How do ulcerative colitis and diverticulitis differ. What are the main symptoms of each condition. How are these digestive disorders diagnosed and treated. What causes ulcerative colitis and diverticulitis.

Understanding Ulcerative Colitis and Diverticulitis: An Overview

Ulcerative colitis and diverticulitis are two distinct digestive conditions that can cause significant discomfort and health issues. While they share some common symptoms, these disorders have unique underlying causes, affect different parts of the digestive system, and require tailored treatment approaches.

Are ulcerative colitis and diverticulitis the same condition. No, they are separate disorders with distinct characteristics. Ulcerative colitis is a chronic inflammatory bowel disease that affects the inner lining of the large intestine, causing inflammation and ulcers. Diverticulitis, on the other hand, occurs when small pouches (diverticula) that form in the colon wall become infected or inflamed.

Ulcerative Colitis: Causes, Symptoms, and Risk Factors

Ulcerative colitis is a complex condition with no single identified cause. Research suggests that a combination of genetic predisposition, immune system abnormalities, and environmental factors contribute to its development.

Potential Causes of Ulcerative Colitis

• Genetic factors
• Autoimmune reactions
• Microbiome imbalances
• Environmental triggers

Can ulcerative colitis be inherited. While not directly inherited, having a family history of ulcerative colitis does increase one’s risk of developing the condition. Genetic factors play a role in susceptibility, but they are not the sole determinant.

Common Symptoms of Ulcerative Colitis

Ulcerative colitis symptoms can vary in severity and may include:

• Persistent diarrhea
• Abdominal pain and cramping
• Rectal bleeding or blood in stool
• Urgency to defecate
• Weight loss
• Fatigue
• Fever

Is ulcerative colitis always severe. No, the severity of ulcerative colitis can range from mild to severe. Some individuals may experience long periods of remission with few or no symptoms, while others may have frequent flare-ups and more persistent symptoms.

Diverticulitis: Understanding Its Development and Manifestation

Diverticulitis occurs when small, bulging pouches (diverticula) in the digestive tract become infected or inflamed. These pouches most commonly form in the colon, particularly in the sigmoid colon.

Risk Factors for Diverticulitis

Several factors can increase the likelihood of developing diverticulitis:

• Age (more common in people over 40)
• Low-fiber diet
• Obesity
• Lack of physical activity
• Smoking
• Certain medications (e.g., NSAIDs, steroids)

Does a high-fiber diet prevent diverticulitis. While a high-fiber diet doesn’t guarantee prevention, it can significantly reduce the risk of developing diverticulitis. Fiber helps soften stool and promotes regular bowel movements, reducing pressure on the colon wall.

Recognizing Diverticulitis Symptoms

The symptoms of diverticulitis can develop suddenly and may include:

• Severe abdominal pain, typically on the lower left side
• Fever and chills
• Nausea and vomiting
• Constipation or diarrhea
• Bloating and gas
• Changes in bowel habits

Can diverticulitis resolve on its own. Mild cases of diverticulitis may improve with rest, dietary changes, and antibiotics. However, severe cases or recurrent episodes often require medical intervention and, in some instances, surgery.

Diagnostic Approaches: Differentiating Ulcerative Colitis and Diverticulitis

Accurate diagnosis is crucial for effective treatment of both ulcerative colitis and diverticulitis. While some symptoms may overlap, healthcare professionals use a combination of clinical evaluation, laboratory tests, and imaging studies to distinguish between these conditions.

Diagnostic Tools for Ulcerative Colitis

• Colonoscopy with biopsy
• Flexible sigmoidoscopy
• Stool tests
• Blood tests
• CT scan or MRI (in some cases)

Is a colonoscopy always necessary to diagnose ulcerative colitis. While a colonoscopy is the gold standard for diagnosing ulcerative colitis, other tests may be used in conjunction or as alternatives in certain situations. However, a colonoscopy with biopsy provides the most definitive diagnosis and allows for assessment of disease extent and severity.

Diagnostic Procedures for Diverticulitis

• CT scan
• Abdominal ultrasound
• Blood tests
• Stool tests
• Colonoscopy (usually performed after acute symptoms subside)

Why is a CT scan preferred for diagnosing diverticulitis. A CT scan is often the preferred imaging method for diagnosing diverticulitis because it can clearly show inflamed or infected diverticula, as well as any complications such as abscesses or perforations. It’s a quick and non-invasive way to assess the severity of the condition and guide treatment decisions.

Treatment Strategies: Managing Ulcerative Colitis and Diverticulitis

The treatment approaches for ulcerative colitis and diverticulitis differ significantly due to the distinct nature of these conditions. While both aim to alleviate symptoms and prevent complications, the specific medications and interventions vary.

Ulcerative Colitis Treatment Options

Treatment for ulcerative colitis typically involves a long-term management plan, which may include:

• Anti-inflammatory medications (e.g., 5-aminosalicylates, corticosteroids)
• Immunosuppressants
• Biologic therapies
• Janus kinase (JAK) inhibitors
• Dietary modifications
• Stress management techniques
• Surgery (in severe cases)

Can ulcerative colitis be cured completely. Currently, there is no complete cure for ulcerative colitis. However, with proper treatment and management, many patients achieve long-term remission and lead normal, active lives. In some severe cases where medical management is ineffective, surgical removal of the colon (colectomy) can eliminate the disease, but this is considered a last resort.

