Researching and Diagnostics of Diverticulitis

Pathophysiology

Diverticulitis pathophysiology is not understood and studied completely.
Earlier studies showed that diverticulitis appeared because of the diverticulum’s obstruction and trauma with subsequent infection, ischemia, and microperforation (Strate & Morris, 2019).
More recent research shows that chronic inflammation and alterations in the gut microbiome are likely to cause this disease.
A chronic inflammatory state is associated with diverticulitis since a Western diet, obesity, and physical inactivity are possible risk factors of this disease that also cause systemic inflammation.
According to Strate and Morris (2019), “diet and lifestyle factors may induce alterations in the gut microbiome that lead to mucosal inflammation and diverticulitis” (p. 1285).

Severe constant pain accompanied by spasms or cramps in the abdomen’s lower left side (Khatri, 2019).
Nausea and vomiting.
Fever or chills.
Abdominal tenderness and bloating.
Diarrhea, constipation, or thin stools.

Researchers typically divide diverticulitis into four stages.
Stage I: The colon mesentery confines a pericolic abscess.
Stage II: Local perforation of a pericolic abscess leads to a pelvic abscess (Tochigi et al., 2017).
Stage III: Either a pelvic or a pericolic abscess ruptures into the general peritoneal cavity, and generalized peritonitis appears (Tochigi et al., 2017).
Stage IV: The free perforation of the diverticulum leads to fecal peritonitis.

This disease is generally diagnosed during an acute attack.
Ruling out other causes for symptoms is essential.
To diagnose diverticulitis, medics can use a patient’s medical history, a physical exam, and particular tests.
In medical history, a doctor may study symptoms, medicines, health, diet, and bowel movement patterns.

Assessment techniques to diagnose diverticulitis include abdominal palpation, percussion, auscultation, and the inguinal rings’ examination.
Moreover, medics usually take the patient’s temperature and perform laboratory tests and urinalysis.
There is also often a digital rectal exam.

The differential diagnosis of diverticulitis involves gynecologic and urologic disorders;
inflammatory and mechanical disorders of the gastrointestinal tract;
malignancy;
and functional disorders.

Generally, treatment options depend on the severity of one’s condition and symptoms and signs.
For uncomplicated diverticulitis, a patient may be treated at home, and their treatment plan involves antibiotics to treat infection and a serious diet that starts from only drinking liquid.
Persons with complicated diverticulitis usually get hospitalized, and their treatment includes intravenous antibiotics and inserting a tube to drain an abdominal abscess.
In case of complications or a weakened immune system, either type of surgery, namely primary bowel resection or bowel resection with a colostomy, is required.

It is possible to improve significantly after two days of the beginning of treatment.
A high-fiber diet allows to control and eliminate further symptoms.
About eighty percent of patients never have a second diverticulitis episode.

The purpose is to allow a patient’s digestive system to rest.
The diet starts with eating nothing by mouth.
Then, there are several days with clear liquids like broth or water (“Diverticulitis diet,” 2019).
Then it is recommended to slowly add low-fiber foods such as eggs and cereals.
To avoid complications, this diet should be controlled by a doctor.

Many aspects of diverticulitis are studied by researchers, including the following:
how decisions about elective surgery are made by patients and medics;
reducing infection and controlling pain after surgery;
determining the risk that acute diverticulitis will recur or occur in people with diverticular disease (National Institute of Diabetes and Digestive and Kidney Diseases, 2018).

About twenty percent of people with incident diverticulitis have one or more recurrence.
The prevalence of hospitalization for diverticulitis in the U.S. is “greatest in whites (62/100,000), similar in African Americans and Hispanics (approximately 30/100,000), and lowest in Asians” (Strate & Morris, 2019, p. 1283).
Approximately fifty percent of Americans older than sixty have diverticulitis.

Diverticulitis diet. (2019). Mayo Clinic.

Khatri, M. (2019). Diverticulitis. WebMD.

National Institute of Diabetes and Digestive and Kidney Diseases. (2018). Clinical trials for diverticular disease. NIDDK.

Strate, L. L., & Morris, A. M. (2019). Epidemiology, pathophysiology, and treatment of diverticulitis. Gastroenterology, 156, 1282–1298.

Tochigi, T., Kosugi, C., Shuto, K., Mori, M., Hirano, A., & Koda, K. (2017). Management of complicated diverticulitis of the colon. Annals of Gastroenterological Surgery, 2(1), 22–27.