Diverticular Disease

Question 1

What is a diverticula?

Answer 1

pouches in bowel wall (a defect in the bowel wall continuity), usually from 0.5 – 1cm

Question 2

What is diverticulosis?

Answer 2

the presence of diverticula without symptoms

Question 3

What is diverticulitis?

Answer 3

inflammation of diverticula

Question 4

Give an outline of diverticulosis

Answer 4

• Very common as people age
• Low fibre diets and obesity are risk factors
• Often diagnosed incidentally on colonoscopy or CT scan
• No treatment necessary, but advice regarding high fibre diet and weight loss is appropriate

Question 5

How does diverticulitis present?

Answer 5

• Left iliac fossa / lower left abdominal pain and tenderness
• Fever
• Diarrhea
• PR blood / mucus
• Nausea and vomiting

Question 6

How to manage diverticulitis?

Answer 6

• Consider admission if unwell
• Antibiotics
• Analgesia
• Fluid resuscitation
• May require surgical resection if severely septic / peritonitic or develops complications

Question 7

What are complications of diverticulitis?

Answer 7

• Haemorrhage
• Perforation
• Abscess
• Fistula (e.g. between colon and bladder / vagina)
• Ileus / obstruction