Diverticulitis is an infection in the tissues around the colon which occurs when the colon gets ruptured. Colon, shaped like long tube, is large intestine which is responsible for storing and eliminating waste products. Due to the pressure in the colon, tissues are pushed out from the walls of the colon – a small sac (tissue) that is pushed out from the colonic wall is known as a diverticulum, diverticula if more than one sac is oozing out. Although tissues could be pushed out from throughout the colon but the occurrence in the end of left colon is most common. It is known as sigmoid colon. Diverticulosis, in simple words, is the condition when a person has diverticula in his colon.
This condition is rarely seen in people living in Asia and Africa but it is very common for the people living in Western countries to suffer from Diverticulosis. Before 40, it is rather unusual for someone to develop Diverticulosis as it starts after 60. It is still unknown why but the wall of the colon gets thick as you age. Most probably it is due to the increase in pressure which is required to eliminate the wastes. To take an example, if a person’s diet has low fiber content, then he’ll pass hard and small stool which takes more pressure to go by. Less fiber in the diet also closes off segments of the colon from the rest when muscle in the colon contracts. Thus, the pressure in the closed off colon is not dissipated throughout and thereby pressure gets high in that segment. Eventually, the intestinal lining gets pushed out to the muscular walls through areas that are weak which leads to formation of diverticula.
This condition has no specific symptoms – it is mostly diagnosed incidentally while testing for some other intestinal troubles. The symptoms that are witnessed in this condition are abdominal cramping, diarrhea, constipation. All these symptoms make it difficult for the colon to pass stool from the let colon because it gets narrowed. The serious symptoms include colon obstruction, bleeding in the colon, divertoculitis and collection of pus in pelvis region.
Rupturing of the diverticulum causes bacteria to spread in the tissues around the colon. Inflamed diverticulum leads to collection of pus in the pelvis and sometimes, it erodes into the bladder and causes bladder infection. When the diverticulum explodes into a blood vessel, it causes bleeding which could last several days. Those with active bleeding are often hospitalized and severe blood losses are counteracted with blood transfusions. An individual could also go into shock, lose consciousness and get dizzy in case of severe bleeding and incessant blood pressure dropping. Surgically, bleeding diverticulum could be removed if the patient frequently complaints of persistent bleeding.
Once the doctor suspects Diverticulosis, it could be detected by running a few tests. The first one is a simple Barium X-Ray is used to see the colon – the diverticulum is seen protruding the wall. Your doctor may also insert flexible tubes in the rectum which gets the direct view of the intestine. Short tubes or long tubes help in the diagnosis and to rule out other conditions. CT scan and ultrasound can detect pus in the pelvis region. These are used if patient complains of pain and fever.
Doctors prescribe anti-spasmodic drugs to those who have mild abdominal pain. These include Librax, Bentyl, Donnatal and Levsin. These oral medicines work well in cases when the symptoms of the diverticulitus are mild. The anti-biotics like Cipro, Flagyl, Keflex and Vibramycin are also prescribed by the doctors. Furthermore, many doctors recommend a diet rich in fiber to prevent further complication of the condition. They advise against consumption of nuts, seeds and corns. However when the condition gets too bad, fiber should be avoided. Hospitalization and surgery are required in extreme cases.
In cases when Diverticulosis doesn’t respond to anti-biotics and medical treatments, surgery gets indispensable. Through surgery, pus is removed from the pelvis and the segment of the colon with diverticuli is removed. If the patient has severe bleeding, the diverticuli causing the bleeding is also taken out. For that to happen, the surgeon should know where exactly it is coming from. As described earlier, diverticula erode into the urinary bladder and causes infection and passage of gas when urinating. This is another situation that needs surgery. Besides these, patients with frequent attacks of diverticulitis also go for surgery to get all the diverticula removed from the colon.
Diverticula, if formed in the colon, are definitely permanent. There is no treatment uncovered yet which could stop the complications of the diverticular disease. In theory, diet rich in fiber helps prevent constipation and further worsening of the condition. Also, doctors recommend that patients of the diverticular disease should avoid nuts, seeds and corns. Also, if the patient experiences abdominal pain, fever or unexplained chills, he should consult his doctor for there are always possibilities of complications.