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How to Heal Diverticulitis.

How to Heal Diverticulitis.

May 24, 2020 0 Comments

Diverticulitis is one of the main causes of the acute abdomen. Acute abdomen accounts for roughly 50% of all urgent admissions to general surgical units. The acute abdomen may be a consequence of 1 or more pathological processes which may be inflammation, perforation, or obstruction.

Diverticula contain outpouchings within the bowel, most typically within the colon, but may be seen everywhere within the gut. a real diverticulum may be a blind outpouching of the alimentary canal that communicated with the lumen and every one the three layers of the bowel wall, that reflects failed involution of the vitelline duct. The foremost common true diverticulum is that the Meckel diverticulum.

Rule of 2s is applied for Meckel diverticulum.

  • occur in approximately 2% of the population.
  • Are approximately 2 inches (5 cm) long.
  • Are twice as common in males.
  • Are most frequently asymptomatic by age 2 (only approximately 4% are ever symptomatic).

Diverticulitis results from micro-perforation of a diverticulum and resultant extracolonic inflammation. Diverticular bleeding can also occur from an artery at the mouth of the diverticulum.


Presentation

Diverticulosis is most often asymptomatic. Although diverticulosis is also found in patients being investigated for symptoms of abdominal pain and altered bowel habits, a causal link is difficult to determine.

Typical symptoms of diverticulitis include left lower quadrant abdominal pain together with fever and chills and alteration of bowel habits. Localized left quadrant abdominal tenderness is also elicited on physical examination.

 

Diagnostic Findings

Diverticulitis may be related to an elevated white somatic cell (WBC) count with a left shift. Diverticula are frequently seen on screening colonoscopy. Imaging studies, most typically CT scans, will be useful within the diagnosis of diverticulitis. Colonoscopy is contraindicated for 4-6 weeks after an episode of acute diverticulitis, but should be performed at that time interval to exclude a perforated neoplasm.


Treatment

Diverticulitis treatment can be divided into pharmacologic and non-pharmacologic treatment.


Pharmacologic Treatment

  • Oral antibiotics like ciprofloxacin and metronidazole for 10-14 days may suffice for mild diverticulitis.
  • Despite optimistic initial reports, mesalamine doesn't appear to be effective in preventing recurrence of diverticulitis in clinical trial controlled trials; no therapy has been proven to stop recurrent diverticulitis
  • Hospital admission, bowel rest, IV fluids, and broad-spectrum IV antimicrobial agents are typically required in moderate to severe cases.

Non-pharmacologic Treatment

  • Increased dietary fiber is mostly recommended in patients with diverticulosis. although no hard data exist to support its benefit.
  • A low-residue diet is suggested for mild diverticulitis, although no evidence exists to support this practice.

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Surgical Management

  • Surgical consultation should be obtained early in moderate to severe diverticulitis because operative intervention is also necessary should a complication arise.
  • Surgical resection can also be necessary for recurrent diverticulitis, typically after three or more recurrences at the identical location.

Mild cases of diverticulum will be resolved completely with medication, diet, and high fluid intake but severe cases may end up in recurrence and no treatment is successful in giving a complete resolution. Only 5% of individuals with diverticulosis ever go to develop diverticulitis.