Diverticulitis Treatment Approaches

The treatment for diverticulitis depends on the severity of the condition:

• Mild cases:
  • Oral antibiotics
  • Temporary liquid diet
  • Pain relievers
• Severe cases:
  • Hospitalization
  • Intravenous antibiotics
  • Bowel rest (no food by mouth)
  • Drainage of abscesses
  • Surgery (for complications or recurrent episodes)

How long does it take to recover from diverticulitis. Recovery time varies depending on the severity of the condition. Mild cases may improve within a few days to a week with proper treatment. More severe cases requiring hospitalization may take several weeks for full recovery. After the acute phase, patients are typically advised to follow a high-fiber diet and make lifestyle changes to prevent recurrence.

Living with Ulcerative Colitis and Diverticulitis: Lifestyle Modifications and Long-term Management

Both ulcerative colitis and diverticulitis require ongoing management and lifestyle adjustments to minimize symptoms and prevent complications. While the specific recommendations may differ, there are some common strategies that can benefit individuals with either condition.

Dietary Considerations

For ulcerative colitis:

• Identify and avoid trigger foods
• Eat smaller, more frequent meals
• Stay hydrated
• Consider probiotic supplements
• Limit dairy if lactose intolerant

For diverticulitis:

• Gradually increase fiber intake (after acute episodes)
• Stay well-hydrated
• Avoid seeds and nuts during flare-ups
• Incorporate probiotic-rich foods

Should individuals with diverticulitis always avoid seeds and nuts. The long-held belief that seeds and nuts should be universally avoided in diverticular disease has been challenged by recent research. Current guidelines suggest that these foods do not need to be routinely avoided unless they specifically trigger symptoms in an individual. However, during acute flare-ups, a low-fiber diet is often recommended.

Stress Management and Mental Health

Both conditions can be exacerbated by stress, and living with a chronic digestive disorder can take a toll on mental health. Stress management techniques that may be beneficial include:

• Regular exercise
• Meditation and mindfulness practices
• Cognitive-behavioral therapy
• Support groups
• Adequate sleep

How does stress affect digestive disorders like ulcerative colitis and diverticulitis. Stress can trigger or worsen symptoms in both conditions. In ulcerative colitis, stress may lead to flare-ups by affecting the immune system and gut function. For diverticulitis, stress can alter gut motility and potentially increase the risk of inflammation. Managing stress is an important part of overall treatment for both disorders.

Complications and When to Seek Medical Attention

Both ulcerative colitis and diverticulitis can lead to serious complications if left untreated or poorly managed. It’s crucial for individuals with these conditions to be aware of warning signs that require immediate medical attention.

Potential Complications of Ulcerative Colitis

• Severe bleeding
• Perforated colon
• Severe dehydration
• Liver disease
• Increased risk of colon cancer
• Toxic megacolon (rare but life-threatening)

Possible Complications of Diverticulitis

• Abscess formation
• Perforation of the colon
• Peritonitis
• Intestinal obstruction
• Fistula formation

When should someone with ulcerative colitis or diverticulitis seek emergency care. Immediate medical attention is necessary if experiencing:
– Severe, persistent abdominal pain
– High fever (above 101°F or 38.3°C)
– Persistent vomiting
– Inability to keep liquids down
– Signs of dehydration (extreme thirst, dry mouth, dark urine, dizziness)
– Severe rectal bleeding or large amounts of blood in stool
– Sudden, severe changes in bowel habits

Research and Future Directions in Digestive Health

The field of gastroenterology is continually evolving, with ongoing research aimed at improving our understanding and treatment of conditions like ulcerative colitis and diverticulitis. Recent advancements and future directions include:

Emerging Therapies for Ulcerative Colitis

• Novel biologic therapies targeting specific inflammatory pathways
• Stem cell transplantation
• Microbiome-based treatments
• Personalized medicine approaches based on genetic profiling

Innovations in Diverticulitis Management

• Minimally invasive surgical techniques
• Probiotics and prebiotics for prevention
• Advanced imaging techniques for early detection
• Targeted antibiotic therapies

What role does the gut microbiome play in ulcerative colitis and diverticulitis. The gut microbiome is increasingly recognized as a crucial factor in both conditions. In ulcerative colitis, dysbiosis (imbalance in gut bacteria) may contribute to inflammation and disease progression. For diverticulitis, alterations in the microbiome may increase susceptibility to infection and inflammation. Ongoing research is exploring ways to manipulate the gut microbiome as a therapeutic approach for both disorders.

As research progresses, it’s likely that we’ll see more tailored treatment approaches for both ulcerative colitis and diverticulitis. Patients are encouraged to stay informed about new developments and discuss emerging treatment options with their healthcare providers.

Understanding the differences between ulcerative colitis and diverticulitis is crucial for proper diagnosis and management. While both conditions affect the digestive system and share some symptoms, they are distinct disorders with unique causes, progression, and treatment approaches. By working closely with healthcare providers and staying informed about their condition, individuals with ulcerative colitis or diverticulitis can effectively manage their symptoms and improve their quality of life.

