A Diverticulitis is
an inflammation of the intestine bulges. These small, balloon-shaped
structures are also called diverticula. They do not protrude into the
inside of the intestine, but rather turn outwards - in those places in the
intestinal wall in which there are gaps in the muscles. The protuberances
almost always develop in the penultimate part of the colon. Diverticulitis
particularly often affects the so-called sigma - a 40 to 50 centimeter long
S-shaped section of the large intestine. This is where the intestinal
contents exert the greatest pressure on the intestinal wall.
Doctors differentiate between the following three
clinical pictures: techwadia
- Diverticulosis : The protuberances develop in several places on the
intestinal wall. The condition is one of the most common benign
changes in the digestive tract. Diverticula in the intestine are
harmless in most cases. In more than 80 percent of all cases, they do
not cause symptoms and do not need to be treated by doctors.
- Diverticular disease: The protuberances caused symptoms similar to those
of irritable bowel syndrome . Examples
are abdominal pain and gas .
- Diverticulitis : The protrusions have become inflamed and cause
discomfort. Stool particles containing bacteria accumulate in the
diverticula. These press on the intestinal wall, irritate it and
bacteria cause inflammation.
Acute and chronic diverticulitis
Doctors differentiate between two forms - acute and
chronic diverticulitis, depending on the duration and complications.
- Acute
diverticulitis : In most cases, only one diverticulum
and the adjacent intestinal areas are inflamed. There are different
stages: In uncomplicated diverticulitis, the inflammation is still limited
to the colon wall and no complications have arisen. In complicated
diverticulitis, however, the inflammation has already caused
complications, such as fistulas or a perforated bowel . However,
this only occurs in about five percent of patients.
- Chronic
diverticulitis : The inflammation is permanent or keeps
flaring up. Doctors refer to the latter as chronic recurrent
diverticulitis. There are chronic courses that do not cause
complications and others in which the colon wall changes anatomically as a
result of the regular inflammation. It can thicken and narrowing
(stenoses) can occur in the intestinal space due to the scarred
tissue. In the worst case, the intestinal obstruction (ileus)
occurs. This is an emergency and
doctors must treat it immediately with surgery! Sometimes
channel-like connecting passages (fistulas) to other sections of the
intestine or organs such as the urinary bladder are formed.
Diverticulitis: causes and risk factors
The causes of diverticulitis can be
different. However, diet plays a
central role . Because a diet low in fiber promotes the formation of
bulges in the intestines. It is the "most important risk factor for
diverticular disease", explains the German Society for Gastroenterology,
Digestive and Metabolic Diseases (DGVS).
This is how diet, fiber, and diverticulitis are related
- Dietary
fiber binds water in the digestive
tract. This makes the chair softer and more voluminous. It can
then be transported more easily through the digestive tract and there is
less pressure on the intestinal wall.
- Low-fiber foods, on the other hand, make the stool hard and
firm. It stays in the intestine longer and can lead to constipation . In addition, the hard manure
has a smaller volume. Therefore, the intestinal muscles have to exert
more pressure to move the stool through the intestinal passage. If
the connective tissue in the intestine is weaker in some places, the
intestinal wall can bulge outwards there - sack-shaped protuberances, the
diverticula, develop. If stool containing bacteria builds up there,
diverticulitis can develop.
The fact that diet plays a special role in
diverticular disease can also be seen in historical developments: for around
100 years, the number of diverticulitis patients in western industrialized
countries has increased sharply, parallel to the change in the eating habits of
many people.
Today these often look like this:
- Fruits, vegetables and whole grain products, which contain a lot of
fiber, are too seldom on the plate.
- Instead, pizza, french fries, burgers or other ready-made meals
that hardly contain any fiber are on the menu.
- The consumption of red meat, such as pork, beef, veal and lamb, has
also increased enormously. A high consumption of meat is also
considered a risk factor for the development of intestinal diverticula. Vegetarians
and vegans are much less likely to get it. This is shown by various
studies, such as the Health Professionals Follow-Up Study of the Harvard
School of Public Health (USA).
Diverticulitis: Other Causes
In addition, other risk factors are known that
increase the risk of diverticulitis. These include, for example:
- Age : In many people, the connective tissue becomes weaker as
they grow older . One in ten
people over 50 is affected by diverticula, and one in three over the age
of 60. More than 60 percent of those over 70 have such benign changes
in their intestines. However, younger people can also have less
elastic connective tissue. The predisposition for this can be
inherited.
- Obesity (often a result ofpoornutrition) andlack of exercise - low physical activity also
affects bowel function.
- Painkillers : Frequent use of painkillers from the group of nonsteroidal
anti-inflammatory drugs (NSAIDs) can promote inflammation in the
intestines. Active ingredients from this group are, for example,
ibuprofen, diclofenac and acetylsalicylic acid (ASA).
Diverticulitis: symptoms
Diverticulitis can cause a variety of
symptoms. They can be of different strengths. The following symptoms
are common in acute diverticulitis:
- Pain that occurs suddenly, persists and mostly affects the
left lower abdomen. But they can also occurs on the right in the
middle or lower abdomen. Often the pain intensifies when eating and
improves after a bowel movement or after the passage of intestinal winds. The
pain can also increase with physical activity. They can also radiate
into other parts of the body. For example, some people feel pain in
their back when they have diverticulitis.
- Hardened
structures ("rollers") in the abdomen,
which are associated with pressure pain
- Feeling sick
- fever
- Stool
irregularities such as constipation (sheep
droppings-like stools are also possible), diarrhea and
flatulence
- An
urge to defecate , which can be very painful
- Nausea, vomiting
- Loss of appetite
Chronic diverticulitis: symptoms
Chronic diverticulitis can cause complications and
the following symptoms:
- Blood
in the stool (diverticular bleeding )
- Bleeding from the rectum (rectal bleeding)
- Intestinal constriction (stenosis) up to intestinal obstruction
(ileus)
- Intestinal tear (perforation)
- Inflammation of the peritoneum (peritonitis)
- Abscesses - encapsulated collections of pus
- Fistulas - canal-like connecting ducts between the inflamed
diverticulum and other areas of the intestine or neighboring
organs. If the urinary bladder is affected, a bladder infection can develop. When the
vagina is involved, genital pain (including during intercourse) may occur
- Visible blood in the urine
