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Diverticular Disease

Diverticular Disease

Diverticulosis of the colon: It is a precursor of diverticular disease and a common condition that is characterized by focal mucosal outpouchings (small pouches or sacs known as diverticula) from the colon.

While most patients with colonic diverticulosis are asymptomatic, some may experience symptoms due to complications such as infection, bleeding, and obstruction.

Diverticular disease encompasses a spectrum of conditions, including diverticulitis. Diverticulitis is a condition the focal mucosal outpouching(s) become infected or inflamed. Severe diverticulitis may result in abscess formation and/or perforation.

The symptoms of diverticular disease depends on the type and severity of complications arising from this condition.

Mild diverticulitis may present with mild to moderate abdominal pain, localized to the affected part of the colon, and fever. Severe or perforated diverticulitis is characterized by severe and/or generalized abdominal pain, and sepsis. Other symptoms include fatigue, nausea and vomiting.

Bleeding arising from colonic diverticular disease can range from small and self-limiting episodes to large volume bleeding with blood clots which will require urgent medical attention.

Other symptoms of colonic diverticular disease include bloating and change in bowel habit and/or stool calibre, which may warrant further investigations such as a computed tomography (CT) scan and/or colonoscopy.

Further complications of diverticular disease and diverticulitis include abscess formation, fistulation into adjacent organs such as bladder or small intestine, perforation, bleeding and intestinal obstruction.

Uncomplicated colonic diverticulosis does not require any treatment.

The treatment for diverticulitis may include the administration of antibiotics and a period of bowel rest. Localised abscesses may be amenable to percutaneous drainage under appropriate radiological guidance. Severe cases with sepsis may require surgery to resect the affected diseased segment of colon.