What is diverticulitis and how does it affect the digestive system. How does diverticulitis differ from other inflammatory bowel diseases. Can diverticulitis be classified as an autoimmune disorder. What are the potential links between diverticulitis and the immune system. How does the gut microbiome influence diverticulitis development. What are the current treatment approaches for diverticulitis. How can lifestyle changes help manage diverticulitis symptoms.

Understanding Diverticulitis: A Common Digestive Condition

Diverticulitis is a digestive condition that affects a significant portion of the population, particularly those over the age of 60. But what exactly is this condition, and how does it impact our health?

Diverticulitis occurs when small pouches called diverticula, which form in the wall of the colon, become inflamed or infected. These pouches, known as diverticula, are a result of a condition called diverticulosis. While diverticulosis itself is often asymptomatic, diverticulitis can cause significant discomfort and health complications.

What causes diverticulitis?

The exact cause of diverticulitis isn’t fully understood, but several factors are thought to contribute to its development:

• Low-fiber diet
• Aging
• Obesity
• Lack of exercise
• Smoking
• Certain medications (e.g., nonsteroidal anti-inflammatory drugs)

These factors can lead to increased pressure within the colon, potentially causing the formation of diverticula and subsequently, diverticulitis.

The Immune System’s Role in Diverticulitis: Exploring the Connection

While diverticulitis is primarily considered a structural problem of the colon, there’s growing interest in understanding its relationship with the immune system. This has led to questions about whether diverticulitis could be classified as an autoimmune disorder.

How does the immune system interact with diverticulitis?

The immune system plays a crucial role in the body’s response to diverticulitis. When diverticula become infected or inflamed, the immune system activates to fight off the infection and repair damaged tissue. This immune response involves the release of inflammatory mediators and the recruitment of immune cells to the affected area.

However, in some cases, this immune response may become dysregulated, leading to chronic inflammation and recurrent episodes of diverticulitis. This has led researchers to investigate whether there might be an autoimmune component to the condition.

Is Diverticulitis an Autoimmune Disorder? Examining the Evidence

To answer the question of whether diverticulitis is an autoimmune disorder, we need to consider several factors and examine the available evidence.

What defines an autoimmune disorder?

Autoimmune disorders are characterized by the immune system mistakenly attacking the body’s own tissues. In these conditions, the immune system fails to distinguish between foreign invaders and the body’s healthy cells, leading to inflammation and tissue damage.

Does diverticulitis fit the criteria for an autoimmune disorder?

While diverticulitis involves inflammation and immune system activation, it doesn’t fully meet the criteria for a classic autoimmune disorder. The primary issue in diverticulitis is the structural weakness in the colon wall that leads to the formation of diverticula. The immune response in diverticulitis is generally a reaction to bacterial infection or tissue damage, rather than a direct attack on healthy tissue.

However, some researchers have proposed that there may be autoimmune-like mechanisms involved in certain cases of diverticulitis, particularly in individuals who experience recurrent or chronic inflammation.

The Gut Microbiome and Diverticulitis: A Complex Relationship

The gut microbiome, the vast community of microorganisms living in our digestive tract, plays a crucial role in our overall health and immune function. Recent research has begun to explore the relationship between the gut microbiome and diverticulitis.

How does the gut microbiome influence diverticulitis?

The gut microbiome is believed to play a significant role in the development and progression of diverticulitis. Alterations in the balance of gut bacteria, known as dysbiosis, may contribute to inflammation and the development of diverticulitis.

• Bacterial overgrowth: An imbalance in gut bacteria can lead to overgrowth of certain species, potentially increasing the risk of infection in diverticula.
• Immune modulation: The gut microbiome helps regulate the immune system. Dysbiosis may lead to altered immune responses, potentially contributing to chronic inflammation.
• Barrier function: A healthy gut microbiome helps maintain the integrity of the intestinal barrier. Disruptions in this barrier may increase susceptibility to infection and inflammation.

Understanding the role of the gut microbiome in diverticulitis may lead to new therapeutic approaches, such as probiotics or targeted microbiome interventions.

Diverticulitis vs. Other Inflammatory Bowel Diseases: Key Differences

While diverticulitis shares some similarities with other inflammatory bowel diseases (IBDs), such as Crohn’s disease and ulcerative colitis, there are important distinctions to be made.

