Diverticulitis
Inflammation or infection of small pouches (diverticula) that form in the walls of the colon.
Overview
Diverticulitis is inflammation/infection of diverticula (outpouchings) in the colon, most commonly the sigmoid colon. While most episodes resolve with antibiotics, complicated diverticulitis (abscess, perforation, fistula, stricture) requires surgical intervention.
Causes
- Diverticula (outpouchings in colon wall)
- Obstruction of diverticulum by fecal material
- Microperforation leading to inflammation
- Low-fiber diet leading to high intraluminal pressure
Risk Factors
- Age over 50
- Low-fiber diet
- Obesity
- Sedentary lifestyle
- Smoking
- NSAID use
- Immunosuppression
Symptoms
Diagnosis
- CT abdomen with contrast (gold standard — shows inflammation, abscess, perforation)
- Blood tests (elevated WBC, CRP)
- Colonoscopy (6-8 weeks after acute episode — to rule out cancer)
- Hinchey classification for severity
Treatment Options
Surgical Treatment
Surgery is indicated for: recurrent episodes (>2 complicated attacks), Hinchey III-IV (purulent/fecal peritonitis), fistula formation (colovesical, colovaginal), or stricture causing obstruction. Elective laparoscopic sigmoid colectomy with primary anastomosis is preferred. Emergency surgery may require Hartmann's procedure.
Recovery
Elective sigmoid colectomy: 4-6 days hospital stay, full recovery 3-4 weeks. Emergency Hartmann's: longer recovery, stoma reversal in 3-6 months. Post-surgery: high-fiber diet, regular follow-up.
Prevention
- High-fiber diet (30g/day)
- Regular exercise
- Maintain healthy weight
- Adequate hydration
- Avoid smoking
- Limit red meat
Frequently Asked Questions
Do all diverticulitis episodes need surgery?
Can I prevent diverticulitis from recurring?
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