diverticular disease Flashcards
diverticulum
pouch or pocket in bowel wall
diverticulosis
presence of diverticula without inflammation or infection
diverticulitis
inflammation and infection of diverticula
how to diverticula form
circular muscle layer of large bowel has weak points where blood vessels penetrate it
gaps allow mucosa to herinate through –> diverticula
most commonly affected section of bowel
sigmoid colon
diverticulosis risk factors
age
low fibre
obesity
use of NSAIDs
diverticulosis mx
nothing ifasymptomatic
increse fibre
bulk-forming laxatives
surgery
what to avoid in diverticulosis
stimulant laxatives e.g. senna
acute diverticulitis presentation
pain LIF fever diarrhoea N+V rectal bleed abdo mass if abscess raised CRP and WCC
acute diverticulitis Mx - uncomplicated in primary care
- oral co-amoxiclav at least 5 days
- analgesia (avoid NSAIDs and opiates)
- only take clear liquids and avoid solid foods until Sx improve
- follow up < 2days to review
acute diverticulitis Mx - complications or severe pain requiring hosp admission
- NBM or clear fluids only
- IV antibx
- IV fluids
- analgesia
- urgent Ix e.g. CT
- urgent surgery if complications
acute diverticulitis complications
perforation peritonitis peridiverticular abscess large haemorrhage fistula obstruction