Diverticulosis

By a lack in the muscles of the intestinal wall especially with people becoming older and an increased pressure in the large intestine as well as an inherited metabolic disorder some kind of outpouchings only existing of intestinal mucosa can be developed. These outpouchings are called diverticulosis. Often affected is the ileum, also called sigma, that means an S-shaped area intestinal area n the lower underbelly.

Pathogenesis:
The reasons for the complaints are: wrong nutrition (less fibres and too much fat), inactivity, overweight, intestinal hypomotility together with congestion.

The diverticulosis is the most common disease of the large intestine amongst civilized countries and is increasing proportionally to the increasing of the age of a person (at an age of 60 about 40% of the people are affected.

Risks, intestinal perforation:
Complications like developing an abscess, bleedings, inflammation (= diverticulosis), ruptures (perforation of the large intestine with bowel evacuation, fistulas, ileus, gastrointestinal bleeding caused by diverticulosis.

Fiber-rich nutrition, plentiful fluid intake.

When suffering from already existing symptom-free diverticulosis: healthy nutrition, which means a slag-rich nutrition and plentiful fluid intake, if necessary intake of stabilizing agents, weigh reduction

In general: Please avoid the above mentioned causes of complaints.

Most of the patients (about 80%) suffer from no complaints.
Typical type of pain: pressure-sensitivity on the left side of the underbelly, fever

A close first examination including a interview and anamnesis of the patient
clinico-diagnostic laboratory, complete blood count CBC,
ultrasonography, X-ray examinations (if necessary), CAT scan of the abdomen, contrast enema of the colon

When suffering from diverticulosis: Part of the therapy is always a fiber-rich nutrition and a plentiful fluid intake, also dietary change.

When suffering from congestion (obstipation): eg. milk sugar (lactulosis)
When suffering from diverticulitis (accute inflammation):
low-fiber nutrition, antibiotics,
antiphlogistic medication (5-aminosalicylacids) or infusion therapy
Immobilization of the intestine, leave out nutrition
Antispasmodic medication and analgesic medication, perhaps operation

Surgical treatment:
Medical complications -> often in emergency case with a high-operational risk for the patient

Best-case scenario: reconcilement and consensus between the internist and the surgeon