Condition treated

The most important point to remember is that everyone with a bowel problem can be helped and many can be completely cured.
It is never too late to get help with your bowel problems. If you would like some advice on how to approach your GP regarding your bowel problem do get in touch.

Woman wearing a light blue t-shirt and dark blue jeans with her hands pressed towards her abdomen. The area of the stomach is being highlighted in red in order to simulate pain. Her face or bottom legs are not visible in the picture, the accent is on the abdomen.

Diverticular Disease

Diverticula of the large bowel are out-pouchings in the wall of the colon. Diverticular disease includes a spectrum of conditions ranging from asymptomatic diverticular disease, to symptomatic uncomplicated diverticular disease, and complicated diverticular disease that includes acute and chronic diverticulitis.

Diverticulosis most often is uncomplicated and asymptomatic. Between 10 and 25% of patients will develop acute diverticulitis (inflammation of the diverticula) in their lifetime.

Diverticular Disease

Diverticula of the large bowel are out-pouchings in the wall of the colon. Diverticular disease includes a spectrum of conditions ranging from asymptomatic diverticular disease, to symptomatic uncomplicated diverticular disease, and complicated diverticular disease that includes acute and chronic diverticulitis.

Diverticulosis most often is uncomplicated and asymptomatic. Between 10 and 25% of patients will develop acute diverticulitis (inflammation of the diverticula) in their lifetime.

Woman wearing a light blue t-shirt and dark blue jeans with her hands pressed towards her abdomen. The area of the stomach is being highlighted in red in order to simulate pain. Her face or bottom legs are not visible in the picture, the accent is on the abdomen.

Complications

Complications of diverticulitis include:

Abscess
Intestinal fistula
Intestinal perforation
Intestinal obstruction
Peritonitis
Sepsis and septic shock
Diverticular bleeding (more common in diverticulosis than diverticulitis)

Symptoms

Left lower quadrant pain is the most common presenting complaint and occurs in 70% of patients. Pain is often described as crampy and may be associated with a change in bowel habits. Other symptoms include nausea and vomiting, constipation, diarrhea, flatulence, and bloating.

Diagnosis

A computed tomography (CT) scan of the abdomen is considered the best imaging method to confirm the diagnosis.

Treatment

Most episodes of acute diverticulitis respond to medical treatment:

Antibiotics
Clear liquid diet
Pain-killers

After recovering from acute diverticulitis, patients should have their colons examined to rule out malignancy by colonoscopy or CT colonography (virtual colonoscopy).

Emergency surgery is performed when severe complications arise or when the patient does not respond to medical treatment.

Complications requiring surgical intervention include the following:

Purulent peritonitis
Uncontrolled sepsis
Fistula
Obstruction

In most cases surgery will involve bowel resection with the formation of a colostomy; this can be reversed later in the majority of cases.