How does diverticulitis differ from Crohn’s disease and ulcerative colitis?

The main differences between diverticulitis and IBDs like Crohn’s disease and ulcerative colitis include:

1. Cause: Diverticulitis primarily results from structural issues in the colon, while Crohn’s disease and ulcerative colitis are thought to have a stronger autoimmune component.
2. Location: Diverticulitis typically affects the sigmoid colon, while Crohn’s disease can affect any part of the digestive tract, and ulcerative colitis is limited to the colon and rectum.
3. Nature of inflammation: In diverticulitis, inflammation is often localized to the diverticula, while in IBDs, inflammation is more diffuse and can affect larger areas of the intestine.
4. Treatment approach: While there may be some overlap in treatments, the management of diverticulitis often focuses on preventing and treating acute episodes, whereas IBD treatment aims to control chronic inflammation and prevent disease progression.

Understanding these differences is crucial for accurate diagnosis and appropriate treatment of digestive disorders.

Current Treatment Approaches for Diverticulitis: Managing Symptoms and Preventing Complications

The treatment of diverticulitis depends on the severity of the condition and whether it’s an acute episode or a chronic problem. Let’s explore the current approaches to managing this condition.

What are the primary treatment options for diverticulitis?

Treatment for diverticulitis typically involves a combination of the following approaches:

• Antibiotics: Used to treat bacterial infections associated with acute diverticulitis.
• Pain management: Over-the-counter or prescription pain relievers may be recommended to alleviate discomfort.
• Dietary modifications: A low-fiber or liquid diet may be recommended during acute episodes, followed by a gradual transition to a high-fiber diet for long-term management.
• Probiotics: Some studies suggest that probiotics may help reduce inflammation and prevent recurrence of diverticulitis.
• Surgery: In severe cases or when complications occur, surgical intervention may be necessary.

It’s important to note that treatment plans are often individualized based on the patient’s specific symptoms, medical history, and overall health status.

Are there any emerging therapies for diverticulitis?

As our understanding of diverticulitis evolves, researchers are exploring new potential therapies. Some areas of interest include:

• Targeted microbiome interventions
• Anti-inflammatory agents
• Immunomodulatory therapies
• Minimally invasive surgical techniques

While these approaches are still in various stages of research and development, they hold promise for improving the management of diverticulitis in the future.

Lifestyle Modifications for Managing Diverticulitis: Empowering Patients

While medical treatments play a crucial role in managing diverticulitis, lifestyle modifications can significantly impact the course of the disease and help prevent recurrences.

What lifestyle changes can help manage diverticulitis?

Several lifestyle modifications have been shown to be beneficial for individuals with diverticulitis:

1. High-fiber diet: Consuming a diet rich in fiber can help prevent constipation and reduce pressure in the colon.
2. Regular exercise: Physical activity can promote healthy bowel function and reduce the risk of diverticulitis.
3. Hydration: Drinking plenty of water helps soften stools and prevent constipation.
4. Stress management: Chronic stress may exacerbate digestive issues, so stress-reduction techniques like meditation or yoga may be helpful.
5. Smoking cessation: Quitting smoking can improve overall digestive health and reduce the risk of complications.
6. Weight management: Maintaining a healthy weight can reduce the risk of developing diverticulitis and its complications.

Implementing these lifestyle changes can not only help manage diverticulitis but also improve overall digestive health and well-being.

The Future of Diverticulitis Research: Promising Directions and Unanswered Questions

As our understanding of diverticulitis continues to evolve, researchers are exploring new avenues to improve diagnosis, treatment, and prevention of this common digestive condition.

What are the current research priorities in diverticulitis?

Several key areas of research are currently being pursued:

• Genetic factors: Identifying genetic markers that may predispose individuals to diverticulitis.
• Microbiome studies: Further investigating the role of the gut microbiome in the development and progression of diverticulitis.
• Immune system interactions: Exploring the complex relationship between the immune system and diverticulitis to develop targeted therapies.
• Predictive models: Developing tools to better predict who is at risk for developing diverticulitis or experiencing complications.
• Novel treatment approaches: Investigating new medications, probiotics, and minimally invasive surgical techniques.

