Diverticulosis

Symptoms

Often the Diverticulosis goes unnoticed or becomes part of a Colonoscopy to Colon cancer screening found by chance. 80% of the patients never have symptoms from their diverticulosis. The rest of those affected mostly suffer from differently strengthen, cramping pain in the left lower abdomenwhich sometimes radiate into the back.

Depending on the position of the sigmoid, the pain can also lie above the pubic bone or extend into the right lower abdomen. In some patients, a tender roller can be felt in the left lower abdomen.
In addition, patients often suffer from flatulence, stool irregularities such as diarrhea and hard bowel movements, and even constipation. Depending on the patient, the consistency of the stool can change or be constant even when using the toilet, and the stool can be partially covered with mucus or blood.
Here you can find more information about Changes in bowel movements or Blood in the stool - these are the causes!

Diverticulosis itself is symptom-free. If symptoms develop, it is correct to speak of diverticular disease.

Please also read: Pain after defecation

therapy

If you are informed about the presence of diverticula in the intestine, you should contact one without any symptoms diet high in fiber and fiber respect, think highly of. This diet is supposed to prevent inflammation and the development of further diverticula. A lot of fiber is especially in Grain, Legumes, fresh vegetables and fruit contain. A daily intake of at least 1.5 - 2 liters helps the fiber swell and keeps stool soft to counteract constipation. The consumption of animal products, e.g. flesh and Eggs however, should be reduced.

Important: During an acute Diverticulitis a different nutrition plan applies than for diverticulosis. Until the inflammation has healed here low-fiber diet to be favoured!

Because the pouches of the intestinal wall are not recoverable sufferers should adjust their diet accordingly for their life. To relieve the intestines, should Stool irregularities through food or light laxativese.g. Movicol or Lactulosecan be regulated after consulting a doctor. In addition to the diet should also be regular physical activity be taken care of, as this stimulates the metabolism and digestion and this in turn prevents constipation. At stomach pain a muscle relaxant, e.g. Butylscopolamine (Buscopan®) that relieve discomfort. Medicines that promote indolence in the intestine should only be taken after consulting a doctor to prevent possible worsening of diverticulosis. So it is for example Morphine as a pain reliever for known diverticulosis, as it increases the pressure inside the intestine. Existing sacs can enlarge and new diverticula can form.

surgery

At 5% of patients with diverticulosis is due to surgery moderate to massive bleeding necessary. In most cases, however, the bleeding sources dry up without surgery. In the case of uncomplicated diverticulosis, surgery is not justified. The risks of an operation outweigh the possible risks of a disease that is not or only slightly symptomatic and the course of which cannot be predicted.
Only when at least two flare-ups diverticulitis, surgical removal of the repeatedly inflamed bowel area should be considered. This is intended to reduce the likelihood of a complication in the event of re-inflammation. Usually the planned surgery only when the inflammation in the intestine has calmed down.
In the case of young and high-risk patients, the decision to have an operation is often made earlier, sometimes even after the first attack, as this is the case with these Risk of recurrence is increased. During the operation, the laparoscopic keyhole technique used to ensure, among other things, faster wound healing with less complications. To do this, 4 small incisions are made on the abdominal wall. CO2 gas is pumped into the abdominal cavity to create a better field of vision and work. A small camera and surgical instruments are then inserted into the abdominal cavity through the small incisions. The inflamed section of the intestine is identified, separated out and the two ends of the intestine sutured with a suture aid. After the operation, patients usually feel one instant relief of complaints. For the first few days after the operation, the intestines are still mostly full painful. However, these complaints usually dry up quickly. After the surgical wounds have healed, bowel movements are mostly somewhat due to the shortened bowel softer than before. Otherwise nothing changes for the patient.

Complications

In diverticulosis, bleeding occurs in 10-30% of cases, although 80% of the bleeding sites close again on their own. If the diverticula filled with intestinal contents become infected, about 20% of the diverticulum carriers develop diverticulum disease or acute or chronic diverticulitis. Inflamed diverticula can burst and lead to an infection in the abdomen. Depending on the size of the defect and the amount of intestinal bacteria that penetrate the abdomen, various clinical pictures can develop.

Is the tear or the intestinal perforation (perforation) is sealed by other organs, a skin or a capsule, one speaks of a covered perforation. This usually leads to local inflammation with abscess formation (capsule with accumulation of pus). After the abscess has healed, a wound duct (fistula) remain between the intestine and surrounding organs such as the urinary bladder or ovary. Intestinal contents can thus get into other organs and trigger inflammation in these places. A free perforation (intestinal breakthrough) requires that the intestinal contents reach the abdominal cavity through the hole in the intestinal wall. This usually leads to severe peritonitis (Peritonitis). Sepsis (blood poisoning) with possible fatal consequences are further complications of an intestinal perforation with peritonitis. After every inflammation, scars form in the abdomen and intestines. These can either constrict the intestine from the outside or reduce the diameter of the intestine from the inside. The passage through the chair is therefore restricted by the bottleneck. If the intestine is completely pressed or constricted, an intestinal obstruction occurs (Ileus), which urgently needs an operation.

Read more about this: Abscess in the intestine