Diverticular Diseases

Question 1

What is a diverticula?

Answer 1

Little outpouching in the wall lining of the intestinal mucosa.

MC- Sigmoid as small diameter

Question 2

Pathophysiology of a diverticula

Answer 2

Diverticula are thought to form due to increased intra-colonic pressure at naturally weak parts of the colon, where penetrating arteries enter the wall of the colon.

Question 3

RF of diverticular diseases

Answer 3

Reduce wall tone - CTD (Marfans, ED)
Increase Abdo wall pa - COPD, Chronic cough, Age, obesity,
NSAID increase risk of perforation

Question 4

What are the different definitions in diverticular diseases:

Answer 4

Diverticulosis: the presence of diverticula in an asymptomatic patient

Diverticular disease: SX present - intermittent lower left abdominal pain, constipation, rectal bleeding
NO inflammation and infection

Diverticulitis: where diverticula become inflamed and infected
Typically causing: severe lower abdominal pain, fever, general malaise, and occasionally rectal bleeding

Question 5

Dx Diverticula

Answer 5

Usually diagnosed incidentally w/ Colonscopy/CT scan

Question 6

Epidemiology of diverticular diseases

Answer 6

Diverticula are very common with increasing age, affecting 66% of patients over 80 years old [1]. 25% of patients with diverticulosis develop symptoms, whilst almost 80% of these people have an episode of diverticulitis.

Question 7

treating divertiuclar disease

Answer 7

if diverticulosis - do nothing / low res diet
if diverticular diseases - use bulk forming laxative e.g ispaghula husk
if diverticulitis - abx - co amoxiclav + paracetamol