Colonoscopy. A colonoscopy is a procedure that allows the gastroenterologist to examine the lining of the colon and rectum wall for any problems, including diverticula. Your doctor may also use this test to identify inflammation or bleeding in the colon.
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.
Core tip: Diverticular disease, which encompasses the range of clinical manifestations and complications that can occur with colonic diverticula, is frequently encountered in clinical practice. Colonoscopy is a vital tool in the diagnosis and management of diverticular disease.
Symptoms of diverticulosis and diverticulitis are similar to other conditions, such as appendicitis, ovarian cyst, peptic ulcer, Crohn's disease, and irritable bowel syndrome – so the doctor may do tests such as x-rays, ultrasound, or endoscopy to make the right diagnosis.
A cohort study including 445,456 Danish adults found that patients with diverticular disease had a 120% higher risk of colon cancer compared to those without diverticulitis after an 18-year follow-up period [2]. This positive association was also revealed in several other observational studies [3,4,5].
After adjusting for covariates, having a diagnosis of diverticular disease was associated with a 33% increased risk of overall cancer (95% confidence interval [CI] = 1.31 to 1.36). The risk increases also persisted compared with siblings as secondary comparators (HR = 1.26, 95% CI = 1.21 to 1.32).
The risk of having colorectal cancer after an episode of acute diverticulitis is 44-fold higher than that of an age- and gender-adjusted reference population.
An abdominal CT scan is the most precise tool doctors use to diagnose diverticular disease. A CT scan provides cross-sectional, two- and three-dimensional images of structures in the gastrointestinal tract.
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.
“Generally speaking, inflammation from diverticulitis can cause scar tissue formation and breakdown of the colon wall, and if the colon wall develops a hole, then an abscess will form,” warns Will Bulsiewicz, MD, a gastroenterologist and gut health expert in Mount Pleasant, South Carolina.
Diverticular disease of the colon has a high global prevalence. The guidelines suggest performing a colonoscopy 4-6 weeks after the acute episode to exclude colorectal cancer (CRC).
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.
Surgery usually isn't necessary in people who have acute diverticulitis. But there are exceptions: If abscesses (collections of pus) have formed, and treatment with antibiotics isn't successful, surgery is unavoidable.
In most cases of surgery for diverticulitis, a colostomy is not required.
Your NYU Langone gastroenterologist may recommend surgery if symptoms of diverticulitis haven't improved after nonsurgical treatment; if a perforation or fistula, a connection that forms between the intestines and another organ, develops in the colon wall; or if a diverticular pouch ruptures.
Diverticulosis: You can have it for years and never know — if you take care of yourself. About one or two percent of patients under 30 experience diverticulosis while people age 60 and older have some degree of the condition.
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.
Several factors may increase your risk of developing diverticulitis: Aging. The incidence of diverticulitis increases with age.
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.
Abdominal and Pelvic CT: A CT scan is the best test to diagnose diverticulitis. It can also help determine the severity of the condition and guide treatment. You may receive an intravenous (IV) injection of contrast material. You may also drink an oral contrast material one hour before your scan.
It is possible that diverticulitis may initiate inflammatory changes which resemble Crohn's disease histologically, but do not carry the clinical implications of chronic inflammatory bowel disease.
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.
Most people with diverticulitis recover completely. But, at its most severe, a pouch can burst open, spilling fecal matter directly into a person's bloodstream. This results in an immediate risk of developing a blood infection called sepsis, which can be life-threatening.