Diverticular disease

High intra-lumen pressure (due to lack of fibre) cause protrusions of mucosa and submucosa through the bowel wall - commonly sigmoid colon (areas that are not covered by teniae coli). Common in developed world

Use of NSIADS increases the risk.

Bulk-forming laxatives should be used. Stimulant laxatives should be avoided.

 

• Asymptomatic 90-99%
• Cramping abdominal pain

Acute diverticulitis

• Pain and tenderness in the left iliac fossa
• Fever
• Diarrhoea, n&v,
• Rectal bleeding
• Raised CRP

 

Oral co-amox for 5-7 days, paracetamol, only take in clear liquids - avoid solid food until symptoms improve - 2-3 days

Acute complications

• Abscess
• Perforation + haemorrhage
• Peritonitis

Chronic Complications

• intestinal obstruction
• fistula