What are the main differences between ulcerative colitis and diverticulitis. How do symptoms, causes, and treatments differ for these colon conditions. When should you see a doctor for digestive issues.

Understanding Ulcerative Colitis and Diverticulitis: An Overview

Digestive disorders can significantly impact quality of life, and two conditions that often cause confusion due to some overlapping symptoms are ulcerative colitis (UC) and diverticulitis. While both affect the large intestine, they have distinct characteristics, causes, and treatment approaches. This comprehensive guide will explore the key differences between these two conditions to help you better understand their nature and implications.

Defining Ulcerative Colitis: Chronic Inflammation of the Colon

Ulcerative colitis is a chronic inflammatory bowel disease (IBD) that primarily affects the large intestine or colon. It causes inflammation and ulcers in the innermost lining of the colon, leading to a range of uncomfortable and sometimes severe symptoms.

Key Characteristics of Ulcerative Colitis:

• Chronic, lifelong condition
• Affects approximately 1 million Americans
• Can occur at any age, including young adults in their 20s and 30s
• May lead to life-threatening complications if left untreated
• Often associated with weight loss and arthritis

Diverticulitis: When Diverticula Become Inflamed

Diverticulitis is a condition that occurs when small, bulging pouches (diverticula) in the colon wall become infected or inflamed. These pouches, known as diverticula, are common in older adults and are usually harmless when not inflamed (a condition called diverticulosis).

Important Facts About Diverticulitis:

• Not a lifelong condition, but can recur
• Typically begins in middle age and becomes more common with advancing age
• About 50% of people over 60 have diverticulosis
• Up to 30% of those with diverticulosis develop diverticulitis
• 5-15% of diverticulitis cases involve symptoms like bloody stools

Comparing Symptoms: Overlaps and Distinctions

While ulcerative colitis and diverticulitis share some common symptoms, they also have distinct features that can help differentiate between the two conditions.

Shared Symptoms:

• Abdominal pain
• Cramping
• Diarrhea
• Rectal bleeding
• Fever

Unique Symptoms of Ulcerative Colitis:

• Urgent need to have a bowel movement
• Difficulty passing stool despite urgency
• Unintended weight loss
• Fatigue
• Stunted growth in children

Distinctive Symptoms of Diverticulitis:

• Nausea
• Vomiting
• Abdominal swelling or bloating
• Constipation (more common than diarrhea)

Is there a key difference in bowel habits between the two conditions? Yes, while ulcerative colitis is typically associated with diarrhea, diverticulitis more commonly presents with constipation.

Exploring Causes and Risk Factors

The exact causes of ulcerative colitis and diverticulitis remain unclear, but research has identified several risk factors and potential triggers for each condition.

Shared Risk Factors:

• Age: Risk increases with advancing years
• Race: White individuals have a higher risk for both conditions

Ulcerative Colitis: Potential Causes and Risk Factors

• Abnormal immune response
• Genetic predisposition
• Family history of UC
• Ashkenazi Jewish descent

Do diet and stress cause ulcerative colitis? While they don’t directly cause UC, diet and stress can trigger symptoms and lead to flare-ups in those who already have the condition.

Diverticulitis: Possible Causes and Risk Factors

• Bacterial infection in diverticula
• Increased pressure in the colon
• Obesity
• Smoking
• Sedentary lifestyle
• Low-fiber, high-animal fat diet
• Certain medications (steroids, opioids, NSAIDs)

Diagnostic Approaches: Identifying the Correct Condition

Accurate diagnosis is crucial for effective treatment of both ulcerative colitis and diverticulitis. While some diagnostic methods overlap, there are specific tests that help differentiate between the two conditions.

Common Diagnostic Steps for Both Conditions:

1. Detailed medical history and physical examination
2. Discussion of symptoms, diet, bowel habits, and medications
3. Blood tests to check for inflammation and anemia
4. Stool samples to rule out infections

Specific Tests for Ulcerative Colitis:

• Colonoscopy with biopsy
• Flexible sigmoidoscopy
• CT scan or MRI

Diagnostic Tools for Diverticulitis:

• CT scan of the abdomen and pelvis
• Colonoscopy (usually performed after acute symptoms subside)

Why is a colonoscopy timing different for diverticulitis? In cases of acute diverticulitis, doctors typically wait until symptoms improve before performing a colonoscopy to avoid potential complications.