These research directions hold promise for improving our ability to prevent, diagnose, and treat diverticulitis more effectively in the future.

What questions remain unanswered about diverticulitis?

Despite advances in our understanding of diverticulitis, several important questions remain:

1. What are the precise mechanisms that lead to the formation of diverticula?
2. Why do some individuals with diverticulosis develop diverticulitis while others do not?
3. Are there distinct subtypes of diverticulitis that require different treatment approaches?
4. How can we better predict and prevent recurrent episodes of diverticulitis?
5. What is the long-term impact of diverticulitis on overall digestive health and quality of life?

Answering these questions will be crucial for developing more effective strategies to manage diverticulitis and improve outcomes for patients.

In conclusion, while diverticulitis is not typically classified as an autoimmune disorder, its relationship with the immune system and the gut microbiome is complex and multifaceted. As research in this field progresses, we may gain new insights into the underlying mechanisms of diverticulitis and develop more targeted and effective treatments. For now, a combination of medical management, lifestyle modifications, and ongoing research offers hope for better outcomes for individuals living with this common digestive condition.

Conditions | Gastroenterology

Colorectal Conditions

Colorectal diseases refer to conditions impacting the colon or rectum, including colorectal cancer, colon polyps, colitis, and Crohn’s disease. These conditions can range from mild irritations to serious illnesses.

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Crohns Disease

Crohn’s disease is an autoimmune disease of the digestive tract. Your body’s immune system should protect your body from sicknesses. But in Crohn’s disease, your immune system attacks the digestive tract by mistake.

Learn More

Diverticulitis

Diverticulosis [dahy-ver-tik-yuh-LOH-sis] is a condition that impacts about half of people over age 60. It causes small pouches (diverticula) to bulge out through weak spots on the digestive tract — most often on the colon (large intestine). They can also form on the esophagus, stomach, and small intestine.

Learn More

Esophagitis

Eosinophilic [ee-uh-sin-uh-FIL-ik] esophagitis [ih-SOF-uh-JAHY-tis], or EE, is an allergic reaction that causes inflammation (swelling) in the esophagus. The esophagus is the tube going from your mouth to your stomach. The inflammation can make the esophagus become more narrow and stiff. This can make swallowing difficult and cause food to get caught in your esophagus.

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Gluten Intolerance

Gluten intolerance is a disorder similar to celiac disease that makes it difficult to eat gluten, a protein found in rye, wheat, and barley. The treatment for gluten intolerance is a gluten-free diet, which can make your symptoms better.

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Hepatitis

Hepatitis is a disease that irritates the liver and causes it to swell.

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Hernias

A hiatal hernia is a condition in which the top of the stomach bulges through an opening in the diaphragm called the hiatus. The diaphragm is the large muscle that helps you breathe. The diaphragm separates the stomach from the chest. A hiatal hernia moves up into the chest and can cause pain and other symptoms.

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Irritable Bowel Syndrome

Normally, a healthy colon keeps its contents moving through it with a regular rhythm. With IBS, the rhythm of your colon speeds up, causing diarrhea, or slows down, causing constipation.

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Liver Disease

The liver is the largest organ in your body. It performs many important functions, but can be damaged by many different conditions, such as hepatitis, hemochromatosis, and fatty liver disease.

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Pancreatitis

Pancreatitis is a condition in which the pancreas is irritated or inflamed (swollen).

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Peritonitis

Peritonitis [PEH-ree-TUHN-eye-TIS] is an inflamed peritoneum, the part of your body that surrounds your organs. It is usually caused by an infection. Peritonitis is treated with antibiotics and often needs surgery to help heal the injury that let the infection in.

Learn More

Rectal Prolapse

Rectal prolapse is when the lowest part of the large intestine, called the rectum [REK-tum] slips out of the anus. It can make it difficult to hold in your bowel movements.

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A hypothesis: is diverticulitis a type of inflammatory bowel disease?

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. 2006 Aug;40 Suppl 3:S121-5.

doi: 10.1097/01.mcg.0000225502.29498.ba.

Martin H Floch 
¹

Affiliations

Affiliation

• ¹ Section of Digestive Disease, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, USA.

• PMID:

  16885694

• DOI:

  10.1097/01.mcg.0000225502.29498.ba

Martin H Floch.

J Clin Gastroenterol.

