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Diverticulitis is the inflammation or infection (or both) of balloon-like sacs or pouches (diverticula) that form in the wall of the colon, typically the large colon. Diverticula of the colon occur when the inner layers of the bowel protrude through the outer muscular layers.

Diverticulitis Causes and Risk Factors

Doctors are not sure of the exact causes of diverticula in the colon (diverticulosis), but they think that a low-fiber diet plays a role. Without fiber to add bulk to the stool, the colon has to work harder than normal to push the stool forward. The pressure from this may cause pouches to form in weak spots along the colon.

In addition, the following may increase the risk of developing diverticulitis:

  • Aging (more common in persons over 40)
  • Obesity
  • Smoking
  • Lack of exercise
  • High-fat, low-fiber diet
  • Certain medications, including steroids, opiates and nonsteroidal anti-inflammatory drugs, such as ibuprofen and naproxen

Symptoms of Diverticulitis

  • Lower abdominal pain and tenderness, typically on the left side
  • Fever
  • Nausea and vomiting
  • Constipation
  • Bloating

Complications of Diverticulitis

An estimated 10 to 35 percent of patients with diverticulitis will develop significant complications, including:

  • Abscess (pus in the diverticulum)
  • Bowel obstruction
  • Perforated bowel
  • Fistula (abnormal connection between the large intestine and another organ, such as the bladder or small intestine)
  • Peritonitis (bacterial contamination of the abdomen, which can occur if the infected or inflamed diverticulum ruptures, leaking intestinal contents into the abdominal cavity)

Diagnosing Diverticulitis

If diverticulitis is suspected, your doctor will perform a physical examination and take a medical history, asking questions about your symptoms. Your doctor may also order tests, including a computed tomography (CT) scan of the abdomen and pelvis, and a colonoscopy to be performed after the episode has ended.

Treatment for Diverticulitis

For a mild case of diverticulitis, your doctor may prescribe rest, a liquid diet and oral antibiotics. If your condition is more severe, you may need to be hospitalized for treatment with intravenous antibiotics and/or surgery.

Surgery for Diverticulitis

Emergency surgery is necessary for a patient whose intestine has ruptured and for those patients with peritonitis. Surgery may also be necessary for patients whose severe diverticulitis symptoms are not relieved by nonsurgical treatment (such as antibiotics) within 48 hours, or for patients with increasing pain, tenderness and fever.

During surgery for diverticulitis, the surgeon removes the affected section of the intestine. In healthy people who do not have a perforation, abscess or severe intestinal inflammation, the surgeon will immediately surgically join the ends of the intestines. If these conditions are present, however, the surgeon may need to perform a temporary colostomy, a procedure in which the surgeon creates an opening between the large intestine and the skin surface. When the inflammation is no longer present and the patient’s condition has improved (typically after about 10 to 12 weeks), the ends of the intestine are rejoined in a follow-up procedure, and the colostomy is closed.

Surgical treatment for fistula involves removing the section of large intestine where the fistula begins, rejoining the cut ends of the large intestine, and repairing the other affected area, such as the bladder or small intestine.

Getting Help

Physicians affiliated with Memorial Hermann have experience treating both mild and severe cases of diverticulitis. The general surgeons affiliated with Memorial Hermann Memorial City Medical Center specialize in abdominal surgeries.

To schedule an appointment with a physician affiliated with Memorial Hermann, click here or call 713-222-CARE (2273).