Passmedicine

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

What are the risk factors for diverticulosis?

Answer 2

increasing age

low-fibre diet

Question 3

How does diverticulosis present?

Answer 3

painful diverticular disease: altered bowel habit, colicky left sided abdominal pain. A high fibre diet is usually recommended to minimise symptoms
Diverticulitis:
left iliac fossa pain and tenderness
anorexia, nausea and vomiting
diarrhoea
features of infection (pyrexia, raised WBC and CRP)

Question 4

How is diverticulosis managed?

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

What are the complications of diverticulosis?

Answer 5

abscess formation
peritonitis
obstruction
perforation