Ulcerative Colitis vs. Diverticulitis: How They Differ

Ulcerative colitis and diverticulitis are both conditions that affect your digestive system. Although they have some common symptoms, they are entirely different conditions, with unique causes and treatment plans.

Both ulcerative colitis and diverticulitis are digestive conditions that can cause uncomfortable symptoms like stomach pain, diarrhea, and blood in your stool. But there are key differences between the two.

Diverticulitis is a condition characterized by the development of small, bulging sacs in the colon (large intestine). On the other hand, ulcerative colitis is a chronic condition where the inner lining of the colon becomes inflamed and causes ulcers to develop.

Diverticulitis and ulcerative colitis require different treatment plans, which is why it’s important that you visit your healthcare professional if you have symptoms of either condition.

Let’s take a look at the differences and similarities between ulcerative colitis and diverticulitis, as well as how to get a diagnosis and treatment.

While both conditions affect your digestive system and have several overlapping symptoms, ulcerative colitis and diverticulitis are two distinct conditions with unique causes and symptoms. Here’s what to know about each condition.

Ulcerative colitis: Causes and symptoms

Ulcerative colitis is a type of inflammatory bowel disease (IBD). People with ulcerative colitis develop inflammation and ulcers in their large intestine. It’s considered chronic, meaning that people who have the condition have it for life. Still, with the right treatment, many people are able to effectively manage their symptoms.

It’s not known exactly what causes ulcerative colitis. Medical experts believe the following factors may play a role:

• Your genes: If your parents or grandparents had ulcerative colitis, you may have inherited certain genes that make you more prone to developing it too.
• Unusual immune reactions: It’s thought that ulcerative colitis may be triggered by abnormal reactions in the immune system.
• Microbiome differences: Certain bacteria, viruses, and fungi in your digestive tract (known as your microbiome) may play a role in triggering ulcerative colitis.
• Environmental factors: Experts believe that your surroundings may play a role in causing ulcerative colitis, especially if you have other risk factors.

Ulcerative colitis symptoms can vary a lot from person to person. Some of the most common symptoms include:

• diarrhea
• stomach pain
• blood in stool
• decreased appetite
• weight loss
• fatigue
• malnutrition, such as anemia
• decreased growth (in children)

Diverticulitis: Causes and symptoms

Diverticulitis is a condition where small pouches or sacs develop in the lining of your colon (large intestine). These pouches in the wall of your colon can become infected or inflamed, causing a diverticulitis flare-up.

Although there’s no single cause of diverticulitis, it does become more common as you age. There are several other factors that can increase your risk of developing diverticulitis, such as:

• a family history of diverticulitis
• a diet that’s low in fiber
• a diet that’s high in red meat
• having obesity
• a sedentary lifestyle
• smoking
• decreased immune function
• certain medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs) and steroids.

Symptoms of diverticulitis are mainly digestive in nature, and may be moderate to more severe. Typical symptoms of diverticulitis include:

• stomach pain, usually on the left side
• abdominal bloating
• constipation
• diarrhea
• vomiting
• nausea
• fever
• chills

Because both ulcerative colitis and diverticulitis have digestive symptoms — and many symptoms that overlap — it’s not possible to tell which condition you have from symptoms alone. That’s why it’s vital to talk with your doctor if you have symptoms of either condition.

The type of physician that diagnoses these conditions is called a gastroenterologist. Many people visit their primary care provider (PCP) first with digestive symptoms, and then get a referral to a gastroenterologist if their PCP thinks a full workup and diagnosis is necessary.

Many of the tests used to help diagnose ulcerative colitis and diverticulitis are the same. Testing may include:

• blood tests to look for nutritional deficiencies and signs of infections
• stool tests
• a colonoscopy, to visualize the lining of the rectum and colon

If your doctor thinks you may have diverticulitis, you may also have imaging tests, such as an MRI, CT scan, or an ultrasound.

If ulcerative colitis is suspected, your doctor may also order a flexible sigmoidoscopy, which is used to view and analyze the lining of the rectum and lower colon. An ulcerative colitis diagnosis often also involves a biopsy of the large intestine.

Ulcerative colitis and diverticulitis have different treatment plans and treatment durations. Again, this is why it’s imperative to get a proper diagnosis so that your treatment plan is geared toward the correct condition.

Treatment for diverticulitis

Typically, treatment for diverticulitis has involved antibiotics to treat infections, along with dietary changes like increased fiber or fiber supplements. However, more recently, experts recommend preserving antibiotics for the most complicated cases of diverticulitis.

Sometimes medications are prescribed to decrease inflammation, and pain relievers are often used to reduce pain and discomfort as the infection clears.

Treatment for ulcerative colitis

Treatment for ulcerative colitis involves a combination of medication and dietary changes, and less commonly, surgery.

Most medications prescribed for ulcerative colitis aim to reduce inflammation in the colon. The type of medicine that’s prescribed will depend on the severity of the disease. Common medications include:

• Aminosalicylates: Recommended for people with mild to moderate ulcerative colitis, this type of medication (also known as 5-ASA drugs), helps ease symptoms by decreasing inflammation in the colon.
• Corticosteroids: Used for mild to moderate ulcerative colitis, corticosteroids help decrease your body’s overall immune system response, which reduces inflammation. This medication is usually prescribed for people who don’t get symptom relief from aminosalicylates.
• Immunosuppressants: Prescribed for people with moderate to severe ulcerative colitis, immunosuppressants decrease your body’s response to its own immune system.
• Biologics: Developed in a lab from a living organism, these drugs prevent specific proteins in your body from causing inflammation. Biologic drugs are usually used to treat moderate to severe ulcerative colitis.

