Diverticulitis

Sometimes small bumps grow in your gut.

These bumps are part of your large intestine. Usually, these bumps do not hurt. But sometimes, they can get red and sore. This is caused by a tiny infection.

When they are sore, your belly might hurt. You might also feel sick or have a fever. Doctors use special scans to see the bumps. Most people feel better with medicine and rest. It is good to eat fruits and vegetables.

Sometimes, small pouches grow in the wall of the large intestine. We call these pouches diverticula. Having these pouches is called diverticulosis. Most of the time, they do not cause any trouble.

But sometimes, these pouches can get red and sore. This is called diverticulitis. It happens when a bacterial infection occurs in the pouches. This can cause sudden pain in the belly. In North America, the pain is usually on the left side. In Asia, the pain is often on the right.

People might also feel sick, have a fever, or see blood. Doctors use a CT scan to see the pouches. A CT scan is a special way to take pictures of the body.

Some people have mild cases. They may need medicine or a liquid diet. Other cases are more serious. They might need to stay in a hospital. Some people may even need surgery. To stay healthy, it helps to eat fruits and vegetables. It also helps to avoid too much red meat.

Diverticulitis is a disease that affects the large intestine. It happens when small pouches called diverticula become inflamed. These pouches are little bulges in the wall of the gut.

Having these pouches without any soreness is called diverticulosis. Many people have these pouches but never feel sick. However, diverticulitis can cause sudden pain in the lower belly. This pain is the most common sign of the disease.

How the disease works involves a bacterial infection. The inflammation happens inside those small pouches. This process can lead to many different feelings. Some people feel nausea or have a fever. Others might deal with diarrhea or constipation.

Sometimes, the pouches can even rupture or break. This is a serious complication called a perforation. If the infection spreads, it can cause peritonitis. This is when the lining of the belly becomes inflamed.

Doctors use special tools to find out what is happening. A CT scan is the main way to see the colon. This machine takes detailed pictures of the inside of the body.

Doctors may also use an ultrasound to look at the bowel wall. They look for thickening or swelling in the area. Blood tests can also show if a person has a high white blood cell count. This helps them know if there is an infection. Some doctors might use a colonoscopy to look inside as well.

This condition is very common in the Western world. About 35% of people in these areas have diverticulosis. In contrast, less than 1% of people in rural Africa have it. The disease is more common as people get older. For people under 40, the rate is about 5%. For those over 60, it can reach 50%. In 2003, it caused about 13,000 deaths in Europe. In 2013, it cost the United States about $2.4 billion a year.

Many things can change how much risk a person has. Eating a diet with fruits and vegetables may help. Some studies show that too much red meat is a risk factor.

It is also helpful to stay active and avoid smoking. Scientists are still learning about how much fiber matters. They also found that avoiding nuts and seeds is not necessary. This is because there is no evidence they cause the pouches to get sore. Being healthy in these ways can help protect the gut.

Diverticulitis is a gastrointestinal disease involving the large intestine. It occurs when small, abnormal pouches called diverticula become inflamed or infected. Having these pouches without any active inflammation is a separate condition known as diverticulosis. While many people live with diverticulosis without any issues, diverticulitis can cause significant medical problems. It is currently the most frequent anatomic disease of the colon.

The mechanism of diverticulitis involves a bacterial infection within these pouches. Scientists believe the process may start due to changes inside the colon. For example, high pressures from abnormally vigorous contractions may play a role. In the colon, right-sided diverticula are considered micro-hernias of the mucosa and submucosa. These occur where blood vessels penetrate the muscular layer. In contrast, left-sided diverticula are called pseudodiverticula because the herniation does not pass through all layers of the colon. When bacteria infect these areas, inflammation occurs.

Doctors classify the severity of the disease into different stages. Uncomplicated diverticulitis is localized inflammation without an abscess or perforation. Complicated diverticulitis includes more serious issues like an abscess or a fistula. A fistula is an abnormal connection between the colon and an adjacent organ. One widely used system is the German Classification. Stage 0 is asymptomatic diverticulosis. Stage 1a is uncomplicated diverticulitis. Stage 2b involves an abscess larger than one centimeter. Stage 3c describes relapsing diverticulitis that includes complications.

Diagnosis often relies on medical imaging to see the internal structure of the gut. A computed tomography scan, or CT scan, is the mainstay for diagnosing the condition.

CT scans can reveal localized thickening of the colon wall. They also show if inflammation has extended into the surrounding fat. Ultrasound is another tool used for preliminary investigation. It can show a thickened bowel wall or an obstructive fecalith. Doctors also look for elevated C-reactive protein and high white blood cell counts in blood tests. During the acute phase, doctors avoid using a colonoscopy because of the risk of perforation.

There is a wide range of symptoms depending on the individual. Most people experience a sudden onset of lower abdominal pain. In North America and Europe, this pain is usually on the left lower side in the sigmoid colon. In Asia, the pain is typically on the right side in the ascending colon. Other symptoms include fever, nausea, diarrhea, or constipation. Blood in the stool or fever can suggest a complication. About 5% of people experience a variant called smoldering diverticulitis. This involves frequent relapsing symptoms without progression to major complications.

Research has identified several risk factors and patterns related to the disease. Genetics play a major role, with one review estimating that 50% of the risk is attributable to genetic factors. Other risks include obesity, smoking, and physical inactivity. Diet is a complex topic in medical research. A 2017 analysis found that diets high in red meat, refined grains, and high-fat dairy were linked to increased risk. Conversely, diets high in fruits, vegetables, and whole grains were associated with a decreased risk. Interestingly, there is no evidence that avoiding nuts and seeds prevents inflammation. In fact, some studies suggest nuts and corn might help adult males avoid diverticulitis.

Significant statistics highlight the global impact of this disease. Diverticulitis is very common in the Western world, where about 35% of people have diverticulosis. In rural Africa, however, it affects less than 1%. The disease also becomes much more frequent as people age. It affects only about 5% of people under age 40, but rises to 50% for those over 60. The economic impact is also large. In 2013, the costs associated with diverticular disease were approximately US$2.4 billion in the United States. In Europe, the disease resulted in about 13,000 deaths in 2003.