This article is about intestinal pouches that are inflamed. For non-inflamed pouches, see Diverticulosis.
Medical condition
Diverticulitis
Other names
Colonic diverticulitis
Section of the large bowel (sigmoid colon) showing multiple pouches (diverticula). The diverticula appear on either side of the longitudinal muscle bundle (taenium), which runs horizontally across the specimen in an arc.
Specialty
General surgery
Symptoms
Abdominal pain, fever, nausea, diarrhea, constipation, blood in the stool[1]
Complications
Abscess, fistula, bowel perforation[1]
Usual onset
Sudden, age > 50[1]
Causes
Uncertain[1]
Risk factors
Obesity, lack of exercise, smoking, family history, nonsteroidal anti-inflammatory drugs[1][2]
Diverticulitis, also called colonic diverticulitis, is a gastrointestinal disease characterized by inflammation of abnormal pouches—diverticula—that can develop in the wall of the large intestine.[1] Symptoms typically include lower abdominal pain of sudden onset, but the onset may also occur over a few days.[1] There may also be nausea, diarrhea or constipation.[1] Fever or blood in the stool suggests a complication.[1] People may experience a single attack, repeated attacks, or ongoing "smouldering" diverticulitis.[2][4][5]
The causes of diverticulitis are unclear.[1] Risk factors may include obesity, lack of exercise, smoking, a family history of the disease, and use of nonsteroidal anti-inflammatory drugs (NSAIDs).[1][2] The role of a low fiber diet as a risk factor is unclear.[2] Having pouches in the large intestine that are not inflamed is known as diverticulosis.[1] Inflammation occurs in between 10% and 25% at some point in time, and is due to a bacterial infection.[2][6] Diagnosis is typically by CT scan, though blood tests, colonoscopy, or a lower gastrointestinal series may also be supportive.[1] The differential diagnoses include irritable bowel syndrome.[2]
Preventive measures include altering risk factors such as obesity, inactivity, and smoking.[2] Mesalazine and rifaximin appear useful for preventing attacks in those with diverticulosis.[2] Avoiding nuts and seeds as a preventive measure is no longer recommended since there is no evidence these play a role in initiating inflammation in diverticula.[1][7] For mild diverticulitis, antibiotics by mouth and a liquid diet are recommended.[1] For severe cases, intravenous antibiotics, hospital admission, and complete bowel rest may be recommended.[1] Probiotics are of unclear value.[2] Complications such as abscess formation, fistula formation, and perforation of the colon may require surgery.[1]
The disease is common in the Western world and uncommon in Africa and Asia.[1] In the Western world about 35% of people have diverticulosis while it affects less than 1% of those in rural Africa,[6] and 4–15% of those may go on to develop diverticulitis.[3] In North America and Europe the abdominal pain is usually on the left lower side (sigmoid colon), while in Asia it is usually on the right (ascending colon).[2][8] The disease becomes more frequent with age, ranging from 5% for those under 40 years of age to 50% over the age of 60.[9][1] It has also become more common in all parts of the world.[2] In 2003 in Europe, it resulted in approximately 13,000 deaths.[2] It is the most frequent anatomic disease of the colon.[2] Costs associated with diverticular disease were around US$2.4 billion a year in the United States in 2013.[2]
^ abcdefghijklmnopqrstuv"Diverticular Disease". www.niddk.nih.gov. September 2013. Archived from the original on 13 June 2016. Retrieved 12 June 2016.
^ abcdefghijklmnopTursi A (March 2016). "Diverticulosis today: unfashionable and still under-researched". Therapeutic Advances in Gastroenterology. 9 (2): 213–28. doi:10.1177/1756283x15621228. PMC 4749857. PMID 26929783.
^ abCite error: The named reference UpToDate was invoked but never defined (see the help page).
^Rink AD, Nousinanou ME, Hahn J, Dikermann M, Paul C, Vestweber KH (October 12, 2019). "[Smoldering diverticultis - still a type of chronic recurrent diverticulitis with good indication for surgery? - Surgery for smoldering diverticulitis]". Zeitschrift Fur Gastroenterologie. 57 (10): 1200–1208. doi:10.1055/a-0991-0700. PMID 31610583. S2CID 204702433.
^"Colonic Diverticular Disease".
^ abMandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. Churchill Livingstone. 2014. p. 986. ISBN 9781455748013. Archived from the original on 2016-08-08.
^Young-Fadok TM (October 2018). "Diverticulitis". New England Journal of Medicine. 379 (17): 1635–42. doi:10.1056/NEJMcp1800468. PMID 30354951. S2CID 239933906.
^Feldman M (2010). Sleisenger & Fordtran's Gastrointestinal and liver disease pathophysiology, diagnosis, management (9th ed.). [S.l.]: MD Consult. p. 2084. ISBN 9781437727678. Archived from the original on 2016-08-08.
^Young-Fadok TM (2018). "Diverticulitis". The New England Journal of Medicine. 379 (17): 1635–1642. doi:10.1056/NEJMcp1800468. PMID 30354951. S2CID 239933906.
Diverticulitis, also called colonic diverticulitis, is a gastrointestinal disease characterized by inflammation of abnormal pouches—diverticula—that can...
Diverticulitis is defined as diverticular disease with signs and symptoms of diverticular inflammation. Clinical features of acute diverticulitis include...
circular muscle layer. Complicated acute diverticulitis is distinguished from uncomplicated diverticulitis by the presence of abscess or colonic perforation...
abdominal pain or signs of peritonitis are localised in the LLQ, colitis, diverticulitis, ureteral colic or pain due to ovarian cysts or pelvic inflammatory...
and sepsis. Perforation may be caused by trauma, bowel obstruction, diverticulitis, stomach ulcers, cancer, or infection. A CT scan is the preferred method...
lower quadrant the symptoms often lead to a misdiagnosis for diverticulitis. Diverticulitis manifests with evenly distributed lower abdominal pain accompanied...
depends on whether peritonitis is localized (e.g., appendicitis or diverticulitis before perforation), or generalized to the whole abdomen. In either...
may include bloody stools, chills, dehydration, diarrhea, and fever. Diverticulitis is a condition where small bulging sacs, usually found in the large...
such as appendicitis, leaking or ruptured abdominal aortic aneurysm, diverticulitis, or ectopic pregnancy. In a third of cases, the exact cause is unclear...
out-pouchings), diverticulitis is not typically associated with active bleeding. There are several complications that can arise from diverticulitis, and one...
diagnosed with endoscopic biopsies. Diverticulitis is a common condition with different presentations. Although diverticulitis may be the source of a colonic...
executive vice president. He is currently out of action indefinitely due to diverticulitis. Before joining AEW in 2019, Omega was known for his tenure in New Japan...
abdominal pain, a differential diagnosis might include ?diverticulitis (read as "query diverticulitis"). Betteridge's law of headlines – Journalistic adage...
introduced guidance to use mesalamine to treat acute uncomplicated diverticulitis. Most often reported side-effects are gastrointestinal (GI) (but may...
abdominal (peritoneal) surface due, for example, to appendicitis or diverticulitis. The tensed muscles of the abdominal wall automatically go into spasm...
quickly won the UFC Heavyweight Championship, but was sidelined with diverticulitis in 2009. On his return in 2010, Lesnar defeated Interim UFC Heavyweight...
brought on by an aortic aneurysm, while others list sepsis caused by diverticulitis. Seven months after Steele's death, the surviving members of Type O...
usually arising from an infectious intra-abdominal process such as diverticulitis. Hepatic portal venous gas is a rare finding on radiological exams....
including hypertension and high cholesterol. He also suffered from diverticulitis. An autopsy was pending as of January 11, 2016.[ref] On September 12...
liver. Common causes are abdominal conditions such as appendicitis or diverticulitis due to haematogenous spread through the portal vein. It can also develop...
Castro's health deteriorated; international press speculated that he had diverticulitis, but Cuba's government refused to corroborate this. He continued to...
schistosomiasis Urinary tract infection (UTI) caused by bacterial infection Diverticulitis Hypotension Mass in the abdomen Reactive arthritis Acute intermittent...
debris may enter the diverticular outpouchings, causing inflammation or diverticulitis. On CT or MRI imaging, it appears as a sac-like outpouching. If the...
removed, e.g. due to colon cancer requiring a total mesorectal excision, diverticulitis, injury, etc., so that it is no longer possible for feces to exit via...
with a brief appearance by Vance. Arnaz suffered a severe attack of diverticulitis in 1971, which required an operation and several years of recovery....
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