Researching and Diagnostics of Diverticulitis

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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).

Signs and Symptoms

  • 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.

Stages

  • 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.

Diagnosis

  • 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.

Diagnostic Testing

  • What is more, the following tests may be used to diagnose this disease:
  • blood test for anemia or inflammation;
  • CT scan to get images of a patient’s gastrointestinal tract;
  • lower GI series to view the large intestine of a person;
  • colonoscopy to look inside one’s colon and rectum.

Assessment Techniques to Make the Diagnosis

  • 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.

Differential Diagnosis

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

Treatment

  • 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.

Treatment Outcomes

  • 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.

Special Dieting

  • 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.

Clinical Trials

  • 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).

Statistics

  • 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.

References

Diverticulitis diet. (2019). Mayo Clinic.

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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.

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NursingBird. (2022, July 16). Researching and Diagnostics of Diverticulitis. Retrieved from https://nursingbird.com/researching-and-diagnostics-of-diverticulitis/

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NursingBird. (2022, July 16). Researching and Diagnostics of Diverticulitis. https://nursingbird.com/researching-and-diagnostics-of-diverticulitis/

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"Researching and Diagnostics of Diverticulitis." NursingBird, 16 July 2022, nursingbird.com/researching-and-diagnostics-of-diverticulitis/.

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NursingBird. (2022) 'Researching and Diagnostics of Diverticulitis'. 16 July.

References

NursingBird. 2022. "Researching and Diagnostics of Diverticulitis." July 16, 2022. https://nursingbird.com/researching-and-diagnostics-of-diverticulitis/.

1. NursingBird. "Researching and Diagnostics of Diverticulitis." July 16, 2022. https://nursingbird.com/researching-and-diagnostics-of-diverticulitis/.


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NursingBird. "Researching and Diagnostics of Diverticulitis." July 16, 2022. https://nursingbird.com/researching-and-diagnostics-of-diverticulitis/.