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Diverticulitis

What is Diverticulitis?

Balloon-like sacs or pouches called diverticula can form in the wall of the large intestine (also known as the colon). Diverticula of the colon form when the inner layers of the bowel protrude through weak spots in the outer muscular layers. This condition is called diverticulosis. When the pouches become infected, it becomes a more serious problem called diverticulitis.

While some cases of diverticulitis can be relatively minor, it may also be a sign of a more serious underlying condition. At Memorial Hermann, our affiliated physicians have experience diagnosing and treating patients with complications arising from diverticulitis, including, if necessary, performing specialized abdominal surgery.

Diverticulitis Causes and Risk Factors

Medical experts are not certain of the exact causes of diverticula in the colon, but research suggests a low-fiber diet may be a factor. Without fiber to add bulk to the stool, the colon has to work harder than normal to push stool forward. The strain from this exertion may cause pouches to form in weak spots along the colon.

In addition to a high-fat, low-fiber diet, the following factors may increase your risk of developing diverticulitis:

  • Age (diverticulitis is more common in patients over 40 years old)
  • Obesity
  • Smoking
  • Lack of exercise
  • Certain medications, including steroids, opiates and nonsteroidal anti-inflammatory drugs, such as ibuprofen and naproxen
  • Family history

Symptoms of Diverticulitis

Diverticula can develop anywhere within the digestive tract, but are most commonly found within the left and sigmoid colon – the last part of the large intestine, leading into the rectum. Occasionally, diverticula do appear in the small intestine, though the presence in this area rarely leads to diverticulitis.

Diverticulosis is a relatively benign condition, so most people do not realize when diverticula have begun to form in their intestines. However, the potential for diverticula to become inflamed and infected is a true cause for concern.

The following are a few symptoms that may indicate the presence of inflammation or infection:

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

Complications of Diverticulitis

There are two types of diverticulitis: acute and chronic.

Acute diverticulitis manifests as a sudden individual attack of infection and inflammation of the diverticula that may subside after time and treatment.

Chronic diverticulitis, on the other hand, never goes away completely and results in multiple attacks.

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

  • Abscess (pus in the diverticulum)
  • Intestine blockage
  • Perforated intestine that can lead to peritonitis – a bacterial contamination of the abdomen, which can occur if the infected or inflamed diverticulum ruptures, leaking intestinal contents into the abdominal cavity
  • Fistula – an abnormal connection between the large intestine and another organ, such as the bladder, vagina or small intestine

Diagnosing Diverticulitis

Patients with new or sudden abdominal pain should seek immediate medical treatment from a professional.

Your physician will perform a physical examination, take your medical history and ask you questions about your symptoms in order to determine the location and severity of your abdominal discomfort.

If diverticulitis is suspected, additional tests may be ordered, including a computed tomography (CT) scan of your abdomen and pelvis, as well as, a colonoscopy to be performed after the initial attack has ended.

Treatment for Diverticulitis

For a mild case of diverticulitis, your physician will likely 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 an option for patients whose severe diverticulitis symptoms are not relieved by nonsurgical treatments such as antibiotics, or for patients with intense and increasing pain, tenderness and fever.

During surgery for diverticulitis, your surgeon will remove the affected section of the intestine. If you’re healthy and do not have a perforation, abscess or severe intestinal inflammation, the surgeon will likely surgically join the ends of the intestines.

With more complicated findings, however, your surgeon may need to perform a colostomy, a procedure in which an opening is created between the large intestine and the skin surface. The stool then drains into a bag adhered to the skin. When the inflammation is no longer present and your condition has improved, the ends of the intestine may be able to be rejoined in a follow-up procedure, and the colostomy can be 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, vagina or small intestine.

The colorectal and general surgeons affiliated with Memorial Hermann specialize in performing laparoscopy and other minimally invasive surgical procedures to treat diverticulitis.

Robotic-assisted and laparoscopic surgery typically are preferred approaches by both surgeons and patients, as a minimally-invasive approach can result in fewer complications, smaller scars and a shorter recovery time.

What to Do If You Have Diverticulitis

At Memorial Hermann, our affiliated colorectal and general surgeons specialize in abdominal surgeries, and have experience treating both mild and severe cases of diverticulitis. If you or a loved one begin to develop symptoms of diverticulitis, it’s important that you schedule an appointment with a specialist to conduct a proper medical exam.

Schedule an appointment today with a Memorial Hermann-affiliated physician using our online ScheduleNow portal or by filling out a contact us form.