Dr. M.J. Bazos, MD Patient Handout

DIVERTICULITIS

About Your Diagnosis

Diverticuli are herniations of the colon mucosa through the muscular layer of the colon. This produces a small saclike swelling in the colon wall. Diverticulitis occurs when diverticuli become inflamed and infected. Small abscesses form and then rupture causing symptoms. Diverticulitis occurs during lifetime in about half of the individuals who have diverticuli. Roughly 3,000 cases per 100,000 individuals occur annually. It is not a contagious or cancerous condition. A barium enema x-ray examination is used to detect this condition. Diverticuli may also be found on colonoscopy or flexible sigmoidoscopy (lighted flexible tubes used to examine the colon). With treatment the prognosis is good. Relapses do occur, however.

Living With Your Diagnosis
The initial symptoms of diverticulitis are intermittent cramping and abdominal pain that becomes constant. The location of the pain is usually in the left lower abdominal area. Fever and chills can occur, as well as constipation or diarrhea. There is generally a loss of appetite and nausea. Examination may reveal tenderness and a mass over the painful area. An elevated white blood cell count is usually present. Complications of diverticulitis include hemorrhage (bleeding), perforation (rupture), bowel obstruction, and abscess formation.

Treatment
Treatment is generally outpatient unless the symptoms are severe and there are signs of widespread infection or complications. Bed rest, stool softeners, a liquid diet, and oral antibiotics are the basis of outpatient treatment. If hospitalized, the treatment is similar. You are put at bed rest and intravenous fluids are given. Intravenous antibiotics are started, and analgesics are given for pain control. Initially you may not be allowed to eat. As the symptoms resolve, your diet is slowly returned to a high-fiber, low-fat diet. If the case is severe or complicated, surgical resection of the affected area of colon is an option. Surgical resection is a treatment option for frequent reoccurrences.


The DOs
• Take medications as prescribed.
• Eat a high-fiber, low-salt, low-fat diet between attacks.
• Drink plenty of fluids between attacks.
• Maintain proper physical activity between attacks.
• Maintain proper weight. Try to lose weight if overweight.
• Maintain proper bowel habits by trying to have a bowel movement daily.
• Watch for signs of blood in the stool or dark tarry bowel movements.
• Watch for signs of reoccurrences and other complications, such as abdominal pain and fever.

The DON’Ts
• Do not strain with bowel movements.
• Avoid laxatives.

When to Call Your Doctor
• If you have blood in the stool.
• If abdominal pain develops or becomes worse.
• If a fever develops and you have abdominal pain.

Websites:
National Digestive Diseases Information Clearinghouse
www.niddk.nih.gov
nddic@aerie.com