Diverticulitis is a disease of the digestive tract — most commonly the large intestine — in which diverticula, or pouches, that have grown in the digestive tract become inflamed and, possibly, infected. The protrusion can lead to the bowels being obstructed or punctured, causing constipation, diarrhea, abdominal cramping and other pain. There is really only one type of diverticulitis, though it can vary in intensity and may affect just about any part of the digestive tract, including the stomach, bladder and esophagus. It is one of three diseases — including diverticulosis and fistula — on a spectrum of diverticular disease. Each is a separate condition, but one can progress to another.
Diverticulosis involves the bulging out of tissue pockets, or diverticula, from the walls of the intestine, most commonly in the colon. The cause of diverticulosis is unknown, but it is believed to be related to pressure within the walls of the intestine. Some researchers and physicians speculate that this pressure results from a low-fiber diet and lack of exercise. This condition can result in rectal bleeding when a small blood vessel in a diverticulum ruptures. If this occurs, the patient should seek medical attention, because surgery is sometimes necessary to stop the bleeding.
Diverticulitis results when the diverticula caused by diverticulosis become inflamed or infected. This infection can usually be cleared by treatment with antibiotics. If the infection goes untreated and gets worse, it can lead to abscess formations in the wall of the colon.
Fistulas are abnormal connections between two organs or between an organ and the skin. This happens more commonly when damaged tissues connect during infection. Therefore, if diverticulitis causes an infection that spreads outside the colon, a fistula may develop between the colon and nearby organs such as the bladder, small intestine and skin. This can be corrected surgically but also can result in a life-long increase in urinary tract infections.
Diverticulitis can lead to scarring when infected tissue heals. This scarring sometimes causes a partial or total block of the intestine. While partial blockage will benefit from treatment but is not an emergency, total blockage is a dangerous situation that requires emergency surgery.
Patients suffering from a diverticular disease can be treated in a variety of ways, though the recommended treatment usually depends on the severity of the condition. For mild diverticulitis, a liquid or low-fiber diet is prescribed to allow the colon to rest while the obstruction resolves; antibiotics also are recommended. A high-fiber diet will be prescribed once the condition is resolved to help prevent its return. Recurrent diverticular disease may require more advanced care, including a stricter antibiotic regimen and pain relievers.
For severe diverticulitis, hospitalization and surgery may be required. A perforation or fistula will also require surgery to correct the problem. In rare, severe cases, bowel resection may be necessary.
