Diverticular disease and diverticulitis pt 3 - Diagnosis and Treatment

Diverticular disease and diverticulitis Part 2

Causes

Diverticular disease

It is not known why only 1 in 4 people with diverticula develop symptoms of diverticular disease. Several factors have been identified that appear to increase the risk of developing diverticular disease including:

• smoking
• being overweight or obese
• having a history of constipation
• physical inactivity
• use of non-steroidal anti-inflammatory drugs (NSAIDs) type of painkillers, such as ibuprofen or diclofenac

Diverticulitis

Diverticulitis is caused by an infection of one or more of the diverticula. It is thought that an infection develops when a hard piece of stool gets trapped in one of the pouches. This gives bacteria in the stool the chance to multiply and spread, triggering an infection.

Diagnosis

Diverticular disease can be difficult to diagnose from the symptoms alone because there are many other conditions that cause similar symptoms, such as irritable bowel syndrome (IBS). As a first step, blood tests can rule out other conditions such as coeliac disease (abnormal immune response to gluten found mainly in wheat). Other diagnostic tools include Colonoscopy and Barium enema X-ray. To diagnose diverticulitis a blood test may be taken because a high number of white blood cells indicate infection. A barium enema X-ray may be used, as well as a CT scan if symptoms are particularly severe.

Treatment

Eating a high-fibre diet can help control symptoms. Some people will notice an improvement after a few days, although it can take around a month to fully feel the benefits. Most cases of diverticular disease can be treated at home. The over the counter (OTC) painkiller, paracetamol, is recommended to help relieve symptoms. Painkillers known as non-steroidal anti-inflammatory drugs (NSAIDs), such as aspirin and ibuprofen, are not recommended because they irritate the lining of the stomach and can upset the stomach and increase the risk of internal bleeding.

Heavy or constant rectal bleeding occurs in about 1 in 3 cases of diverticular disease. This can happen if the blood vessels in the large intestine are weakened by the diverticula, making them vulnerable to damage. The bleeding is usually painless but losing too much blood can be potentially serious and need a blood transfusion. Signs of heavy bleeding (apart from the amount of blood) include:

• feeling very dizzy
• mental confusion
• pale clammy skin
• shortness of breath

In this situation, immediate medical attention is needed.

To be continued: next week

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