Treatment Strategies: Managing Symptoms and Preventing Complications

The treatment approaches for ulcerative colitis and diverticulitis differ significantly due to the nature of each condition. While UC requires long-term management, diverticulitis treatment often focuses on resolving acute episodes.

Ulcerative Colitis Treatment Options:

• Anti-inflammatory drugs (e.g., aminosalicylates, corticosteroids)
• Immunosuppressants
• Biologics
• Targeted synthetic small molecules
• Surgery (in severe cases or if complications develop)

Diverticulitis Treatment Approaches:

• Antibiotics for mild cases
• Clear liquid diet during acute episodes
• Pain relievers
• Hospitalization for severe cases
• Surgery for recurrent or complicated diverticulitis

Can dietary changes help manage these conditions? Yes, both ulcerative colitis and diverticulitis patients may benefit from dietary modifications, but the specific recommendations differ. UC patients often need to identify and avoid trigger foods, while those with diverticulitis are typically advised to follow a high-fiber diet to prevent recurrence.

Long-term Outlook and Prognosis

Understanding the long-term implications of ulcerative colitis and diverticulitis is crucial for patients and healthcare providers alike. While both conditions can significantly impact quality of life, their progression and management differ considerably.

Ulcerative Colitis Prognosis:

• Chronic condition requiring lifelong management
• Periods of remission and flare-ups
• Increased risk of colorectal cancer
• Potential for extraintestinal manifestations (e.g., joint pain, skin issues)
• May require surgery in severe cases

Diverticulitis Outlook:

• Most cases resolve with treatment
• Risk of recurrence varies
• Complications may include abscess, perforation, or fistula formation
• Chronic symptoms are less common but possible
• Surgery may be necessary for recurrent or complicated cases

How often should patients with these conditions follow up with their healthcare providers? For ulcerative colitis, regular follow-ups are essential, typically every 3-6 months during remission and more frequently during flares. Diverticulitis patients should follow up after an acute episode and then as recommended by their doctor, often annually for routine colonoscopies after age 50.

Prevention Strategies and Lifestyle Modifications

While the causes of ulcerative colitis and diverticulitis are not fully understood, certain lifestyle modifications may help manage symptoms and reduce the risk of complications or recurrence.

Ulcerative Colitis Management Strategies:

• Stress reduction techniques (e.g., meditation, yoga)
• Regular exercise
• Avoiding trigger foods
• Quitting smoking
• Limiting alcohol consumption
• Staying hydrated

Diverticulitis Prevention Tips:

• High-fiber diet (gradually increase intake)
• Regular physical activity
• Maintaining a healthy weight
• Quitting smoking
• Limiting red meat consumption
• Staying well-hydrated

Are there any specific dietary recommendations for preventing diverticulitis flare-ups? While old advice suggested avoiding seeds and nuts, current research does not support this restriction. Instead, focus on a balanced, high-fiber diet and stay hydrated to promote regular bowel movements and reduce the risk of diverticulitis.

When to Seek Medical Attention

Recognizing when to consult a healthcare professional is crucial for both ulcerative colitis and diverticulitis. Prompt medical attention can prevent complications and ensure appropriate treatment.

Signs to Seek Help for Ulcerative Colitis:

• Persistent diarrhea with blood
• Severe abdominal pain
• Unexplained weight loss
• Fever lasting more than a day or two
• Signs of dehydration (e.g., decreased urine output, dizziness)

Warning Signs for Diverticulitis:

• Sudden, severe abdominal pain, especially in the lower left side
• Fever above 100.4°F (38°C)
• Persistent nausea and vomiting
• Noticeable changes in bowel habits
• Rectal bleeding or blood in stool

Should you go to the emergency room for severe abdominal pain? If you experience sudden, severe abdominal pain, especially if accompanied by fever, persistent vomiting, or signs of rectal bleeding, it’s advisable to seek immediate medical attention or go to the emergency room.

Living with Ulcerative Colitis or Diverticulitis: Coping Strategies

Both ulcerative colitis and diverticulitis can have a significant impact on daily life. Developing effective coping strategies is essential for maintaining quality of life and managing these conditions effectively.