2006 Aug.

. 2006 Aug;40 Suppl 3:S121-5.

doi: 10.1097/01.mcg.0000225502. 29498.ba.

Author

Martin H Floch 
¹

Affiliation

• ¹ Section of Digestive Disease, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, USA.

• PMID:

  16885694

• DOI:

  10.1097/01.mcg.0000225502.29498.ba

Abstract

It is accepted by epidemiologists that diverticula formation in the colon is related to a deficiency in dietary fiber intake, but the cause of acute diverticulitis remains unknown. A hypothesis is presented that acknowledges from the literature that fiber deficiency is also related to an altered intestinal microecology with a change in the bacterial flora. It is hypothesized that the change in the flora with a decrease in their influence on the immune process permits a low-grade chronic inflammation in the mucosa, which is the first step in developing an acute infection of diverticula or diverticulitis. There is some evidence that the low-grade chronic inflammation is present in subjects with diverticula, which is the forerunner of acute diverticulitis. This hypothesis is strengthened by early reports that anti-inflammatory mucosal agents such as mesalamine and immune process regulators such as probiotics may improve diverticulitis.

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Diverticular disease – treatment in St.

Petersburg. Diverticular disease of the colon

Diverticular disease is a chronic disease that occurs due to the formation of a sac-like protrusion (diverticulum) in the intestinal wall, and, as a result, a congestive process and the development of inflammation.

Sometimes there is a single diverticulum, but, as a rule, most often people have multiple protrusions in one of the sections of the intestine.

Diverticula are divided into “true” and “false”, as well as “congenital” and “acquired”.

• True diverticula are most often congenital – due to a direct violation of the structure of the intestine. One of the features of a true diverticulum is that the walls of the diverticulum have all the layers characteristic of the intestine. True diverticula, for example, include Meckel’s diverticulum: a protrusion of the wall of the small intestine at the confluence of an unclosed embryonic vitelline duct into it as an anomaly of development.
• False diverticula are acquired and represent a bulging of the intestinal mucosa outward through thinned places in its muscular layer.

As a rule, acquired diverticula are multiple and rarely occur in a single number.
Diverticulosis is a change in the intestinal wall with the presence of multiple diverticula in it without inflammatory processes occurring in them and not manifesting themselves clinically.
If an inflammatory process develops in the diverticulum, they speak of diverticulitis and, as a result, the development of diverticular disease.

Incidence of diverticular disease

Of all the diseases of the colon, intestinal damage by diverticula is one of the most common in the modern world. The frequency of diverticular disease reaches an average of 20% in European countries; moreover, in older age groups of the population (60–80 years), the frequency increases, reaching 40–50%, and among patients over the age of 80, the incidence reaches 60–65%. In our country, diverticula of the large intestine are found in approximately 17-28% of gastroenterological patients. The frequency of the disease in men and women is approximately the same.

Classification of diverticular disease

• Uncomplicated. This form is detected incidentally during X-ray or endoscopic examination of the intestine. In blood tests, as a rule, no changes are found. An examination must be carried out to assess the prevalence of intestinal damage, predict the course of the disease and choose a method for preventing complications or treatment.
• Complicated with acute inflammatory process (diverticulitis, diverticular infiltrate, diverticulum perforation, abscess, peritonitis), chronic inflammatory process, and bleeding. The chronic process includes situations when the inflammation cannot be eliminated within 6 weeks, or it occurs again. In severe cases, an infiltrate, narrowing of the intestine, or a fistula from a destroyed diverticulum may form.

Causes of diverticula

The occurrence of this disease does not have any specific cause. It is due to a combination of many factors. There is an opinion about the predisposition of some people to this disease due to congenital underdevelopment of the muscular layer of the intestinal wall. As a result, they develop diverticula with age or under the influence of any factors.

Congenital predisposition plays a role in people with hereditary connective tissue dysplasia syndromes (Marfan, Ehlers-Danlos syndromes, when there is a deficiency of collagen in the human body), a combination of diverticular disease of the large intestine with diseases associated with a decrease in elasticity and strength of the connective tissue (hernias) is also common. , varicose disease, visceroptosis, polycystic).
However, congenital inferiority of tissues is not the only reason for the occurrence of pathological changes in the intestinal wall.

