Diverticulosis

Question 1

What is diverticulosis?

Answer 1

Diverticulosis is an extremely common disorder characterised by multiple outpouchings of the bowel wall, most commonly in the sigmoid colon. Strictly speaking the term diverticular disease is reserved for patients who are symptomatic - diverticulosis is the more accurate term for diverticula being present.

Question 2

Risk factors?

Answer 2

increasing age
low-fibre diet

Question 3

presentation of dicerticulosis?

Answer 3

Diverticulosis can present in a number of ways:

• painful diverticular disease: altered bowel habit, colicky left sided abdominal pain. A high fibre diet is usually recommended to minimise symptoms

One of the diverticular become infected. The classical presentation is:

• left iliac fossa pain and tenderness
• anorexia, nausea and vomiting
• diarrhoea
• features of infection (pyrexia, raised WBC and CRP)

Question 4

Management?

Answer 4

• mild attacks can be treated with oral antibiotics
• more significant episodes are managed in hospital. Patients are made nil by mouth, intravenous fluids and intravenous antibiotics (typical a cephalosporin + metronidazole) are given

Question 5

Complications of diverticulitis include?

Answer 5

• abscess formation
• peritonitis
• obstruction
• perforation

Question 6

Common presentation: 70 year old woman presents with left lower quadrant pain. she reports diarrhoea with one episode of blood. on examination she is pyrexial and has raised inflammatory markers

Answer 6

Acute diverticulitis