Coping with Ulcerative Colitis:

• Join support groups or online communities
• Practice stress management techniques
• Keep a symptom diary to identify triggers
• Work closely with your healthcare team
• Educate family and friends about your condition
• Consider talking to a mental health professional

Managing Life with Diverticulitis:

• Adhere to dietary recommendations
• Stay physically active
• Manage stress through relaxation techniques
• Plan ahead for travel or events
• Communicate openly with your doctor about concerns
• Be prepared for potential flare-ups

How can patients balance their social life with these digestive conditions? Open communication with friends and family, planning ahead for outings, and knowing the locations of restrooms can help. It’s also important to listen to your body and not push yourself beyond your limits.

Research and Future Treatments

Ongoing research in the fields of ulcerative colitis and diverticulitis continues to advance our understanding of these conditions and pave the way for new treatment options.

Ulcerative Colitis Research Focus:

• Targeted therapies for specific inflammatory pathways
• Microbiome manipulation and fecal microbiota transplantation
• Gene therapy approaches
• Novel drug delivery systems
• Personalized medicine based on genetic profiles

Diverticulitis Research Directions:

• Understanding the role of gut bacteria in diverticulitis development
• Investigating non-antibiotic treatments for uncomplicated cases
• Exploring minimally invasive surgical techniques
• Studying the potential of probiotics in prevention
• Developing better imaging techniques for early detection

What promising new treatments are on the horizon for these conditions? For ulcerative colitis, new biologics targeting specific inflammatory pathways show promise, while for diverticulitis, research into non-antibiotic treatments and the role of the microbiome may lead to novel therapies. However, it’s important to note that new treatments must undergo rigorous clinical trials before becoming widely available.

In conclusion, while ulcerative colitis and diverticulitis share some similarities in their symptoms, they are distinct conditions with different causes, treatments, and long-term outlooks. Understanding these differences is crucial for proper diagnosis and management. If you experience persistent digestive symptoms or changes in bowel habits, it’s essential to consult with a healthcare professional for an accurate diagnosis and appropriate treatment plan. With proper care and management, many individuals with these conditions can lead fulfilling, active lives.

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.

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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.

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Diverticulum of the stomach.

What is a gastric diverticulum?

IMPORTANT
The information in this section should not be used for self-diagnosis or self-treatment. In case of pain or other exacerbation of the disease, only the attending physician should prescribe diagnostic tests. For diagnosis and proper treatment, you should contact your doctor.

A diverticulum of the stomach is a congenital or acquired protrusion of the stomach wall, which is usually localized on the posterior surface of its cardiac section. Most often it is asymptomatic, the clinic usually develops when complications appear (inflammation, ulceration, bleeding, etc.). In the diagnosis, radiography with contrast and esophagogastroduodenoscopy are informative. In the absence of complications, the treatment is conservative, with a large size of the diverticulum and its complicated course, surgery is required.

ICD-10

K31.4 Gastric diverticulum

• Causes
• Pathoanatomy
• Symptoms of gastric diverticulum
• Complications
• Diagnostics
• Treatment of gastric diverticulum
• Prognosis and prevention
• Prices for treatment

General

Diverticulum of the stomach is a rather rare disease that equally affects men and women, more often after 40 years. The incidence is 0.01-0.05% of the entire pathology of this organ. However, the improvement of diagnostic procedures in the field of modern gastroenterology suggests that in fact the prevalence of this nosology is somewhat higher – gastric diverticulum is found in 3% of all gastroscopy cases.

Since the course of this pathology in most cases is asymptomatic, diagnosis can be difficult. There are known cases of detection of gastric diverticulum at autopsy in people during whose lifetime this diagnosis was not established. Diverticula can have a variety of shapes and sizes; the prognosis of the course of the disease worsens in proportion to the size of the protrusion.

Diverticulum of the stomach

Causes

Diverticulum of the stomach can be congenital or acquired. Congenital diverticula are the result of an anomaly in the development of the organ wall. Their difference from the acquired ones is the structure of the wall: all layers (mucous, muscular, serous) are present in it. Congenital protrusions often have their own peristalsis, less often complicated.

Acquired diverticula of the stomach are associated with other pathology of the abdominal organs, surgery. The predisposition to pathology is due to the special structure of the muscular membrane of the stomach in the cardiac region, where diverticula are most often found. Longitudinal fibers gradually diverge from the cardia to the greater and lesser curvature, which creates prerequisites for the prolapse of the mucosa between them under certain conditions.

