Acute diverticulitis as a rare complication can occur following prolonged colonoscopy or colo- noscopic polypectomy, especially in those with additional risk factors such as obesity and smoking.
According to the American Gastrointestinal Association (AGA) guidelines, it is recommended to perform a colonoscopy six to eight weeks after resolution of acute diverticulitis [1].
Post-colonoscopy diverticulitis is increasingly recognized as a potential complication.
Diverticulosis is a condition in which small, bulging pouches (diverticuli) form inside the lower part of the intestine, usually in the colon. Constipation and straining during bowel movements can worsen the condition. A diet rich in fiber can help keep stools soft and prevent inflammation.
Mild cases of diverticulitis are usually treated with antibiotics and a low-fiber diet, or treatment may start with a period of rest where you eat nothing by mouth, then start with clear liquids and then move to a low-fiber diet until your condition improves. More-severe cases typically require hospitalization.
Uncomplicated diverticulitis
Your doctor is likely to recommend: Antibiotics to treat infection, although new guidelines state that in very mild cases, they may not be needed. A liquid diet for a few days while your bowel heals. Once your symptoms improve, you can gradually add solid food to your diet.
Symptoms of diverticulitis are more severe and often start suddenly, but they may become worse over a few days. They include: Tenderness, usually in the left lower part of the abdomen. Bloating or gas.
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Despite having some symptoms in common, diverticular disease isn't associated with more serious conditions, such as bowel cancer. However, diverticulitis is often a medical emergency, requiring immediate medical attention and, frequently, admission to hospital.
Diverticulitis: Colonoscopy is relatively contraindicated in acute diverticulitis due to the risk of perforation. However, following an episode of diverticulitis, colono-scopy is recommended to assess for associated colorectal neoplasia.
Other long-term symptoms of diverticular disease include: a change in your normal bowel habits, such as constipation or diarrhoea, or episodes of constipation that are followed by diarrhoea – a classic pattern is multiple trips to the toilet in the morning to pass stools like "rabbit pellets" bloating.
In a case series review, it was found that colonoscopy induced colitis may be associated with bowel spasms secondary to stress, hypovolemia from inadequate bowel preparation, excessive colonic insufflation and prolonged examination during colonoscopy.
In addition, many patients with diverticular disease surgically treated in an emergency setting will live with a colostomy for the remainder of their lives.
A liquid diet and rest are usually the best ways to ease diverticulitis symptoms. If there is a bleed within the intestines you may need to be hospitalized. Only in severe cases is surgery needed to remove the diseased pouches. With the proper care, diverticulosis symptoms may go away within in a few days.
Diverticulitis shouldn't affect your overall life expectancy. Only in the unlikely event of a bowel perforation or a ruptured abscess would you be at risk of life-threatening complications.
Diverticulitis (flare-up) occurs when the diverticula become inflamed and/or infected. There might be an increase in diarrhea, cramping, and bowel irritability, and symptoms can include intense pain, abdominal cramping, bleeding, bloating, and fever.
Actually, no specific foods are known to trigger diverticulitis attacks. And no special diet has been proved to prevent attacks. In the past, people with small pouches (diverticula) in the lining of the colon were told to avoid nuts, seeds and popcorn.
How is uncomplicated diverticulitis treated? In about 95 out of 100 people, uncomplicated diverticulitis goes away on its own within a week. In about 5 out of 100 people, the symptoms stay and treatment is needed. Surgery is only rarely necessary.
If your diverticulitis is mild, your doctor will suggest rest and a liquid diet while your intestines heal. They might also give you antibiotics to treat the infection. Your doctor may also suggest that you take a mild pain reliever like acetaminophen. You may go on a liquid or “diverticulitis diet.”
When stress is added to the overall picture, the problem of diverticulitis becomes an issue. This is due to the body impulses that will immediately address stressful situations by shifting the oxygen and blood from the digestive tract to the brain and muscles.
There are no specific foods you need to avoid. You do not need to avoid any foods such as nuts, seeds, corn, popcorn or tomatoes if you have diverticular disease. These foods do not make diverticular disease worse.
The doctor also may suggest taking a fiber product, such as Citrucel® or Metamucil®, once a day. Your doctor may recommend a low- or high-fiber diet depending on your condition. Listed below are high-fiber food options for diverticulosis and low-fiber food options for diverticulitis.