The distinct diverticulitis symptoms are pain at the left lower quadrant of the abdomen, fever and leukocytosis.
Before getting further with diverticulitis symptoms, significant terms need to be defined for better understanding of the nature of diverticulitis which includes the following:
Diverticulitis is derived from two words: diverticulum and medical suffix -itis which means an inflammatio. This signifies that diverticulitis is an inflammation in the large intestine due to infection that occurs when one or more diverticulum ruptures.
Diverticulum refers to the pouch-like or pocket-like structures that develop and protrudes outward in the walls of the large intestine due to constant exposure to increased intestinal pressure during elimination of feces. This can exist throughout the large intestine but it is more common at the sigmoid colon. This commonly affects individuals above 60 years old.
Sigmoid colon is located at the end portion of the large intestine, nearest to the rectum and anus.
Diverticulosis is a disease that refers to the presence of diverticula (plural term referring to diverticulum) throughout or in some portions of the large intestine.
What causes diverticulitis?
As mentioned earlier, the origin of diverticulitis is the presence of diverticula in the large intestine. When one or more diverticulum ruptures, the ruptured portion of the colon becomes infected called diverticulitis. The primary cause of diverticulum rupture is the increase in intraluminal colonic pressures.
Another factor considered to cause diverticulitis is decrease in intake of fiber in the diet. Dietary fiber promotes effective bowel movement. It softens the stool and forms a bulk for more ease in eliminating wastes such as feces. Therefore, if there is lesser fiber intake, there would be increased pressure within the intestine due to an attempt to pass out a hardened stool.
Furthermore, there was a misconception about nuts in the diet as possible cause of diverticulitis. Some scientific research conducted suggests that nuts aid in preventing the development of diverticulitis instead.
What are diverticulitis symptoms?
Diverticulitis symptoms would usually include abdominal pain, fever and leukocytosis.
The abdominal pain usually occurs at the lower left quadrant of the abdomen, where the sigmoid colon is located. Besides, the sigmoid colon is the most common portion of the large intestine affected by diverticulitis.
The fever is a typical symptom indicating presence of inflammation and infection in the colon.
Leukocytosis is an increase in the white blood cells count. Similarly, this is a common indication for the presence of inflammation and infection. The normal white blood cell (WBC) or leukocyte count is 5 to 109 x 109 per Liter. Above this range is considered leukocytosis.
Other diverticulitis symptoms that are manifested by persons having diverticulitis are diarrhea or constipation. The diarrhea can be brought about by the hyperactivity of the bowel due to the presence of inflammation or infection. On the other hand, constipation may result from the inability of the large bowel to efficiently eliminate wastes due to the presence of the said infection or inflammation as well. The hardened feces might clog up at the end portion of the colon.
Furthermore, the ruptured diverticulum may also lead to bleeding episodes when the blood vessels nearby the affected site are eroded. This will be evident in the color of the stool of the affected person. A person having diverticulitis with active bleeding may have bloody stool.
How is diverticulitis diagnosed?
There are several diagnostic exams that can be done to diagnose diverticulitis. These tests may include barium enema, sigmoidoscopy, colonoscopy, abdominal ultrasound and Computed Tomography scan.
Barium enema also known as barium x-ray is done by introducing a contrast called barium into the large intestine through the rectum. Once the large intestine is filled in with barium, the person will be then subjected to plain abdominal x-ray. This will display presence of diverticula as the barium follows the contour of the large intestine and pouch-like structures will be evident on the intestinal wall structure.
Other tests that might be done are sigmoidoscopy or colonoscopy. With sig oidoscopy a small elastic tube-like instrument with scope called sigmoidoscope is used to visualize the sigmoid colon. While with colonoscopy, a longer tube tube with scope is used called colonoscope.
Last but not the least is ultrasound and Computed Tomography scan. These two tests will be performed to determine whether there is pus formation on the abdomen and pelvic region.
How is diverticulitis treated?
Treatment for diverticulitis comes in two ways: medical treatment and surgical treatment.
Since there is presence of inflammation and infection, antiotics or antibacterial drugs will be administered. In fact, mild diverticulitis symptoms can be addressed with oral antibiotics. Some of the antibacterial agents that are commonly administered to patients with diverticulitis are ciprofloxacin, metronidazole, cephalexin and doxycycline.
However, when diverticulitis symptoms are accompanied by severe pain and high fever, antibiotics are administered intravenously for rapid effect. Furthermore, when the patient’s body is not responsive to the antibiotics administered or there is pus formation as well as large intestine obstruction, surgery would be the resolution.
The surgery that is usually done for diverticulitis is laparoscopic sigmoidectomy . This is the surgical removal of a portion of the colon called the sigmoid colon to get rid of the diverticula particularly when diverticulitis symptoms are becoming severe through laparoscopic approach.