Two groups of factors lead to the formation of a gastric diverticulum. The first includes any diseases that cause spastic contraction of the walls of the stomach and an increase in pressure in the cavity of the organ: inflammatory diseases of the gastrointestinal tract (gastritis, gastroduodenitis, gastric ulcer), tumors. It is known that ordinary peristaltic contractions of the stomach cannot provoke an increase in intracavitary pressure sufficient to form a protrusion.

The second group of factors includes operations and adhesions of the abdominal cavity, as a result of which there are constant tractions of the stomach wall from the outside, stimulating the formation of a saccular formation. With a mixed genesis, a gastric diverticulum can form as a result of an increase in pressure in the organ cavity, and then the size of the protrusion progresses due to tractions of the stomach wall.

Pathology

In 75% of cases, diverticula are located in the cardia, along the back wall of the stomach, about two centimeters from the esophageal opening of the diaphragm (this localization is most characteristic of congenital diverticula). Much less often, protrusions of the stomach wall are located along the greater curvature (10%), in the pyloric region (8%). Diverticula of other localization occur in no more than 2% of cases. In addition, formations are almost never located along the anterior wall of the stomach.

The difference between congenital and acquired diverticula is their shape and size. Since the congenital diverticulum has a muscular membrane, its shape is usually correct, rounded, and its own peristalsis is observed in it. The sizes of congenital protrusions are often small, no more than 3-4 cm. Acquired diverticula are characterized by a round, oval or pear-shaped shape, they do not peristaltize. In small formations under the mucosa, a thin muscle layer can be determined; in medium-sized diverticula single muscle fibers are detected; in large diverticula of the stomach, this layer is absent.

Symptoms of gastric diverticulum

The disease is characterized by an asymptomatic course, due to which many patients do not even suspect that they have this disease. In rare cases, different variants of the clinical course are possible. The dyspeptic form is accompanied by nausea, vomiting, heartburn, belching, and periodic diarrhea. Also, the diverticulum can be manifested by the clinical picture of a stomach ulcer: acute abdominal pain, vomiting of coffee grounds, chalk, lack of appetite.

Rarely enough, the pathology is disguised as an oncological disease, vague pains, asthenia and exhaustion phenomena, and anemia are noted. The course of the disease can be characterized by periods of exacerbation, during which the patient makes the above complaints, and remission, when nothing bothers him.

Complications

Diverticulum of the stomach can be complicated by an inflammatory process – this condition is called diverticulitis. The longer the inflammation persists in the diverticulum, the more likely it is to progress with the formation of ulcers, bleeding, and perforation. In this case, the patient has a clinic of an acute abdomen. Extremely rarely observed malignancy of the protrusion.

Diagnostics

During a routine consultation with a gastroenterologist, it is almost impossible to suspect a gastric diverticulum in a patient, since this disease does not have a characteristic clinical picture. However, the specialist may prescribe additional studies that will establish the correct diagnosis. To identify the diverticulum of the stomach, two methods are of greatest importance: radiography of the stomach with contrast and esophagogastroduodenoscopy.

Radiography of the stomach is carried out in various positions: horizontal, with the head and foot ends lowered. This allows the contrast to fill the diverticulum well. At the same time, a plus-shadow is determined on the radiograph, similar to the picture of an ulcerative niche. The difference between small diverticula and gastric ulcers is the presence of a neck, a horizontal level in the protrusion.

EGDS makes it possible to identify the entrance to the diverticulum, examine its walls, assess the size and condition of its cavity. If the diverticulum is congenital, then the folds of the mucous membrane continue from the walls of the stomach through the neck to the diverticulum. Peristalsis of the stomach is not disturbed. Mucous diverticulum has a well-defined relief. The difference of the acquired diverticulum is the breakage of the mucosal folds at the entrance to its cavity, the decrease in peristalsis in this area.

Treatment of gastric diverticulum

An uncomplicated diverticulum does not require treatment. After the initial detection of this disease, control (radiological or endoscopic) is necessary after six months. If inflammation and other complications of the pathology are not detected, then follow-up control is performed annually. In the presence of an unexpressed inflammatory process, the patient is hospitalized in the department of gastroenterology for conservative treatment.

