DIVERTICULAR DISEASE

Question 1

What is diverticulosis?

Answer 1

Outpocketings of the colonic mucosa and submucosa through weaknesses of muscle layers in the colon wall.

Question 2

Where in the colon are diverticula most commonly found?

Answer 2

Sigmoid

Question 3

What causes diverticula in the colon?

Answer 3

Constipation and increased pressure leads to herniation of mucosa.

Question 4

What are the clinical features of diverticulosis (uncomplicated ie not diverticulitis)?

Answer 4

Often asymptomatic
Colicky left sided discomfort
Bloating
Constipation

Question 5

How might you investigate someone with suspected diverticulae?

Answer 5

Endoscopy

Barium enema

Question 6

How do you treat uncomplicated diverticulosis?

Answer 6

High fibre diet

Question 7

What are the complications of diverticulosis?

Answer 7

Diverticulitis
Diverticular disease (bleeds)
Perforation causing peritonitis

Question 8

What are the features of diverticular disease?

Answer 8

Change in bowel habit
Rectal bleeding
Abdominal pain

Question 9

What is diverticulitis?

Answer 9

Inflammation of colonic diverticula leading to severe pain.

Question 10

What are the clinical features of diverticulitis?

Answer 10

Left iliac fossa pain
Tenderness
Fever
Nausea
Vomiting
Diarrhoea/Constipation
Raised white blood cell count

Question 11

How do you manage diverticulitis?

Answer 11

Analgesia
Bowel rest (nil by mouth)
IV fluids
Antibiotics

Surgical resection if medical management fails or perforation occurs