What Are the Different Types of Diverticular Disease?

Diverticulosis refers to cystic protrusions of any part of the gastrointestinal tract, which often occur in the large intestine. Several diverticulum coexist, which is called diverticulosis. If the diverticulum becomes infected, it is called diverticulitis. Most patients with diverticulosis are asymptomatic. Some patients may experience abdominal pain, diarrhea, and bleeding.

Basic Information

English name

dlerticulosis

Visiting department

Basic surgery

Multiple groups

People who eat less whole wheat, fruits and vegetables

Common locations

the large intestine

Common causes

It is not clear that excreting small pieces of hard feces from a low-fiber diet creates stress

Common symptoms

Abdominal pain, diarrhea, and other abnormal bowel movements

Causes of diverticulosis

The cause of diverticulum formation is unclear. In addition to congenital factors, the pressure caused by the excretion of small pieces of hard feces from a low-fiber diet is one of the reasons for this. The high pressure generated by abnormal movements of the colon forces the intestinal endothelium to penetrate the weak points of the outer muscular layer of the colon.

Diverticulitis can develop diverticulitis. Inflammation can cause perforation, abscess formation, or peritonitis. In many cases, the infected part of the intestine will adhere to the bladder or vagina, form a sinus with the colon, and cause an internal fistula. Repeated infections thicken the walls of the colon, causing the colon to narrow, with incomplete or complete obstruction.

Clinical manifestations of diverticulosis

Most patients with diverticulosis are asymptomatic. When patients have unexplained abdominal pain, diarrhea, and other abnormal bowel movements, the possibility of diverticulosis needs to be considered. The opening of the diverticulum can bleed, or a major bleeding, the blood enters the intestinal cavity and is then discharged through the anus. This symptom can be caused when stool is incarcerated in the diverticulum and damages the blood vessels (vessels next to the diverticulum). Diverticula bleeding is more common in the ascending colon than in the descending colon. Colonoscopy can determine the cause of the bleeding. Diverticulosis occurs mostly in the colon. The condition can be divided into two stages:

1. Diverticulum formation stage

The colon wall bulges, forming an abnormal sac, called a diverticulum;

2. Diverticulitis stage

The body's metabolites and bacteria are trapped in the diverticulum, causing infection and, in severe cases, causing perforation.

Diverticulosis examination

Barium enema

If there are symptoms such as rectal bleeding or diverticulitis, and there is no acute abdomen clinically, the diagnosis can be confirmed by barium enema angiography, especially gas-barium contrast angiography or colonoscopy.

2. Nuclide scanning

For patients with bleeding, a radionuclide scan can be used. If the bleeding rate is greater than or equal to 1 ml / min, angiography is the best method; if the bleeding stops automatically or after angiography, further examination should be performed within 2 to 3 weeks to rule out bleeding caused by other causes.

3. Colonoscopy

A full colonoscopy is the best way to determine the cause of bleeding.

Diverticulosis diagnosis

Diagnosis can be made based on the above symptoms, signs, and colonoscopy.

Diverticulosis Treatment

1. If diverticulosis develops into diverticulitis, bed rest is required. Liquid or low-fiber diets are used. The pain of diverticulitis often occurs in the right abdomen and usually worsens within a few days. The pain may also occur suddenly, much like appendicitis.

2. Diverticulitis may perforate, causing acute peritonitis. If peritonitis occurs, immediate surgery is needed to remove the inflammatory colon. A temporary colostomy is performed to excrete the contents of the colon. After the inflammation is controlled, the redirected colon part in the ostomy is connected with the rest of the colon or directly connected to the rectum.

Prevention of diverticulosis

Low-fat, low-sugar, and high-fiber diets can prevent diverticulosis and diverticulitis. People with a low fiber content and who eat less whole wheat, fruits, and vegetables are more likely to develop diverticulosis than people on a high-fiber diet. In order to prevent or control diverticulosis, you should drink plenty of water and increase fiber content in your diet. At the same time, you should eat regularly, exercise actively, take a full rest and control stress.