What Causes Diverticulitis? Diverticulitis Symptoms and Treatment

by Abbas Jahangir · June 15, 2024

Diverticula are sac-shaped structures formed as a result of bubble-shaped herniations in the large intestine. Diverticulosis or diverticulum disease is the name given to the presence of one or more diverticula. Inflammation and infection of these small sacs is called diverticulitis. Diverticular disease is common and often causes no symptoms and does not require treatment. A high-fiber diet, exercise, and drinking plenty of water can help prevent diverticula from developing. Mild cases of diverticulitis are treated with antibiotics. If it becomes severe or additional problems develop, surgery is required for treatment.

What is Diverticula?

The answers to the questions “What does diverticulum mean?” or “What does diverticula in the intestine mean?” are often wondered. Diverticula are small, bubble-shaped structures characterized by herniation in the lining of the inner surface of the digestive tract. The most common region is the large intestine, or the lower part of the colon as it is called in the medical literature. Diverticula usually do not cause any problems or symptoms and are more common after the age of 40. The condition characterized by the development of inflammation or infection in the diverticular structures, which have an appearance that can be called bubbles in the intestine, is called diverticulitis, and the disorder caused by the presence of diverticula in the body is called diverticular disease or diverticulosis. Diverticulitis can cause severe abdominal pain, fever, nausea, and significant change in bowel habits. Mild diverticulitis can be treated with rest, dietary changes and antibiotics. Severe or recurrent cases of diverticulitis may require surgery.

What Causes Diverticulitis?

Diverticulum usually develops as a result of naturally weak areas in the large intestine being put under pressure. This pressure applied to the intestine causes sacs of various sizes to herniate out of the colon wall. Diverticulitis occurs when the diverticulum wall ruptures, causing inflammation and sometimes infection in that part of the intestine. Scientists don’t know the exact cause of diverticulosis. However, low-fiber diet and resulting constipation are most blamed for diverticulum formation and therefore diverticulitis. Not eating enough fibrous foods causes feces to accumulate in the large intestine, waste accumulation and constipation. Constipation creates pressure by putting extra load on the colon walls. This increased pressure results in the formation of small pockets in weak areas of the colon. Several factors can increase a person’s risk of developing diverticulitis:

Age: The incidence increases after the age of 40.
Obesity: Especially morbid obesity increases the risk.
Smoking: Smokers are significantly more likely to experience diverticulitis than non-smokers.
Not Exercising: Regular exercise every day reduces the risk of diverticulitis.
High Animal Fat, Low Fiber Diet: Risk increases when the two factors occur together. However, the effect of low fiber content alone on the risk of diverticula is not clear.
Some Medications: Regular intake of some medications such as steroids and opioids increases the risk.

What are the symptoms of diverticulitis?

Diverticulitis, characterized by inflammation or infection in one or more of the diverticula, manifests itself with various symptoms. Symptoms of intestinal diverticula may include:

Abdominal Pain: Diverticulitis pain manifests itself as abdominal pain that can continue for several days continuously. This pain occurs more in the lower left side of the abdomen. But sometimes, especially in people of Asian descent, there is more pain on the right side of the abdomen.
cramps in the abdomen
Nausea and vomiting
Fire
Shake
Abdominal tenderness and bloating
Constipation or, less commonly, diarrhea
bleeding from the anus

It’s best to seek medical help when you have persistent, unexplained abdominal pain, especially if it is accompanied by fever, constipation, or diarrhea.

Does Diverticula Turn into Cancer?

Although some lifestyle factors may lead to an increased risk of both diverticula and cancer, no causal relationship has yet been established between diverticula or diverticulitis and cancers of the colon or rectum. For example, eating a diet high in fat and low in fiber increases the risk of both diverticulitis and colon cancer.

What Should Diverticula Patients Not Eat?

While nuts, plant seeds, and corn were until recently thought to cause diverticulitis attacks, newer research shows that these foods do not cause flare-ups. Since different foods can trigger the disease in each individual, a person can avoid foods that worsen the disease by keeping track of which foods cause symptoms.

Diverticula Diet

Having regular bowel movements, avoiding constipation and straining, and diet are important to prevent diverticular disease and reduce its complications. For this purpose, it is useful to eat as follows:

Consuming Foods Containing More Fiber: Fiber draws more water into the stool, making it more voluminous and soft. Thus, it moves faster in the intestines and is eliminated more easily.
Drinking Plenty of Water: Consuming more fibrous foods causes more water absorption. For this reason, it is necessary to increase the amount of water drunk along with fibrous foods to keep the stool soft and mobile.
Exercising Regularly: Regular physical activity helps food move through the intestinal system. Exercising regularly for 30 minutes every day, if possible, significantly prevents constipation.

How to Diagnose Diverticulitis?

Diverticulitis is usually diagnosed during an acute attack. Since abdominal pain is a symptom of many other diseases, the doctor must rule out other causes. For this reason, diagnosis begins with a physical examination that includes checking the sensitivity in the abdomen. A pelvic exam is also often necessary to rule out pelvic disease in women. After the examination, you may order the following tests:

Blood and urine tests to check for the presence of infection
Pregnancy test for women of childbearing age to rule out pregnancy as a cause of abdominal pain
Liver function tests to rule out liver-related causes of abdominal pain
Stool testing to rule out infection in people with diarrhea
A CT scan, which can confirm a diagnosis of diverticulitis by viewing inflamed or infected sacs. CT can also indicate the severity of diverticulitis and guide treatment.

How to Treat Diverticulitis?

Intestinal diverticulum treatment is planned depending on the severity of the symptoms seen in the person. If symptoms are mild, home treatment may be sufficient. In this case, the doctor may make the following recommendations for treatment:

Antibiotics are prescribed to treat the infection. However, new guidelines state that antibiotics may not be necessary in very mild cases.
In order for the intestines to recover more easily, it is recommended to eat a liquid diet for a few days. Once symptoms improve, solid foods are gradually added to the diet.

If the patient has an attack with severe symptoms or other health problems, treatment is usually given by hospitalization. In this case, treatment includes:

Intravenous antibiotic treatment
If an abscess has formed in the abdomen, placing a drainage tube in the area to drain it

Diverticula surgery is most likely needed to treat the condition if:

If there is a complication in the intestine such as abscess, fistula, obstruction, perforation in the intestinal wall
If you have more than one diverticulitis attack
If the person has a weak immune system

How is Diverticul and Diverticulitis Treated with Surgery?

There are two main types of surgery that can be performed on people with diverticulum disease:

Primary Intestinal Resection: In this surgical method, diseased sections of the intestine are removed and healthy sections are reconnected. This procedure allows bowel movements to return to normal. Depending on the amount of inflammation, open or endoscopic surgery may be preferred.
Intestinal Resection with Colostomy: If the large intestine and rectum contain so much inflammation that it is not possible to reconnect healthy sections of intestine, the surgeon first opens a colostomy. Rectum is the name given to the part of the intestine located between the large intestine and the anus. A colostomy is placed by making an incision in the abdominal wall and connecting it to the healthy part of the large intestine. The person’s feces pass through the opening into a bag and accumulate in the bag. Once the inflammation in the intestine subsides, the colostomy can be removed and rotated to reconnect the intestine.

What Should Be Considered After Diverticula Surgery?

It is recommended that the patient get up and move around as soon as possible after surgery to reduce the risk of blood clots. It is normal to have pain in the procedure area for a few days after the surgery. Most patients can return to normal activities within 1-2 weeks after surgery.

It is important to have your check-ups at regular intervals for early diagnosis and treatment of all kinds of health problems.