Issue 5 Stories
On-Call Advice

Please explain what diverticulitis is and how it’s treated.

Blue Ridge Region physicians of Sentara Martha Jefferson Hospital and Sentara RMH Medical Center answer your health and wellness questions

Diverticulitis refers to inflammation or infection of the small pouch-like recesses, called diverticula, that can form in the digestive tract—especially in the lining of the colon, the lower portion of the large intestine. No one knows why these marble-sized pouches form, but a low-fiber diet may be one cause. Lack of fiber makes the colon work harder to eliminate waste, and this may cause diverticula to form in weak areas of the colon wall. Most people form diverticula at some point—especially after middle age—and most of the time they cause no serious problems.

The cause of diverticulitis is not fully understood, either, but doctors think the condition may arise from bacteria caught in pouches that happen to tear. Risk factors associated with a higher incidence of diverticulitis include age; obesity; lack of exercise; a low-fiber diet; smoking; and taking certain medications like ibuprofen, naproxen, steroids and opioids.

Diverticulitis can be very painful. Typical symptoms include persistent abdominal pain—especially in the lower left side—which may get worse with movement; rectal bleeding; bloating; abdominal tenderness; constipation or, less commonly, diarrhea; nausea or vomiting; loss of appetite; and fever or chills. Diagnosis is typically based upon a history of symptoms, as well as blood tests and X-rays or computed tomography (CT) scans.

Treatment depends upon the severity of the condition. Mild cases usually can be treated with rest, diet modifications, antibiotics and over-the-counter pain medications. In the majority of mild cases treated by these means, symptoms are successfully resolved.

Severe cases may lead to complications that include blockage of the colon; abscess, or the collection of pus in the diverticula; and peritonitis, or rupture of a diverticulum that releases its toxic contents into the abdominal cavity. Peritonitis is a medical emergency that requires immediate attention. Severe cases of diverticulitis may be treated by the insertion of a drainage tube in the case of an abscess, or by surgery if there is blockage, or if there is presence or significant risk of peritonitis.

The best way to avoid diverticulitis is to exercise regularly, eat a high-fiber diet and drink plenty of fluids to help your body handle the increased fiber intake.

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