Intestinal diverticulitis is a disease characterized by inflammation of the diverticula. These are small hernia-like "sacs" of the mucous membrane, most often appear in the sigmoid and descending colon, but can affect the entire intestine. Sometimes there is an inflammation of the diverticula, and in some cases, infection.: this condition is diverticulitis. Another name for the disease is diverticular disease.
Stage IIb – Combined abscess with fistulization
Stage III – Generalized purulent peritonitis
Stage IV – Generalized fecal peritonitis
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The exact causes of diverticular disease are still unknown. Diverticula are most often formed when a person naturally has weak spots in the colon, and they succumb to pressure. This leads to hernia-like "pouches" protruding through the wall of the colon. When they rupture, there is inflammation of the diverticula and infection (that is, intestinal diverticulitis develops). Doctors identify several risk factors for the development of this pathology.
Older age: the incidence of diverticulitis increases with age.
Obesity: diverticulitis often occurs when you are overweight.
Smokers suffer from diverticulitis more often.
Diverticular disease can be triggered by a lack of physical activity. Regular exercise reduces the risk of developing this disease.
A diet high in animal fats and low in fiber is associated with the occurrence of this disease. It is believed that a low-fiber diet combined with a high intake of animal fats for a long time leads to increased pressure in the lumen of the colon, which provokes the formation of hernia-like "pouches".
Diverticulitis provokes the regular use of certain medications (these are steroids, opioids, and nonsteroidal anti-inflammatory drugs).
The symptoms of this disease increase over time. When diverticular inflammation occurs, symptoms such as abdominal pain appear, which can be permanent and persist for several days. Other common symptoms are nausea and vomiting, fever, constipation and diarrhea (less common).
In acute diverticulitis, an abscess is possible – the diverticula become inflamed and pus accumulates in them. Inflammation leads to intestinal obstruction, which is caused by scarring. Fistulas (abnormal passages) may also occur between parts of the intestine and other organs. Another serious complication in the acute course of the disease is peritonitis, which can occur if an infected or inflamed diverticulum ruptures and the contents of the intestine enter the abdominal cavity. Peritonitis is manifested by acute symptoms (nausea, vomiting, severe abdominal pain) and requires urgent medical attention.
If diverticulitis is suspected, the patient undergoes a colonoscopy. A camera is inserted through the anus, which allows you to visualize the intestine and assess its condition (the entire colon and the final section of the small intestine). With the help of a colonoscopy, it is possible to identify the presence of hernia-like "pouches" and determine the size of their gates, the condition of the wall, and the exact location. If other suspicious changes in the intestine are detected, colonoscopy allows you to take a biopsy to send the material for histological examination.
Another important study for diverticulitis is irrigoscopy. This method allows you to determine the number of hernia-like "pouches", their exact location, size and shape. The essence of the procedure is to inject a radiopaque preparation into the colon, after which a series of X-ray images are performed, which make it possible to assess the condition of the colon. Computed tomography (CT) scans can be used to assess the condition of the intestinal walls, identify the presence of intraluminal neoplasms and the condition of surrounding tissues. Most often, this study is performed to determine the exact cause of abdominal pain and diagnose diverticular disease.
This disease can be treated with medication. Depending on the complexity of the disease, the patient may be offered surgical treatment.
If the patient went to the doctor in a timely manner with this disease and it did not begin to progress, it is optimal to start treatment with medication. Diverticulitis can be cured with the help of antibacterial and anti-inflammatory therapy. Treatment involves hospitalization: during this period, highly qualified clinic staff will monitor the patient's health and condition at the EMC. Treatment consists of the selection of individual antibacterial therapy, anti-inflammatory therapy, correction of the water-electrolyte balance. The patient also follows a special diet. After 5-7 days, he is discharged with recommendations on diet and further lifestyle.
If conservative treatment is ineffective, the diverticula are destroyed. The doctor can see this process using any imaging method (ultrasound, CT, MRI). Planned surgical treatment is most often recommended in this case.
Diverticulitis requires removal of the affected part of the intestine. Most often it is the sigmoid and descending colon. Open, laparoscopic, and robotic surgeries are performed at the EMC to resect the affected area of the intestinal tube. Depending on the results of the examination, age and the presence of chronic diseases, the method suitable for the patient is selected.
During a robotic operation, the damaged part of the intestine is removed using a high-tech Da Vinci robot operated by a surgeon. The robot is equipped with miniature instruments and high-resolution optics. This method also does not require large incisions and long rehabilitation.
In difficult cases and with a large percentage of intestinal damage, open surgery may be required. Regardless of the complexity of the chosen method of surgery, the EMC surgeon will strive for the minimum possible injury of the treatment, the shortest possible period of hospitalization, and a good cosmetic effect.
After surgery, intra-abdominal bleeding, infectious complications, peritonitis, anastomosis failure, and others are possible. An individual approach to each patient, who is treated by a multidisciplinary team of doctors, allows to avoid complications in the EMC. Before surgery, the patient is advised by doctors of various specialties (surgeons, internists, cardiologists, anesthesiologists, and others). Before surgical treatment, each patient undergoes a comprehensive examination, doctors collectively assess the risks and make a collective decision on the surgical intervention and the most appropriate method. EMC operations are performed by doctors with extensive experience in the surgical treatment of this disease.
It is necessary to exercise regularly: physical exercises contribute to the normal functioning of the intestine and reduce the pressure inside the colon. Increase the amount of fiber consumed: a diet high in complex carbohydrates reduces the risk of developing this disease. Fiber-rich foods such as fresh fruits, vegetables, and whole grains. Drink enough fluids and maintain a water balance: fiber absorbs water and increases the amount of soft, bulky waste in the colon. Constipation is possible without sufficient fluids.
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