Diverticulitis

Diverticulitis is a digestive condition that occurs when small pouches called diverticula, which form in the walls of the colon, become inflamed or infected. These pouches are common, especially in people over the age of 40, and usually don’t cause issues. However, when they become irritated or infected, it leads to diverticulitis—a painful and sometimes serious condition.

The disease varies in severity. Mild cases may respond well to dietary changes and medications, while severe cases might require hospitalisation or surgery. Understanding the symptoms, risk factors, and treatment options is essential for early management and recovery.

Diverticulitis is the inflammation or infection of diverticula. Diverticula are small, bulging sacs that can form in the lining of the colon. When one or more of these pouches become inflamed or infected, the condition is called diverticulitis.

Diverticula themselves are harmless and asymptomatic in most people—a state known as diverticulosis. Only when inflammation sets in does the person experience symptoms.

India

In India, diverticular disease was historically considered rare but is increasingly diagnosed due to improved diagnostic techniques and changes in dietary habits. Although comprehensive national statistics are limited, research suggests an increasing incidence, especially in urban populations adopting low-fibre, Western-style diets.

Worldwide

Globally, diverticulitis is highly prevalent, particularly in developed countries. In the United States and parts of Europe, it affects around 10-25% of individuals with diverticulosis. The risk increases with age, with up to 50% of people over 60 showing diverticula in colonoscopy studies.

1. Uncomplicated Diverticulitis: This is the most common type, where there is localised inflammation without complications.
2. Complicated Diverticulitis: Involves serious conditions such as abscesses, perforation, peritonitis, fistulas, or bowel obstruction.

Understanding the type helps in deciding the level of intervention needed.

The exact cause of diverticulitis is not fully known, but several contributing factors have been identified:

• Low-Fibre Diet: A diet low in fibre leads to constipation, which increases pressure in the colon, causing diverticula to form and potentially become inflamed.
• Aging: Ageing weakens the intestinal walls, making them more susceptible to pouch formation and inflammation.
• Obesity: Excess weight increases abdominal pressure.
• Sedentary Lifestyle: Lack of physical activity can slow bowel function.
• Smoking: Associated with a higher risk of complications.
• Certain Medications: NSAIDs, steroids, and opioids may increase the risk of developing diverticulitis.

Symptoms can range from mild to severe and may include:

• Abdominal Pain: Often severe and localised to the lower left side.
• Fever and Chills: Indicating infection.
• Nausea and Vomiting
• Changes in Bowel Habits: Such as constipation or diarrhoea.
• Bloating and Gas
• Rectal Bleeding (less common but possible)

These symptoms may mimic other gastrointestinal disorders, making proper diagnosis crucial.

To accurately diagnose diverticulitis, healthcare providers typically use a combination of methods:

• Physical Examination: Includes palpation of the abdomen to check for tenderness.
• Blood Tests: To detect signs of infection or inflammation.
• Urine Test: To rule out urinary tract issues.
• Stool Test: To eliminate other causes of symptoms.
• CT Scan: The most definitive test to detect inflamed or infected pouches.
• Colonoscopy: Usually done after recovery to assess the extent of diverticular disease.

Medications

• Antibiotics: For treating infections. (Metron 500mg Injection)
• Pain Relievers: Paracetamol is preferred; NSAIDs may worsen the condition. (Voveran SR 75mg Tablet)
• Antispasmodics: To relieve bowel spasms.
• Laxatives: For constipation, if not contraindicated.

Diet Changes

• Clear Liquid Diet: During flare-ups to allow the bowel to heal.
• Gradual Reintroduction of Low-Fibre Foods: Followed by high-fibre foods once symptoms resolve.

Surgery

Required in cases of recurrent or complicated diverticulitis:

• Bowel Resection: Removal of the affected part of the colon.
• Colostomy: Temporary or permanent opening for stool passage.

While not primary treatments, some alternative approaches may support recovery and wellness:

• Probiotics: May help maintain gut flora.
• Herbal Remedies: Such as slippery elm or chamomile for soothing digestive issues.
• Acupuncture: For pain management.
• Yoga and Meditation: To reduce stress-related gastrointestinal flare-ups.

Always consult a medical professional before starting any alternative therapy.

Several factors increase the risk of developing diverticulitis:

• Age Over 40
• Low-Fibre Diet
• Obesity
• Lack of Exercise
• Smoking
• Certain Medications
• Family History of Diverticular Disease

If left untreated or improperly managed, diverticulitis can lead to:

• Abscess Formation
• Perforation of the Colon
• Fistula
• Peritonitis
• Intestinal Obstruction
• Sepsis

Timely treatment can prevent these serious outcomes.

• Stick to the Recommended Diet: Follow medical advice on fibre intake.
• Monitor Symptoms: Keep track of changes and report persistent symptoms.
• Regular Check-ups: Especially after the first episode.
• Manage Stress: Stress can exacerbate symptoms.
• Educate Yourself: Understand your triggers and avoid them.

• "It only affects older people": Younger adults can also develop it.
• "Seeds and nuts cause diverticulitis": No strong evidence supports this.
• "It always requires surgery": Many cases are managed non-surgically.
• "Antibiotics are always needed": Mild cases may resolve without them.

Seek medical attention if you experience:

• Severe or persistent abdominal pain
• Fever with chills
• Blood in stool
• Nausea with vomiting
• Signs of dehydration

Early intervention improves outcomes.

• What type of diverticulitis do I have?
• What treatment options are best for my case?
• Do I need surgery?
• How can I prevent future flare-ups?
• What dietary changes should I make?
• Are there long-term complications I should be aware of?

• Be Understanding: The condition can be unpredictable.
• Assist with Dietary Changes: Help plan meals.
• Encourage Follow-Ups: Appointments are key.
• Provide Emotional Support: Living with a chronic digestive issue can be mentally taxing.
• Help With Household Tasks: Especially during flare-ups or recovery.

Diverticulitis is a manageable yet potentially serious condition that affects the colon. With proper diagnosis, treatment, and lifestyle adjustments, individuals can live a healthy life and prevent recurrence. Awareness, early detection, and a fibre-rich diet play key roles in management. Consult a healthcare provider for tailored advice and ongoing support.