User:Mr. Ibrahem/Diverticulitis
| Diverticulitis | |
|---|---|
| Other names | Colonic diverticulitis |
 | |
| Section of large bowel (sigmoid colon) showing multiple pouches (diverticula). The diverticula appear on either side of the longitudinal muscle bundle (taenium) which runs horizontally across the specimen in an arc. | |
| Specialty | General surgery |
| Symptoms | Abdominal pain, fever, nausea, diarrhea, constipation, blood in the stool[1] |
| Complications | Abscess, fistula, bowel perforation[1] |
| Usual onset | Sudden, age > 50[1] |
| Causes | Uncertain[1] |
| Risk factors | Obesity, lack of exercise, smoking, family history, nonsteroidal anti-inflammatory drugs[1][2] |
| Diagnostic method | Blood tests, CT scan, colonoscopy, lower gastrointestinal series[1] |
| Differential diagnosis | Irritable bowel syndrome[2] |
| Prevention | Mesalazine, rifaximin[2] |
| Treatment | Antibiotics, liquid diet, hospital admission[1] |
| Frequency | 3.3% (developed world)[1][3] |
Diverticulitis, specifically colonic diverticulitis, is a gastrointestinal disease characterized by inflammation of abnormal pouches—diverticula—which can develop in the wall of the large intestine.[1] Symptoms typically include lower abdominal pain of sudden onset, but onset may also occur over a few days.[1] There may also be nausea; and diarrhea or constipation.[1] Fever or blood in the stool suggests a complication.[1] Repeated attacks may occur.[2]
The causes of diverticulitis are uncertain.[1] Risk factors may include obesity, lack of exercise, smoking, a family history of the disease, and use of nonsteroidal anti-inflammatory drugs (NSAIDs).[1][2] The role of a low fiber diet as a risk factor is unclear.[2] Having pouches in the large intestine that are not inflamed is known as diverticulosis.[1] Inflammation occurs in between 10% and 25% at some point in time, and is due to a bacterial infection.[2][4] Diagnosis is typically by CT scan, though blood tests, colonoscopy, or a lower gastrointestinal series may also be supportive.[1] The differential diagnoses include irritable bowel syndrome.[2]
Preventive measures include altering risk factors such as obesity, inactivity, and smoking.[2] Mesalazine and rifaximin appear useful for preventing attacks in those with diverticulosis.[2] Avoiding nuts and seeds as a preventive measure is no longer recommended since there is no evidence these play a role in initiating inflammation in diverticula.[1][5] For mild diverticulitis, antibiotics by mouth and a liquid diet are recommended.[1] For severe cases, intravenous antibiotics, hospital admission, and complete bowel rest may be recommended.[1] Probiotics are of unclear value.[2] Complications such as abscess formation, fistula formation, and perforation of the colon may require surgery.[1]
The disease is common in the Western world and uncommon in Africa and Asia.[1] In the Western world about 35% of people have diverticulosis while it affects less than 1% of those in rural Africa,[4] and 4 to 15% of those may go on to develop diverticulitis.[3] In North America and Europe the abdominal pain is usually on the left lower side (sigmoid colon), while in Asia it is usually on the right (ascending colon).[2][6] The disease becomes more frequent with age, being particularly common in those over the age of 50.[1] It has also become more common in all parts of the world.[2] In 2003 in Europe, it resulted in approximately 13,000 deaths.[2] It is the most frequent anatomic disease of the colon.[2] Costs associated with diverticular disease were around US$2.4 billion a year in the United States in 2013.[2]
References[edit]
- ^ a b c d e f g h i j k l m n o p q r s t u v "Diverticular Disease". www.niddk.nih.gov. September 2013. Archived from the original on 13 June 2016. Retrieved 12 June 2016.
- ^ a b c d e f g h i j k l m n o p Tursi, A (March 2016). "Diverticulosis today: unfashionable and still under-researched". Therapeutic Advances in Gastroenterology. 9 (2): 213–28. doi:10.1177/1756283x15621228. PMC 4749857. PMID 26929783.
- ^ a b Pemberton, John H (16 June 2016). "Colonic diverticulosis and diverticular disease: Epidemiology, risk factors, and pathogenesis". UpToDate. Archived from the original on 2017-03-14. Retrieved 13 March 2017.
- ^ a b Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. Churchill Livingstone. 2014. p. 986. ISBN 9781455748013. Archived from the original on 2016-08-08.
- ^ Young-Fadok, TM (October 2018). "Diverticulitis". New England Journal of Medicine. 379 (17): 1635–42. doi:10.1056/NEJMcp1800468. PMID 30354951.
- ^ Feldman, Mark (2010). Sleisenger & Fordtran's Gastrointestinal and liver disease pathophysiology, diagnosis, management (9th ed.). [S.l.]: MD Consult. p. 2084. ISBN 9781437727678. Archived from the original on 2016-08-08.