Surgery is usually only recommended when patients don’t respond to other medical treatments.

Both ulcerative colitis and diverticulitis can be serious, especially if untreated. While most people recover after an acute episode of diverticulitis, ulcerative colitis requires lifelong treatment.

If left untreated, ulcerative colitis can be severe. Complications may lead to:

• a perforated colon (hole in the wall of the large intestine)
• fulminant colitis (swelling and distention of the colon)
• toxic megacolon (abnormal and severe dilation of the colon)
• severe dehydration

Treatment of ulcerative colitis is usually effective and long periods of remission are possible. However, having ulcerative colitis may increase your risk of colorectal cancer, especially if the condition is more severe, starts at a younger age, or involves a larger portion of your intestine.

Complications of diverticulitis can include:

• an abscess in the intestine
• phlegmon (a reaction where the body tries to contain an infection)
• a fistula (an unnatural connection between one structure and another, for instance an opening between the bladder and colon)
• a perforated colon
• bowel obstruction (a blockage in the colon)
• secondary bouts of diverticulitis

Although treatment of diverticulitis is usually effective, about 20% to 50% of people will have recurrent symptoms. Diverticulitis is rarely fatal, though some studies have found that the condition slightly increases your chance of colorectal cancer.

Yes, it’s possible to have both ulcerative colitis and diverticulitis at the same time. While there’s not a lot of research about this phenomenon, it’s considered a rare occurrence.

If you have any symptoms of diverticulitis or ulcerative colitis, it’s important to get a proper diagnosis to determine if you have one or the other condition, or both at the same time.

Ulcerative colitis and diverticulitis are both conditions that affect your digestive system. They have some symptoms in common, such as abdominal pain, diarrhea, and blood in the stool. However, they are entirely different conditions, with different diagnoses and treatment plans.

If you have symptoms of either condition, it’s important to see your doctor to determine whether you have either of these conditions. Without the right treatment, both ulcerative colitis and diverticulitis can get worse and lead to potentially serious complications.

Ulcerative Colitis vs. Diverticulitis: What’s the Difference?

Written by Shishira Sreenivas

• Ulcerative Colitis and Diverticulitis: Similarities and Differences
• How Are Symptoms the Same and Different?
• How Are Causes and Risk Factors the Same and Different?
• How Is Diagnosis the Same and Different?
• How Is Treatment the Same and Different?
• Ulcerative Colitis and Diverticulitis: What’s the Outlook?
• More

If you’ve had stomach pain for a while and see blood when you poop, you might have ulcerative colitis (UC) or diverticulitis. The two conditions are different, but some of their symptoms can be the same because they’re both conditions in the large intestine or colon.

UC is a type of inflammatory bowel disease (IBD) that irritates the lining in your large intestine (also known as the colon). This causes tiny open sores, called ulcers, that produce pus and mucous.

Diverticulitis is a condition that you have when one or more tiny, bulging pouches (called diverticula) form over weak spots in the colon wall, and then tear and become infected or inflamed. Diverticula are usually pea-sized and can form anywhere throughout the colon. But they’re commonly found in the lower-left side of your large intestine called the sigmoid colon.

UC and diverticulitis both start out in the large intestine and share symptoms like belly pain and bloody poop. Both conditions are more likely the older you get, and both can range from mild to severe and vary for each person. But they differ in terms of what causes them and how your doctor might treat them.

UC is a lifelong condition that can lead to life-threatening problems. About a million Americans are affected by it. It can affect people at any age, including those in their 20s and 30s. If you have UC, you also might have weight loss or arthritis.

Diverticulitis, not a lifelong condition, is a complication of “diverticulosis.” It’s the term doctors use when one or more of the small bulging sacs grow on your colon wall. It usually starts in middle age and it’s common in older people. Diverticulitis can happen to you once and never happen again, or it might come and go. About 50% of those over the age of 60 have it, and almost everyone above 80 has it, too. Most are mild cases that don’t cause any symptoms and aren’t reasons to worry. Up to 30% of the people with diverticulosis go on to have diverticulitis. And among them, anywhere between 5%-15% will have symptoms like bloody poop.

UC and diverticulitis have some of the same symptoms, but they also have some that are different.

Shared ones include:

• Belly pain
• Cramping
• Diarrhea
• Bleeding
• Fever

If you have one or more of these symptoms, talk to your doctor. UC symptoms also include:

• Urgency to poop
• Trouble pooping despite the urgency
• Weight loss
• Fatigue
• Lack of growth in children

Diverticulitis symptoms also include:

• Nausea
• Vomiting
• Swelling or bloating
• Constipation

It’s important to note that if you have diverticulitis, you’re more likely to have constipation than diarrhea.

Doctors aren’t sure what causes you to get UC or diverticulitis, but the two conditions have some common risk factors:

• Age. Your odds for either condition go up as you get older.
• Race. White people are more likely than those of any other race to have UC or diverticulitis.

