The most common symptom of diverticular disease is intermittent (stop-start) pain in your lower abdomen (stomach), usually in the lower left-hand side. The pain is often worse when you are eating, or shortly afterwards. Passing stools and breaking wind (flatulence) may help relieve the pain.
Doctors believe the main cause is a low-fiber diet. Most people with diverticulosis don't have symptoms. Sometimes it causes mild cramps, bloating or constipation. Diverticulosis is often found through tests ordered for something else.
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.
Antibiotics are generally only recommended for the treatment of uncomplicated diverticulitis if there's an increased risk of complications – for instance if someone has chronic kidney disease, a weakened immune system, high blood pressure or allergies.
Causes of diverticular disease
Old age and diet may be the most important risk factors. More than half of all adults over the age of 70 have the condition. Most of these people are unaware that they have diverticulosis. Diverticulosis is less common in people under 50.
If antibiotics are given for uncomplicated diverticulitis, consider amoxicillin/clavulanic acid or an oral cephalosporin plus metronidazole if the patient can take oral therapy. If intravenous therapy is needed cefazolin, cefuroxime, or ceftriaxone, all plus metronidazole or ampicillin/sulbactam alone can be used.
Laterally, minimally invasive surgery has been utilized in the management of this disease and recent data suggests that localized colonic perforation may be managed by laparoscopic peritoneal lavage, without resection.
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.
Diverticulosis is a clinical condition in which multiple sac-like protrusions (diverticula) develop along the gastrointestinal tract. Though diverticula may form at weak points in the walls of either the small or large intestines, the majority occur in the large intestine (most commonly the sigmoid colon).
The infection in diverticulitis results from normal colonic flora released into the peritoneal cavity through a colonic perforation. This is, therefore, a polymicrobial infection. The most common organisms cultured include anaerobes, such as Bacteroides fragilis, and gram negatives, such as Escherichia coli.
Diverticulitis usually affects the large intestine (colon). Left lower abdominal pain, tenderness, and fever are the typical symptoms.
Most people don't have symptoms from diverticulosis alone. You're likely to never notice it. If you have symptoms of illness, such as lower abdominal pain or fever, you might have an infection (diverticulitis).
Among patients with asymptomatic diverticulosis, the risk of bleeding is approximately 0.5 per 1000 person-years [4]. In a study of 1514 asymptomatic patients with diverticulosis, the cumulative incidence of bleeding was 0.2 percent at 12 months, 2.2 percent at 60 months, and 9.5 percent at 120 months [4].
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.
Research suggests that a diet low in fiber and high in red meat may increase your risk of getting diverticulitis—inflammation of one or a few pouches in the wall of your colon. Eating high-fiber foods and eating less red meat may lower the risk.
Diverticular disease includes diverticulosis and the more severe diverticulitis, two conditions affecting the colon's inner lining.
You may not need treatment if you have a mild and uncomplicated case. But it's important to see a healthcare provider about diverticulitis. If you don't, you may end up with a more severe and complicated case. Certain infections may need to be treated with antibiotics or antivirals to go away.
What tests do doctors use to diagnose diverticular disease? Doctors may order blood tests, a stool test, imaging tests, and a colonoscopy to help diagnose diverticular disease.
Antibiotics usually are needed to treat patients with diverticulitis. For those with relatively mild symptoms, usually oral antibiotics will be sufficient. Common antibiotic choices can include ciprofloxacin, metronidazole, cephalexin, and doxycycline.