Diverticulitis, Causes, SIgns and Symptoms, Diagnosis and Treatment.

Diverticulitis, specifically colonic diverticulitis, is a gastrointestinal disease characterized by inflammation of abnormal pouches—diverticula—which can develop in the wall of the large intestine.[1] Symptoms typically include lower abdominal pain of sudden onset, but the onset may also occur over a few days.[1] There may also be nausea; and diarrhea or constipation.[1] Fever or blood in the stool suggests a complication.[1] Repeated attacks may occur.[2]

The causes of diverticulitis are uncertain.[1] Risk factors may include obesity, lack of exercise, smoking, a family history of the disease, and use of nonsteroidal anti-inflammatory drugs (NSAIDs).[1][2] The role of a low fiber diet as a risk factor is unclear.[2] Having pouches in the large intestine that are not inflamed is known as diverticulosis.[1] Inflammation occurs in between 10% and 25% at some point in time, and is due to a bacterial infection.[2][4] Diagnosis is typically by CT scan, though blood tests, colonoscopy, or a lower gastrointestinal series may also be supportive.[1] The differential diagnoses include irritable bowel syndrome.[2]

Preventive measures include altering risk factors such as obesity, inactivity, and smoking.[2] Mesalazine and rifaximin appear useful for preventing attacks in those with diverticulosis.[2] Avoiding nuts and seeds as a preventive measure is no longer recommended since there is no evidence these play a role in initiating inflammation in diverticula.[1][5] For mild diverticulitis, antibiotics by mouth and a liquid diet are recommended.[1] For severe cases, intravenous antibiotics, hospital admission, and complete bowel rest may be recommended.[1] Probiotics are of unclear value.[2] Complications such as abscess formation, fistula formation, and perforation of the colon may require surgery.[1]