diarrhea (loose stools).
  
  
• Fever and chills.
  
  
• Nausea (upset stomach) and vomiting (throwing up).
  
  
• Pain in your abdomen (stomach).
  
  
• Pain or a burning feeling when passing urine.

How is diverticulitis diagnosed? You may have one or more of the following tests:

• Blood tests: Many different tests will be done with your blood, such as a test to see if you have an infection.
  
  
• Imaging tests:
  
  
  • Abdominal ultrasound: An abdominal ultrasound is a test that is done to see inside your abdomen. Sound waves are used to show pictures of your abdomen on a TV-like screen.
    
    
  • Barium enema: A barium enema is an x-ray of the colon. A tube is put into your anus, and a liquid called barium is put through the tube. Barium is used so that caregivers can see your colon better on the x-ray film.
    
    
  • Colonoscopy: A colonoscopy is a test that is done to look at your colon. A tube with a light on the end will be put into your anus, and then moved forward into your colon. Computerized tomography scan: This test is also called a CT or CAT scan. An x-ray machine uses a computer to take pictures of your abdomen, such as small and large bowels.
    
    
  • Sigmoidoscopy: A sigmoidoscopy test looks for changes in your intestinal (bowel) wall that may be caused by a disease or condition. This test may also help find the cause of bleeding or pain. A long, thin tube with a tiny camera on the end is put through your anus into your rectum (rear-end). It also goes to the part of your intestine called the sigmoid. Caregivers will look for problems in your rectum and lower colon. A small amount of tissue may be taken from the intestine wall and sent for tests. Follow your caregiver's instructions for what to do before, during and after the test.
  
  
• Stool test: A sample of your stool may be taken and sent to the laboratory for tests.

How is diverticulitis treated? To rest your bowel, you may need to rest in bed and have a liquid diet for several days. Caregivers may suggest that you eat more high fiber foods. You may have any of the following treatments:

• Medicines:
  
  
  • Antibiotics: Antibiotics may be given to help treat or prevent an infection caused by germs called bacteria.
    
    
  • Pain medicine: This may decrease or remove your pain.
    
    
  • Stool softeners: You may be given stool softeners to soften your bowel movements, making them easier to pass.
  
  
• Surgery: Surgery may be needed if you have frequent or painful attacks of diverticulitis.

What problems can diverticulitis cause? Diverticulitis may cause one or more of the following problems:

• Abscess: This is a collection of pus in the abdomen caused by an infection.
  
  
• Bleeding: A small blood vessel in a diverticulum may weaken and burst, causing blood in your stool.
  
  
• Bowel obstruction: The infection in your colon may form a scar and narrowing of the bowel. This may lead to a partial or complete blockage of your colon.
  
  
• Fistula: A fistula is a connection of tissue between two organs or between an organ and the skin. This forms when damaged tissues stick together during an infection.
  
  
• Perforation: These are small holes or tears that allow pus or bowel contents to leak out of the colon into the abdomen.
  
  
• Peritonitis: This occurs when infection leaks and spreads outside the colon.

Where can you find support and more information? You may feel scared, confused, and anxious because you have diverticulitis. You may blame yourself and think you have done something wrong. These feelings are common. Talk about these feelings with your caregiver or with someone close to you. Ask your caregiver about support groups for people with diverticulitis. You may also want to contact the following organizations for more information about diverticulitis:

• National Digestive Diseases Information Clearinghouse (NDDIC)
  2 Information Way
  Bethesda, MD 20892-3570
  Phone: 1-800-8915389
  Web Address: www.digestive.niddk.nih.gov
  

• International Foundation for Functional Gastrointestinal Disorders
  P.O. Box 170864
  Milwaukee, WI 53217
  Phone: 1-414-964-1799
  Phone: 1-888-964-2001
  Web Address: http://www.iffgd.org
  

CARE AGREEMENT:

You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.

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