Diverticular disease

Question 1

What causes diverticular disease?

Answer 1

-Diverticulum = out-pouching of the gut wall caused by high intraluminal pressure, mostly due to low fibre diet (mostly asymptomatic)
-Diverticular disease = symptoms due to presence of diverticula
-Diverticulitis = inflammation of the diverticulum
-Most occur within sigmoid colon

Question 2

Who does diverticular disease affect?

Answer 2

-Most common in Westerners >60

Question 3

How does diverticular disease present?

Answer 3

-Often incidental finding from colonoscopy
-Altered bowel habit
-Left-sided colic, often relieved by defecation
-Nausea
-Flatulence

Question 4

How would you investigate a patient with diverticular disease?

Answer 4

-FBC (high WCC), CRP
-Abdo exam would show peritonism
-Colonoscopy

Question 5

How would you manage diverticular disease?

Answer 5

-Bowel rest (fluids only +/- abx)
-Analgesia if not tolerated
-Most attacks settle but risk of perforation or abscess formation if persists