UC might be caused by an abnormal immune response in your body. This means that if your immune system is fighting off a virus or bacteria, it may mistakenly attack cells in your digestive tract, too.

Genes might also play a role. If a close relative like your parent or sibling has UC, you’re more likely to have it, too. If you’re of Ashkenazi Jewish descent (ancestors came from Eastern or Central Europe), your risk is even higher. Diet and stress don’t cause UC, but they may trigger your symptoms and cause flare-ups.

As for what causes diverticulitis, experts believe bacteria found in your poop might get pushed into the bulging sacs as it passes through the colon. This causes the sacs to become infected or inflamed. Another theory is that your poop, especially if you’re constipated, might put a lot of pressure against the colon walls as it passes through. This can cause tears in the sacs and increase your chances of an infection.

Other risk factors for diverticulitis include:

• Obesity
• Smoking
• Lack of exercise
• Diet low in fiber and high in animal fat
• Certain medications (like steroids, opioids, and nonsteroidal anti-inflammatory drugs like ibuprofen)

If you think you have either UC or diverticulitis, talk to your doctor about it. You might be referred to a gastroenterologist, a doctor who specializes in digestive issues, for a correct diagnosis.

Your doctor will first do a detailed medical exam. They’ll ask you about your medical history including things like your diet, your bowel movements, and medications you might be taking.

Common tests to diagnose UC and diverticulitis include:

• Blood tests. This is done to check for infections
• Stool sample test. This checks for bacteria or parasites that might cause your stomach pain, cramps, or diarrhea
• Colonoscopy. The doctor will use a thin, flexible tube with a camera on the tip to explore your entire colon. They may take small tissue samples to test.
• Flexible sigmoidoscopy. This is similar to a colonoscopy, except your doctor will only explore your rectum and s-shaped sigmoid colon – both of which are located at the lower end of your colon. This is usually done if you have severe inflammation.
• Barium enema. This test is also called lower gastrointestinal tract radiography. In this test, your doctor injects a liquid containing barium into your butt. The barium coats your entire colon and makes it easier to see clearly under an X-ray scan.
• CT scan. This test allows your doctor to scan your abdomen and pelvic area and spot inflamed areas in your colon. The scan can detect the irritated or inflamed pouches for diverticulitis and confirm the condition.

In both conditions, treatments usually involve medications or, sometimes, surgery. In severe cases, your doctor may recommend a combination of the two to bring your symptoms under control. Certain over-the-counter medications may ease some of your pain-related symptoms. These include:

• Anti-diarrheal medications
• Pain relievers
• Antispasmodics to ease cramps and bloating
• Iron supplements, especially if you’re bleeding

UC treatments may include:

Anti-inflammatory drugs. This is usually the first line of treatment. This can include drugs like 5-aminosalicylates and corticosteroids. Some newer drugs like sulfasalazine and 5-ASAs (like mesalamine), which are called “steroid-sparing,” can be safely taken long-term. Your doctor may not want you to take steroids long-term because of their side effects.

Immunosuppressant drugs. This helps to reduce inflammation in your colon and cut down the immune response that might attack your digestive cells.

Biologics. This targets the proteins made by your immune system.

Surgery. About 30% of people who have UC need surgery. It’s sometimes the only cure, especially if medications don’t ease your symptoms or they become too difficult to manage. Your doctor may consider a surgery called proctocolectomy.

In this procedure, your entire colon and rectum are removed. Most surgeries also involve a procedure in which your doctor will attach a pouch at the end of the small intestine or outside your body to pass poop directly into it.

Diverticulitis treatments may include:

Antibiotics. If your case is mild, your doctor may prescribe oral antibiotics to bring the symptoms under control. If you have multiple bouts of diverticulitis episodes, you’ll need to go to the hospital for intravenous (IV) antibiotics and fluids. At this point, your doctor may consider surgery as an option, too.

Surgery. Your doctor may recommend you have surgery for diverticulitis because of issues in your colon such as:

• Abscess (a type of walled-off infection)
• Obstruction
• Tears that cause pus or poop to leak into your stomach cavity
• Tunnel-like opening in the colon that connects with other organs (fistula)
• Continuous bleeding (if your diverticulitis is recurring)

In some cases, you may need a colostomy bag after surgery. It’s a pouch that’s attached outside of your body to pass poop into if your colon needs time to heal. Once your colon is healthy, your doctor might remove the colostomy bag.

UC is a lifelong condition, and your symptoms may come and go. About 30% of people with UC have severe symptoms, and flare-ups might happen more frequently. While medications often help, surgery may also be needed.

In contrast, most cases of diverticulitis, even though it’s also considered a lifelong condition, clear up with a 7- to 10-day course of antibiotics and plenty of rest. If you have severe symptoms, talk to your doctor about other treatment options.

Managing your diet and stress and making time for regular physical exercise are key to lowering your risks for both conditions. However, because some of the symptoms are specific, there are steps you can take to avoid your condition flaring up or getting worse.

To prevent diverticulitis, you should:

• Eat more fiber. This helps your poop move better in your digestive tract and reduces any pressure on the colon walls
• Drink lots of water, this prevents constipation.

If you’re not sure what to eat, talk to your doctor.

