Diverticulitis and Diverticulosis

Diverticular disease: Diverticulitis is an
inflammation to a diverticulum, which is an inflammation of saclike bulges
in the wall. Diverticulosis is the presence of diverticula.

Studies shows that diverticula probably result from high intraluminal
pressure on areas of weakness in the GI wall, where blood vessels enter.
Diet, such as highly refined foods, may be a contributing factor.
The like of fiber reduces fecal residue, narrows the bowel lumen, and leads
to higher intra – abdominal pressure during defecation.

In this disorder, bulging pouch like herniations in the GI (gastrointestinal
) wall push the mucosal lining through the surrounding muscle.  Diverticula
occur most commonly in the sigmoid colon, but they may develop anywhere,
from the proximal end of the pharynx to the anus.  Other typical sites
are the duodenum, near the pancreatic border or the ampulla of Vater, and
the jejunum.

Diverticular disease of the ileum is the most common congenital
anomaly of the GI tract. Diverticular disease has two clinical forms.
In Diverticulosis, diverticula are present but do
not cause symptoms.  In diverticulitis, diverticula
are inflamed and may cause potentially fatal obstruction, infection, or
hemorrhage, in this disorder, undigested food mixed with bacteria also
accumulates in the Diverticular sac, forming a hard mass ( fecalith ). 
This substance cuts off the blood supply to the thin walls of the sac,
making them more susceptible to attack by colonic bacteria.


Diverticulosis – recurrent left lower abdominal quadrant pain is relieved
by defecation or passage of flatus.  Constipation and diarrhea alternate.

* This disorder is usually asymptomatic ( without symptoms )

Diverticulitis – the patient may have moderate left lower abdominal
quadrant pain, mild  nausea, gas, irregular bowel habits, low – grade
fever, leukocytosis, rupture of the diverticuli can occur in severe diverticulitis,
and fibrosis and adhesions may occur in chronic diverticulitis.


Asymptomatic Diverticulosis usually does not require treatment.

Patient with intestinal Diverticulosis who experience pain, mild GI
distress, constipation, or have difficulty with bowel movement may respond
well with  a liquid or bland diet, stool softeners, and occasional
usage of mineral oil. These measures relieve symptoms, minimize irritation,
and lessen the risk of progression to diverticulitis. After pain
subsides, patients also benefit from a high residue diet and bulk forming

Patient with mild diverticulitis without signs of perforation must prevent
constipation and combat infection. It may include; bed rest, a liquid
diet, stool softeners, a broad spectrum antibiotic, and antispasmodic to
control muscle spasm, mild to moderate analgesic to control pain and relax
smooth muscle.

* When diverticulitis is unresponsive to medical treatment requires
a colon resection to remove the involved segment. Complications that
accompany diverticulitis may require a temporary colostomy to drain abscesses
and rest the colon, followed by later anastomosis