Diverticular disease Flashcards
1) What are diverticula?
2) What is diverticulosis?
3) What is diverticulitis?
1) Pouches or pockets in the bowel wall
2) Presence of diverticula, without inflammation or infection
3) Inflammation and infection of diverticula
1) How do diverticula form?
2) What is the most commonly affected section of the bowel?
1) High intraluminal pressures force the mucosa to herniate through the muscle layers of the gut at weak points adjacent to penetrating vessels
2) Sigmoid colon
1) Name a risk factor for the development of diverticula
2) Name a symptom diverticulosis can cause
3) How is it usually treated?
1) Low fibre diets, obesity and the use of NSAIDs
2) Lower left abdominal pain relieved by defecation, constipation, altered bowel habits, nausea, flatulence or rectal bleeding
3) Bulk-forming laxatives + increasing dietary fibre
Name 2 ways acute diverticulitis can present
- Pain and tenderness in the left iliac fossa / lower left abdomen
- Fever
- Diarrhoea
- Nausea and vomiting
- Rectal bleeding
- Changes in bowel habit
- Palpable abdominal mass (if an abscess has formed)
- Raised inflammatory markers and white blood cells
Name 2 aspects of the management of uncomplicated diverticulitis in primary care
- Oral co-amoxiclav (at least 5 days)
- Analgesia (avoiding NSAIDs and opiates, if possible)
- Only taking clear liquids until symptoms improve (usually 2-3 days)
- Follow-up within 2 days to review symptoms
Name 2 aspects of the management of more severe diverticulitis
- Nil by mouth or clear fluids only
- IV antibiotics - IV ceftriaxone and metronidazole
- IV fluids
- Analgesia
- Urgent investigations (CT abdo and pelvis with contrast is the most sensitive)
- Urgent surgery may be required for complications
Name 2 complications of diverticulitis
- Perforation
- Peritonitis
- Peridiverticular abscess
- Large haemorrhage requiring blood transfusions
- Fistula
- Post-infective strictures
Which part of the colon is diverticula most commonly found?
Sigmoid colon