The high incidence of diverticular disease in the elderly is associated with a gradual decrease in the tone of the colon wall as the body ages. Diverticular disease is a chronic disease that occurs due to the formation of a sac-like protrusion (diverticulum) in the intestinal wall, and, as a result of a congestive process, the development of inflammation in them. The muscular layer of the colon becomes thicker and less elastic. The supporting connective tissue loses its elasticity, and the intestinal wall becomes less extensible. Therefore, diverticula in people of the older age group appear more often than in young people.

It is also known that diverticula occur significantly more often with a decrease in plant fibers and fiber in the diet. Therefore, in vegetarians, diverticular disease is 3 times less common than in people who limit the intake of vegetables and fruits. Foods low in fiber poorly stimulate intestinal motility, slow down the movement of contents through the large intestine, which increases the absorption of water and, as a result, constipation develops. The retention of feces in the intestines, combined with a violation of the normal intestinal microflora, leads to inflammation and the progression of diverticular disease. This can also explain the more frequent occurrence of diverticula in the sigmoid colon (constipation in this case plays the role of a resolving factor).

The clinical picture in about two out of three cases is not accompanied by any complaints (asymptomatic diverticulosis), the pathology is detected by chance during endoscopic or X-ray studies. Most often, the first signs of diverticular disease are pain and functional disorders in the form of constipation or diarrhea. There are complaints of regularly recurring pain in the abdomen, more often in the left iliac region or lower sections, disappearing after defecation. Pains of varying intensity can exist for a long time – from several weeks to months. Increased pain is sometimes accompanied by fever, signs of intoxication may appear (dry mouth, nausea, tachycardia). Also, bloating and profuse gas separation, various dyspeptic disorders are often noted, which is sometimes hidden under the guise of irritable bowel syndrome.

Complications of diverticular disease of the colon

• Diverticulitis. This is an acute inflammation that occurs in diverticula in a quarter of patients with diverticulosis. Signs of the development of inflammation can be the appearance of pain and tension in the muscles of the anterior abdominal wall, fever, chills, bloating, stool disorders in the form of diarrhea or constipation.

• Diverticulum perforation. Against the background of the inflammatory process in the diverticulum, part of its wall may collapse, and the intestinal contents enter the abdominal cavity. At the same time, local or diffuse peritonitis develops. With perforation (rupture of the wall) of the diverticulum into the retroperitoneal tissue or the space between the sheets of the mesentery, infiltrates or abscesses appear.

• Bleeding. Occurs in approximately 25% of patients with diverticular disease. For many people, it may be the first and only manifestation of the disease. Usually bleeding is associated with ulceration of the wall of the diverticulum as a result of chronic inflammation. Also, in place of a fecal stone, a pressure sore may form with damage to the blood vessel. The intensity of bleeding can be different: from a slight admixture of blood in the feces (sometimes there is hidden bleeding, which is manifested by a gradual increase in anemia), to massive profuse bleeding, accompanied by collapse and even leading to death.

• Intestinal obstruction. The cause of intestinal obstruction may be an inflammatory process around the diverticulum or adhesions, leading to deformation of the intestine and disruption of the movement of stool along it. In rare cases, invagination (screwing) of a part of the intestine with a diverticulum or spasm of smooth muscles may occur.

• Intestinal fistulas. May occur when a diverticulum is perforated and an abscess ruptures into a nearby organ (the so-called “internal fistulas”). Men are more likely to develop fistulas with the bladder, women – with the vagina. With the formation of an entero-vesical fistula, air or an admixture of feces may appear in the urine.

Diagnosis of diverticular disease

• Irrigoscopy is an x-ray examination in which the colon lumen is filled with a contrast suspension and its condition is assessed during filling and after bowel emptying.
• Colonoscopy can detect the presence of multiple diverticula, signs of inflammation or intestinal bleeding, and may also be helpful in detecting associated lesions such as polyps and cancer.
• MSCT (multispiral computed tomography). Appropriate for the differential diagnosis of diverticulitis and tumor lesions of the colon.

Treatment

The main goal of treating diverticular disease is to normalize bowel function, prevent disease progression and complications, and relieve exacerbations.

