Diverticular Disease

Question 1

Outpouchings?

Answer 1

Extension of the wall of the gut

Question 2

In a nutshell, what occurs in diverticular disease?

Answer 2

Pressure pushes against the wall, if the wall is weakened then it will bulge out (much like an aneurysm)

Question 3

Diverticula? (Singular: diverticulum)

Answer 3

Bowel protrusions

Question 4

Diverticular disease?

Answer 4

Multiple diverticula

Question 5

Where do the diverticula occur mainly and why?

Answer 5

In the sigmoid colon because stool is formed and anatomy is curved, but can occur anywhere in the gut

Question 6

What do you need in order for diverticula to occur?

Answer 6

1. increase intraluminal pressure

2. weakened bowel walls (occurs with age d/t degenerative change)

Question 7

Etiology/risks of diverticular disease?

Answer 7

• Low fibre diet -> constipation -> increase intraluminal pressure
• Aging (80% of people over age 85 years have diverticula)
• Poor lifestyle/inactivity
• Poor bowel habits (constipation=increase pressure)

Question 8

Why is poor lifestyle/inactivity a risk factor for diverticular disease?

Answer 8

With inactivity you decrease peristalsis. Decrease peristalsis = decreased stools and decreased absorption of water in the gut causing constipation which increases the intraluminal pressure.

Question 9

Diverticulosis?

Answer 9

Formation of diverticula

Question 10

List 2 characteristics of diverticulosis.

Answer 10

• non-inflamed

- little risk of obstruction within the bowel-> usually asymptomatic

Question 11

List 2 characteristics of diverticulosis.

Answer 11

• non-inflamed

- little risk of obstruction within the bowel-> usually asymptomatic

Question 12

List 2 characteristics of diverticulitis.

Answer 12

• inflamed

- risk of perforation/rupture of the diverticula, which leads to a release of intestinal and wastes into the body

Question 13

List 2 characteristics of diverticulitis.

Answer 13

• inflamed
• risk of perforation/rupture of the diverticula, which leads to a release of intestinal and wastes into the body (risk for further complications)

Question 14

What are the manifestations of diverticulitis?

Answer 14

• dull pain
• nausea and vomiting
• low grade fever (fever can occur in the absence of infection)

Question 15

Which diagnostic testing would you use to diagnose diverticular disease and why?

Answer 15

CT scan (computerized tomography scan) to identify the number and location of diverticula

Question 16

How would you a treat a patient with diverticular disease?

Answer 16

You do not need to intervene if the patient is asymptomatic, but diverticulosis can lead to diverticulitis. Address any risk factors (improve lifestyle). Surgery for obstruction or perforation.