To lower your odds for UC or manage flare-ups, you should:

• Get plenty of sleep. This can ease emotional stress and keep your immune system in check.
• Avoid using too many nonsteroidal anti-inflammatory drugs (NSAIDs). For pain relief and fever, switch to alternatives like acetaminophen (Tylenol).
• Be careful when you take antibiotics. These drugs can trigger UC flare-ups. Let your doctor know if it does.

Top Picks

symptoms, diagnosis, treatment of diverticulitis – Department of the State Hospital NCC No. 2 (CCH RAS)

Diverticula are areas of the intestine in which protrusion of tissues is observed. When inflammation of these areas occurs, intestinal diverticulitis begins. Inflammation is provoked by fecal masses that enter the diverticula and accumulate in them, irritating the walls and leading to the development of infection. Long-term malnutrition is considered the main cause of the onset of the disease. Adult patients usually suffer from diverticulitis – it develops in women and men over 60 years of age.

Causes of disease

The main factor that provokes the disease is malnutrition. This refers to the use of a large number of semi-finished products, low-quality food rich in fat and refined foods. Also, malnutrition includes reduced fiber intake. It is fiber in food that helps the proper movement of the masses through the intestines.

Localization of diverticulitis

The disease can affect different parts of the intestine:

• Diverticulitis of the small intestine – multiple protrusions of the mucosa through weak spots in the walls. In this zone, diverticula appear much less frequently than in the colon. The cause is believed to be a failure of peristalsis.
• Diverticulitis of the large intestine – masses up to two centimeters, often affecting elderly patients. The reason is malnutrition, the predominance of animal food over plant food.
• Diverticulitis of the sigmoid colon – a degenerative tissue disorder that appears as a result of a violation of peristalsis and vascular pathologies.

Symptoms of diverticulitis

When the disease begins, its symptoms in most cases are absent. Only when the disease passes into the chronic stage, there are signs by which it can be identified. Among the warning signs that indicate the presence of problems:

• Bloating, excessive flatulence.
• Traces of blood in the stool.
• Increased body temperature.
• Pain in the lower abdomen and back.
• Nausea, vomiting.
• Decreased appetite.
• Cold sweat.

Disease diagnosis

This serious complication requires immediate diagnosis, analysis of symptoms and treatment. The initial task of the doctor is to distinguish diverticulitis from stomach ulcers and irritable bowel syndrome. It all starts with a patient interview, a medical history, and an initial examination. Diagnostic methods that are used for suspected diverticulitis:

• Colonoscopy
• Sigmoidoscopy
• Irrigoscopy
• Computed tomography of the intestine
• X-ray of the intestines
• ultrasound
• Clinical analysis of urine and blood

Treatment of disease

There is a resolution of diverticulitis without special treatment due to the normalization of nutrition and diet. With a serious stage of the disease, how to treat it is determined individually and often in a hospital. In this case, the patient is given antibiotics and other supportive drugs. The operation is performed in order to separate the affected part of the intestine. Such a measure is required quite rarely:

• If the disease is severely advanced. There are fistulas, perforations, abscesses.
• When antibiotics do not help get rid of the problem.
• There is bleeding, peritonitis.

Risk of complications

Most of the complications of diverticulitis are associated with perforation, leakage of feces through the walls of the intestine:

• Abscess – removal of the affected part or puncture is required.
• Peritonitis is the spread of infection into the abdominal cavity. The operation is necessary to cleanse the abdominal cavity and remove part of the intestine.
• Intestinal obstruction – scarring resulting in partial or complete occlusion of the lumen.
• Fistula – An abnormal connection of an organ or organ to the skin.

Which doctor to contact

With diverticulitis of the colon, an appointment with a proctologist and gastroenterologist is necessary to determine the causes of the disease. You may also need to consult a surgeon, therapist, endoscopy.

To get a consultation with a proctologist, to go through other specialists, the clinic NCC No. 2 (Central Clinical Hospital of the Russian Academy of Sciences) offers. We have only highly professional staff, modern methods of effective diagnosis and treatment of any diseases.

Intestinal diverticulosis – treatment of the sigmoid, colon and colon

Diverticular disease (diverticulosis) operating room. The reason for this situation is diverticular disease with a complicated course.

Currently remains the subject of numerous discussions, seminars, conferences, due to the fact that the problem has not been finally resolved. Many problems can be avoided if a person understands what diverticular disease is, whether he belongs to the risk group for diverticulosis, how to prevent the development of the disease and its complications.

Epidemiology

Applicable to Russia and the former USSR, a rapid increase in the incidence of diverticular disease can be noted. In 1970, the incidence of the disease did not exceed 2-3 per 100,000 people. In 1979 this number increased almost 6 times. According to the data published by the GNCC in 2002, the number of diverticulosis detected during X-ray examination was 14.2% of all coloproctological patients, and already in 2012 this figure doubled and amounted to 28.8%.

The growth of this disease is clearly seen along with the process of industrialization and urbanization due to changes in the way of life, lifestyle and nutrition of people. A decrease in the amount of dietary fiber consumed, a large amount of carbohydrate food with the use of red meat led to a significant jump in cases of diverticulosis.

In contrast, in developing agricultural countries, diverticular disease is characterized by isolated cases, which is determined by the nature of the diet, which includes a significant amount of plant foods. Aging society is another reason for the increase in the incidence of diverticular disease. It is noted that at the age of 40 years the risk of developing diverticulosis varies within 5-10%. Whereas at the age of 60, the percentage of detected cases of the disease is already 30%, and by the age of 80 it exceeds 66%.

