Diverticulitis Essay

June 27, 2022

Diverticulitis is a form of Diverticular disease that occurs when abnormal pouches called diverticula that form on the walls of the lower intestine become inflamed and produces a variety of symptoms such as cramps, bloating, pain in the lower left side of one’s and constipation.

Diverticulitis often results from an inappropriate diet; therefore, “the sigmoid part of the colon has to exert so much pressure to propel the feces that the walls of the intestine herniate.” [1]

If these individual pouches contract an infection or cause an obstruction, a person may require antibiotics or surgery in an acute case. [1]

Diverticulosis and Diverticulitis

Diverticular disease affects the bowel in many forms; however, the most common are diverticulosis and diverticulitis.

These two conditions are connected because both are caused by abnormal pouches called diverticula formation. However, the difference lies in the severity of symptoms patients experience.

People with these abnormal pouches without symptoms have diverticulosis, but once inflammation and symptoms worsen, the condition is considered diverticulitis.

Approximately one in four people with diverticulosis develops symptoms from inflammation or diverticular bleeding. This often occurs in the more developed Western countries such as the United States. [2]

The bowel measures approximately 25 feet long and contains the small and large intestines, which receive food passed through the stomach through the pyloric valve. The small intestine is the first to receive the food, and the muscles contract and carries food along the path that leads into the large intestine.

There are three sections to the small intestine, the duodenum, jejunum, and the i. The walls are covered with microvilli, “hair-like projections of the mucosal lining that absorb nutrients into the bloodstream.” [3]

Once food reaches the duodenum, the breakdown begins as digestive enzymes pass from the stomach, small intestine, and pancreas. Bile from the liver turns proteins into amino acids, fatty acids, and simple sugars.

At this point, the food is transferred to the jejunum, where the nutrients are absorbed, and the remaining vitamins are absorbed in the ileum. [3]

After completing its cycle in the small intestine, the waste is transferred to the large intestine. It is processed through four stages – the first being the cecum, the second ascending and descending colon, the sigmoid colon, and then the rectum.

No nutrients are absorbed when the food is processed through the colon; its only job is to remove excess water from the waste and return it to the bloodstream. As the process continues and the water is removed, the material forms a more solid substance called stool. The waste normally takes approximately one to two days in the colon before the body expels the waste. [3]

As we grow older, most people begin to form abnormal pouches, diverticula that “bulge outward through weak points in the wall of the large intestine,” These individuals are diagnosed with the less severe condition called diverticulosis. [3]

Diverticulosis is present in approximately fifty percent of adults between the age of 60 and 80

This condition can affect the entire colon; however, diverticula often develop in the sigmoid colon. The number of diverticula forms can range from a single lesion to hundreds.

Most lesions are approximately 5 to 20 millimeters long, and it is very rare for a person to develop a giant lesion. Approximately ten to twenty-five percent of people with diverticulosis develop and infection or inflammation of the diverticula and require further treatment.

If this happens, the condition is then called diverticulitis. If diverticulosis and diverticulitis are present simultaneously, the patient is said to have diverticular disease. [3]

Medical professionals believe that diverticulitis is a result of bacteria or hardened stool getting trapped in a diverticulum.

This complication can often cause a small perforation in the tip of the diverticulum, which then allows bacteria to enter the abdomen and leads to contracting an infection. This condition often occurs suddenly, and patients have no warning.

Many patients report pain in the lower left side of the abdomen, nausea, vomiting, chills, constipation, and other symptoms such as diarrhea and urination difficulties. The symptom severity presents according to the “infection and the presence of any complications.” [3]

Several tests can be performed to diagnose the presence of diverticulitis.

These tests include “barium enema, flexible sigmoidoscopy, colonoscopy, and x-ray.” [2] When sigmoidoscopy and colonoscopy are performed, physicians insert a small camera through a tube that is passed through the rectum so that a picture of the bowel can be examined. [2]

Because diverticulitis presents symptoms similar to colon cancer, several physicians prefer to look directly at the affected area, allowing for more certainty in the diagnosis and treatment. [3]

Physicians often treat acute diverticulitis with antibiotics, requiring hospitalization so that treatment methods are provided round the clock. If this treatment does not clear the infection, patients may develop an abscess, defined as “a collection of pus surrounded by inflamed tissue” in the abdominal cavity near the colon. [3]

Other antibiotics can clear the infection, or if unsuccessful, physicians may have to perform a surgical procedure that directly drains the infection from the abscess. [3]

The surgical procedure for acute diverticulitis can be invasive; however most often consists of a small camera being inserted into the abdomen, and surgeons perform “keyhole surgical techniques” (laparoscopy) so that a segment of the area affected can be removed. [4]

After the diseased area is removed, doctors attach the healthy areas back together, aftereving the symptoms in most patients requiring surgical procedures. Laparoscopic surgery for acute diverticulitis is easier for patients as, unlike open surgery, patients experience less pain, and recovery is much faster. [4]

Doctors often attribute the cause of diverticulitis to poor diet and emotional stress. In most Western countries, people have reduced the amount of fiber included in their daily intake, and as a result, constipation is more likely to occur.

Medical professionals say that “indigestible fiber from grains, fruit, and vegetables provide an important bulk,” decreasing constipation and allowing the body to function properly. [4] Because approximately 60% of people over 60 in Western civilizations will develop diverticulosis, studies focus on the appropriate diet for this condition.

In a study between 1986 and 1992 that included 47,888 male health professionals, the diagnosis of diverticular disease was found in those with a low amount of fiber in their diet.

Other studies found similar results; therefore, the American College of Gastroenterology states, “it is reasonable to recommend a diet high in fruit and vegetable fiber to patients with uncomplicated diverticulosis.” [5]

Physicians have associated the onset of diverticulitis with emotional stress; however, this opinion is inconsistent among medical professionals. Dr. Chesley Hines, a gastroenterologist at Ochsner, states, “There is no proven connection between stress and diverticulitis.” [5]

The physicians attribute the cause partially to human emotion in a different opinion. They believe that “Stress may not be the definitive cause,” but the symptoms will likely become magnified. [5]

It is important to note that most often, patients experience minor symptoms from diverticulitis, and these are resolved without treatment, as it is reported that approximately 80% of cases can be treated without extreme measures being taken.

Most often, patients report mild cramping in the abdominal area and slight nausea; physicians recommend altering their diet to include higher amounts of fiber, bed rest, high intake of liquids, and oral antibiotics. [3]

It seems reasonable that if individuals become conscious of living a healthy lifestyle that includes an appropriate diet with a high fiber intake, the chance of contracting diverticulitis is less likely.

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[1] Dunne, L. J. (2002). Nutrition Almanac. New York: McGraw-Hill.
[2] Salzman, H. & Lillie, D. (2005). Diverticular disease: diagnosis and treatment. American Family Physician, 72(7), 1241-1243.
[3] Johns Hopkins (2003). THE SMALL AND LARGE INTESTINES. Digestive Disorders, 30-56.
[4] Lutz, B. (2007). Pain in the Abdomen. New Orleans Magazine, 42(2), 38-40.
[5] Eglash, A. & Lane, C. H. (2006). What is the most beneficial diet for patients with diverticulosis? Journal of Family Practice, 55(9), 813-815.

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