Surgical treatment is carried out when a large diverticulum is detected, ulceration and chronic bleeding, intractable diverticulitis. Increasingly, surgeons are resorting to laparoscopic excision of the gastric diverticulum (diverticulectomy) – this method is safer, provides a quick recovery after surgical treatment. During the operation, excision of the diverticulum is performed, two-layer suturing of the tissues of the stomach.

Sometimes during laparotomic diverticulectomy it can be difficult to find the protrusion itself, in this situation the help of an endoscopist is required. The endoscope is inserted into the formation cavity, which makes it easy to find it. Also, through the endoscope, a barium suspension or methylene blue solution can be introduced into the protrusion area, which will also facilitate the detection of the diverticulum.

Prognosis and prevention

Detection of a diverticulum of the stomach requires the patient to be registered with a dispensary. There is no specific prevention of the disease, however, the timely treatment of inflammatory diseases of the stomach, the introduction of sparing methods of surgical interventions to prevent the formation of adhesions will help to reduce the likelihood of the formation of an acquired protrusion of the wall. The outcome in the uncomplicated course of the disease is favorable, the presence of a diverticulum does not affect the life and performance of the patient. The development of complications worsens the prognosis of the disease.

You can share your medical history, what helped you in the treatment of gastric diverticulum.

Sources

1. self-treatment. In case of pain or other exacerbation of the disease, only the attending physician should prescribe diagnostic tests. For diagnosis and proper treatment, you should contact your doctor.

   | Private Clinic

   Diverticula are small, bulging sacs that can form in the lining of the digestive system (esophagus or intestines). They are most often found in the lower part of the large intestine. Diverticula occur predominantly in people over 40 years of age.

   The presence of diverticula in the colon is known as diverticulosis. When one or more sacs become inflamed and in some cases become infected, the condition is called diverticulitis. Diverticulitis can cause severe abdominal pain, fever, nausea, and marked changes in bowel function.

   Mild diverticulitis can be treated with rest, dietary changes, and antibiotics. Severe or recurrent diverticulitis may require surgery.

   Causes of diverticulitis

   The reasons for the appearance of diverticula in the intestine are still the subject of controversy by most scientists and physicians. Some studies show that genetic predisposition plays a role.

   The sacs in the intestine become inflamed or infected when they are torn or clogged with feces. If there are more bad microbes in the gut than good ones, this can also cause disease.

   The chances of getting diverticulitis increase with age. The disease is more common in people over 40 years of age. Other risk factors include:

   • overweight,
   • smoking,
   • insufficient physical activity,
   • eating large amounts of fat and red meat,
   • fiber deficiency,
   • certain types of medications, including steroids, opioids, and non-steroidal anti-inflammatory drugs such as ibuprofen or naproxen.

   Symptoms of diverticulitis

   Signs and symptoms of diverticulitis include:

   • Pain that may be constant and persist for several days. The pain is usually felt in the left lower abdomen. In some patients, the right side of the abdomen may be more painful.
   • Nausea and vomiting.
   • Fever.
   • Heaviness in the abdomen.
   • Constipation or, less commonly, diarrhoea.

   Diagnosis of diverticulitis

   Diverticulitis or diverticulosis of the large intestine can be diagnosed by endoscopy (colonoscopy), CT, MRI, or barium enema.

   You can undergo a comprehensive examination by a proctologist and sign up for a colonoscopy procedure in the city of Kirov at the Naedine Clinic. Our physicians and endoscopists specialize in the diagnosis and treatment of major diseases of the gastrointestinal tract. First-class equipment, strict requirements for disinfection, long-term qualification of specialists – all this guarantees a high level of medical services and a caring attitude to the health of each patient.

   Treatment of intestinal diverticulosis

   For patients with uncomplicated diverticulosis, doctors may recommend home treatment. However, severe diverticulitis, diverticulitis with complications, or a high risk of complications usually requires hospital treatment.

   Treatment for diverticulitis may include:

   • taking antibiotics, although not all people with diverticulitis need these drugs;
   • liquid diet for some time to give the colon a rest. Gradually, solid foods can be added to the diet as symptoms improve.
   • taking painkillers and antispasmodics. It should be noted that taking non-steroidal anti-inflammatory drugs (NSAIDs) may increase the chance of complications of diverticulitis.

   If diverticulitis does not improve with treatment or develops complications, the patient may need surgery to remove part of the colon, called a colectomy or colon resection.