Diet

Since diverticular disease is much more common in people who restrict their dietary intake of vegetables and fruits, all patients with diverticulosis should use foods high in vegetable fiber and pectin. Wheat bran is very useful (especially coarse bran), which significantly reduces the pressure inside the intestine and accelerates the speed of movement of the contents through the intestine.

Be sure to exclude all foods that cause increased gas formation (legumes, lentils, grapes, sauerkraut, butter and yeast dough, onions) and constipation (blueberries, rice). It is also advisable to exclude seeds, fruits with a large number of grains and excessively coarse fiber (persimmon, pineapple, turnip, radish, radish).

Drug treatment

• In an uncomplicated course, the disease does not require the use of drugs. The need to take medication arises depending on the clinical manifestations.
• Antispasmodics are used for abdominal pain.
• When dysbacteriosis is detected, drugs that help restore normal intestinal microflora.
• With persistent constipation, drugs are taken to enhance the motility of the stomach and intestines: lactulose preparations, vaseline or olive oil orally or in microclysters.
• In case of diverticulosis with clinical manifestations of inflammation, it is necessary to use the whole range of therapeutic measures: laxative diet, antispasmodics; drugs that regulate the motor function of the intestine, and drugs that normalize the composition of the bacterial flora of the intestine.

Surgical treatment

The need for surgical treatment for diverticular disease can arise both urgently and in a planned manner. This happens when complications occur that can threaten a person’s life (bleeding, perforation, peritonitis).
Planned surgical treatment is always aimed at eliminating the threat of such complications. The choice of the operation method in each specific case depends on the prevalence of the process, inflammatory changes in the diverticula, the condition of the intestinal wall and surrounding tissues, the presence of inflammation outside the intestinal lumen or peritonitis. It is important to take into account comorbidities often observed in the elderly. As a rule, resection (removal) of the affected part of the large intestine is performed in a planned manner with simultaneous imposition of an anastomosis.
Surgical treatment in our Clinic is performed laparoscopically, which allows patients to quickly return to active life. A planned operation is always performed during the period of remission, 2-3 months after the removal of an acute attack of the disease. Colon fistulas are an indication for planned surgical treatment, since it is not possible to achieve their self-healing, and chronic inflammation leads both to the development of rough scars that disrupt the passage of intestinal contents, and to the development of chronic intoxication and a decrease in immunity. With the formation of intestinal-vesical fistulas, there is a threat of developing an ascending urinary tract infection and kidney damage.

• Surgical removal of fistulas is a complex surgical intervention requiring the participation of highly qualified specialists. In our clinic, when planning such interventions, if necessary, related specialists (urologists, gynecologists, endoscopists) are involved. In case of intestinal bleeding, conservative treatment (hemostatic therapy) is most often prescribed or endoscopic hemostasis is performed. The operation is performed only when conservative methods of treatment are ineffective.
• Surgical treatment of diverticulum perforation. If the operation is urgent, a colostomy may be used to reduce the risk of postoperative complications. Reconstructive surgery with closure of the colostomy and restoration of intestinal continuity is performed after the inflammatory process subsides (after about 3 months).

Dispensary observation

Patients with diverticular disease should be regularly observed by a gastroenterologist or coloproctologist. Colonoscopy in the absence of complaints is performed at intervals of 1 time in 3 years.
If pain and other manifestations of the disease occur, the examination should be completed as soon as possible. With frequent periodic recurrences of diverticulitis, regular anti-relapse courses of treatment are indicated.

Forecast

The prognosis, as a rule, is favorable, if the disease is detected in a timely manner, the necessary preventive and therapeutic measures are started, provided that the patient complies with all the necessary recommendations.
However, if the need for prevention is ignored, diverticular disease can lead to the development of severe complications that threaten the life and health of the patient. Moreover, the disease is more common among older people who have a variety of concomitant diseases and lower body resistance.

Prevention

Among preventive measures, a varied and balanced diet is of primary importance. Due to the fact that a diet low in plant fibers predisposes to the formation of diverticula, in order to reduce the risk of developing the disease, it is necessary to include plant-based products in large quantities.
Since the timely detection of diverticula plays an important role, it is extremely important to undergo a preventive examination and regularly perform an endoscopic examination of the intestine.

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.
• Sigmoid diverticulitis – 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 questioning the patient, compiling a medical history, conducting 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 blockage of the lumen.