Thus, diverticular disease was, is and remains a serious problem that poses challenges for doctors and patients. To understand the term diverticular disease, a brief description of the anatomy of the colon is necessary.

Anatomy of the colon

The colon consists of the following sections: cecum, ascending colon, transverse colon, descending colon, sigmoid colon. The cecum has the widest lumen, the sigmoid colon has the smallest. The junction of the sigmoid colon with the rectus is referred to as the rectosigmoid junction. It is important to note that this section of the intestine has the narrowest diameter.

The wall of the colon consists of three layers: serous, muscular and mucous. The function of the mucous membrane of the colon is the absorption of water, the formation of fecal masses, preparing them for evacuation by secreting a large amount of mucus and the synthesis of vitamins B and K. Under the epithelium of the colon mucosa there is a submucosa, represented by a loose fibrous connective tissue in which blood and lymphatic vessels and submucosal nerve plexus.

The muscular coat has a skeletal function and is responsible for the progressive movement of stool to the rectum. The muscular coat consists of a continuous inner circular layer, divided into three ribbons of the outer longitudinal layer.

The serous membrane consists of a connective tissue base covered with mesothelium, into which outgrowths of adipose tissue, the so-called fatty pendants, penetrate from the side of the muscular membrane

What is a diverticulum of the intestine intestinal wall. There are true diverticula, which have all the layers of the intestinal wall in the structure, and false ones, in which there is no muscle layer.

In the diverticulum, the mouth, neck, body and bottom of the diverticulum are distinguished. The blood supply of the diverticulum is carried out from the vessels of the submucosal layer, from which thin vascular branches depart, perforating the intestinal wall and heading to the bottom of the diverticulum.

When a diverticulum is formed in the projection of the fat suspension and the mesentery of the colon, it is covered on the outside with adipose tissue, when a diverticulum is formed in the free edge of the intestinal wall, it is covered on the outside only with a serous membrane.

• The number distinguishes between a single diverticulum and multiple diverticula of the colon.
• According to the localization of diverticula, right-sided, left-sided and total lesions of the colon are distinguished.
• Diverticulosis of right-sided localization, as a rule, has a congenital character with a predominance of true diverticula.
• With left-sided localization, diverticulosis in most cases is acquired and there is no muscle layer in the structure of diverticula.

Causes of diverticulosis

Causes of diverticular disease is still the subject of numerous discussions. There are several theories for the occurrence of diverticula. The most likely and most often discussed causes include: increased intraluminal pressure in the intestine, increasing weakness of the intestinal wall, impaired motility of the colon, and congenital predisposition.

Increased intraluminal pressure in the colon:

Currently, the most recognized factor in the occurrence of diverticulosis is food. A decrease in the diet of plant fibers in the proper amount reduces the volume of feces, which in turn leads to a violation of their evacuation with an increase in intraluminal pressure in the intestine. The evidence is based on observations of vegetarians and residents of agrarian countries who consume a significant amount of fiber, in which the risk of diverticula is 42% lower than in a group of people who do not consume vegetable fibers in sufficient quantities.

Increasing weakness of the intestinal wall:

The fact of the appearance of diverticula in old age confirms the theory of weakness of the intestinal wall, which is a consequence of the aging process of the body, when degenerative changes in muscle tissue and collagen fibers develop in the intestinal wall.

Impaired colonic motility:

Impaired intestinal motility leads to constipation and increased pressure in the intestinal lumen when it is necessary to evacuate feces. The loss of elasticity of the intestinal wall leads, when it is stretched, to micro-ruptures of the circular muscles, through which diverticula begin to form.

Vascular disorders in the intestinal wall:

It is impossible not to indicate the vascular component in the formation of the diverticulum. Violation of the blood supply leads to structural changes in the intestinal wall, while at the place where the vessel passes the muscle layer to the intestine, an expansion is formed, which over time transforms into the mouth of the diverticulum.

Congenital predisposition:

Various congenital systemic connective tissue diseases, collagenoses are a provoking factor in the development of diverticulum disease.

Diagnosis of diverticulosis

Irrigoscopy:

One of the most accessible diagnostic methods is irrigoscopy, which allows to reliably identify the location, size and number of diverticula. This method is not recommended for use in complicated cases due to the high risk of perforation of the inflamed diverticulum.

Colonoscopy:

A method to visualize diverticula and identify complications is colonoscopy. With this procedure, with sufficient reliability, it is possible to diagnose inflammatory changes in the region of the mouth of the diverticulum and detect bleeding from the diverticulum. ! This method cannot be recommended as a mandatory procedure if the patient has a clinical picture of an acute surgical disease of the abdominal organs.

Multislice computed tomography:

The safest method for diagnosing diverticular disease, both in the latent period and in diagnosing complications, is computed tomography, which allows not only to confirm the presence of diverticula in a patient, but also to determine the nature of complications. These include acute diverticulitis with perforation, abscess, peritonitis.

! despite the safety, this method is used to a limited extent due to the high cost of the study and inaccessibility, due to the lack of a MSCT machine in a number of hospitals.

