If you are over the age of 60 you may be among millions of Americans who have a condition called diverticulosis. While most people with this condition do not have any noticeable problems, 10 to 25% will develop a more serious condition called diverticulitis1. Los Angeles colorectal surgeon Dr. Zuri Murrell specializes in treatment of this condition, which affects women more than men and which is more common in the Western world.
What is diverticulitis?
Diverticulitis starts when pouches called diverticula form within the lining of the colon. These pouches bulge outward at weak spots along the colon. This initial condition is called diverticulosis and for most people does not cause problems. When the pouches become inflamed or infected the condition is called diverticulitis and must be treated and carefully managed to both clear up infection and reduce inflammation. This not only gives patients relief from the pain and cramping that occurs with diverticulitis, but prevents more serious complications such as peritonitis. Peritonitis occurs when the pouches rupture leaking bacteria into the abdominal cavity. In this case immediate emergency medical treatment is necessary.
Causes of diverticulitis
While the cause of the preceding condition (diverticulosis) is linked to a diet low in fiber, there is a direct relationship to age and this disease. In the development of diverticulitis, there are several risk factors that are present in many cases seen by Dr. Murrell. These include:
- Lack of Exercise
- Low fiber diet high in animal fats
- Certain drugs such as opiates and steroids
Symptoms for diverticulitis can be similar to those from other digestive tract diseases such as stomach ulcers and irritable bowel syndrome. Dr. Murrell urges anyone with these symptoms to arrange an appointment so that proper diagnosis can be done.
Diverticulitis usually causes pain along the left side of the abdomen, which can last several days. People who experience pain along the right side should not dismiss it as unrelated to diverticulitis without having an examination.
Other symptoms are nausea and vomiting with or without a fever, tenderness around the abdomen and a change in bowel habits. White blood cell count can be high if infection is present. Constipation or diarrhea can be symptoms with most people having constipation and difficulty passing broken round shaped stools. Blood can sometimes be present with bowel movements.
Treatment of diverticulitis
Treatment options depend on the severity of the condition and whether or not it is done on an emergency basis. Emergency surgery is necessary in cases of peritonitis, which is very serious. Other situations requiring emergency surgery would be bleeding from the diverticula that is persistent or continues to occur over time.
Some treatment options are prescribed antibiotics, a change in diet and possibly bed rest. Severe pain may require a hospital stay and intravenous antibiotic treatment.
Surgical drainage or removal of infected material may be necessary in cases of a perforated abscess or if the colon has become obstructed from repeated incidents of diverticulitis.
Among the most common treatment for acute diverticulitis involves removing the affected section of the colon in a procedure called colon resection. This may require two surgeries if there is infection present to ensure successful repair of the colon. In that case a temporary colostomy is done which involves creating an opening in the abdomen and attaching a bag to the colon to collect fecal material while the colon itself is healing. Once infection is gone, the colostomy is reversed, the colon is reattached and in over 90% of cases, there is no recurrence of diverticulitis.
Dr. Murrell can use several tests to either confirm diverticulitis or to discover the source of the presented symptoms. After asking questions about bowel habits, medications, diet and exercise habits he can arrange further diagnostic tests, which can include:
- Blood test – to detect infection
- Stool sample – to detect bleeding in the digestive tract
- CT scan, X-ray, Ultrasound – to see inside the digestive tract
- Physical rectal exam – to check for blockage, pain and bleeding
- Colonoscopy – to detect diverticulitis and to screen for colon cancer
Anyone concerned about their digestive health should have an examination to determine the source of their pain, bloating, any bleeding and cramping. Dr. Murrell is a board certified colorectal surgeon practicing in Beverly Hills. He has many years of experience helping people overcome conditions that are a daily challenge. Not only is he praised for his clinical excellence, patients are put at ease immediately by his care and compassion.