Ultrasonography (ultrasound of the abdominal cavity):

An effective and affordable method for diagnosing complications of diverticular disease, reveals inflammatory changes in the colon wall, signs of abscess and peritonitis.

Laparoscopy:

Of the invasive methods for diagnosing complications of diverticular disease, laparoscopy should be noted, which can be considered not only as a diagnostic procedure, but also be of a therapeutic nature. With this method, it is possible to perform sanation measures for local peritonitis, drainage of the abdominal cavity.

Mechanism of development of diverticulum complications

Diverticular disease is a progressive disease. Diverticula do not undergo reverse development. The risk of developing diverticulitis with a 5-year existence of a diverticulum is approximately 10%. With a disease duration of more than 10 years, the risk increases to 25%.

Diverticulitis:

In diverticular disease, inflammatory changes develop in the wall of the diverticulum. The absence of a muscular layer leads to the fact that intestinal contents stagnate in them without the possibility of evacuation. This leads to the formation of fecalite (fecal stone) in the lumen of the diverticulum, followed by inflammation in the wall of the diverticulum.

Diverticulum perforation:

Inflammatory changes may be limited to the wall of the diverticulum with its edema and infiltration. With an aggressive microbial flora, inflammation takes on a malignant course and can lead to perforation of the diverticulum wall, which in turn can be delimited by the adjacent fatty tissue of the intestine or mesentery with the formation of an abscess. Violation of the integrity of the wall of the diverticulum can lead to serious complications in the form of peritonitis when the diverticulum is located on the free edge of the intestine.

Recurrence of diverticulitis:

When acute inflammation is relieved, the diverticulum wall does not recover. The damaged mucosa is replaced by granulation tissue, which comes into close contact with the tissues surrounding the diverticulum, creating favorable conditions for a chronic inflammatory process and subsequent relapses of acute diverticulitis.

Bleeding from the diverticulum

Damage to the inflamed mucosa of the diverticulum by fecal matter when it exits the mouth or the development of a bedsore can lead to bleeding.

Fistula formation:

Fistula formation may occur if inflammation spreads to nearby abdominal organs and/or the anterior abdominal wall. Through such fistulas, intestinal contents can spread into the lumen of the bladder, the uterine cavity, and even to the anterior abdominal wall.

Classification and treatment of complicated diverticular disease

The Hinchey E.J. classification is widely used to characterize the complicated course of diverticular disease. proposed at 1978 year. ! Only a DOCTOR can establish the nature of the complication and prescribe the appropriate treatment. Do not self-medicate, this can lead to serious consequences!

Hinchey I.

Pericolic abscess or infiltrate: an acute condition caused by inflammation of the diverticulum with the possible formation of a limited abscess (abscess) in the mesentery of the colon or in its fatty suspension. The treatment of this complication is conservative, it consists in prescribing a strict diet and antibacterial drugs

Hinchey II.

Pelvic, intra-abdominal or retroperitoneal abscess. This condition is characterized by the formation of an abscess in a limited space in the abdominal cavity or in the retroperitoneal space outside the intestinal wall. Treatment consists of hospitalization in a surgical or coloproctological hospital, bed rest, a strict diet, antibiotic therapy and detoxification treatment. If there is no effect, surgical treatment is indicated. As a rule, a sufficient volume of surgical intervention is the puncture of the abscess in order to evacuate it. However, in case of inefficiency, an emergency operation is indicated to remove the source of purulent infection. At this stage of the development of the disease, it is possible to perform a one-stage resection intervention with the restoration of intestinal continuity.

Hinchey III.

Generalized purulent peritonitis. A terrible complication that develops when an abscess breaks into the free abdominal cavity. Treatment is surgical only. With this complication, resection of the affected area of ​​the colon is performed with the formation of a stoma, sanitation and drainage of the abdominal cavity. Subsequently, a reconstructive intervention is performed aimed at restoring the natural passage through the intestines.

Hinchey IV.

Generalized fecal peritonitis. The most severe complication that develops in advanced cases, with late patients seeking medical help, in debilitated patients, senile people. The volume of the surgical operation is similar to the treatment for Hinchy III, however, the postoperative period requires long-term intensive care in the intensive care unit.

What to do if you have already undergone surgery for complicated diverticulosis with stoma removal

If you have already had emergency surgery and stoma removal, do not despair. Currently, methods for performing reconstructive interventions aimed at eliminating the stoma and restoring the natural passage through the intestine with good functional results have been developed and implemented. As a rule, these operations are recommended to be performed in specialized coloproctological hospitals.

Elective surgery for diverticulosis

Generally, surgery is not indicated after a single bout of diverticulitis, but may be recommended for people younger than 45 years of age. The decision to perform the operation is made individually. After successful conservative treatment of two or more episodes of diverticulitis, elective surgery is recommended. The indications for elective surgery are limited by the high anesthetic and surgical risks established during the examination of the patient.

Elective surgery is mandatory after conservative treatment of complicated diverticulitis. Planned surgical treatment is indicated in the presence of fistulas.

How to avoid complications and what is the diet in case of an established diagnosis of diverticulosis

As a rule, treatment is advisory in nature and is aimed at normalizing the defecation process by prescribing a diet high in dietary fiber, rationalizing the drinking regimen, and preventing constipation.