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British Journal of Nursing (Mark Allen... Feb 2023Diverticulosis and the subsequent progression to diverticular disease and diverticulitis is becoming more prevalent in western countries. The cause for this progression...
Diverticulosis and the subsequent progression to diverticular disease and diverticulitis is becoming more prevalent in western countries. The cause for this progression is not known. Diverticulitis is a significant health burden - both financially to healthcare systems, and to the patients it affects in terms of morbidity. There is a dearth of research pertaining to diverticulitis and its impact on continence. This article examines the parallels between irritable bowel syndrome and diverticular disease, which have many symptom similarities, the overlap between the conditions, and the impact on continence. Current studies regarding the role of fibre in managing diverticular disease are also discussed.
Topics: Humans; Diverticulitis; Diverticular Diseases; Irritable Bowel Syndrome
PubMed: 36828565
DOI: 10.12968/bjon.2023.32.4.168 -
Journal of Clinical Gastroenterology 2008The understanding of diverticulitis has advanced little beyond the initial postulates of Burkitt and Painter who proposed that diverticular disease results from a... (Review)
Review
The understanding of diverticulitis has advanced little beyond the initial postulates of Burkitt and Painter who proposed that diverticular disease results from a deficiency of dietary fiber. Diverticular disease and diverticulitis are viewed simply as a consequence of a diet, which takes in relatively little fiber. Our understanding of diverticulitis has not advanced beyond these basic concepts. As many as two-thirds of individuals in the West have diverticular disease by the age of 85 years, but only 10% to 25% will manifest any related clinical symptoms. Other than age, several risk factors have been identified for the development of diverticular disease and diverticulitis. In particular, obesity and red meat intake are risk factors. Smoking is more controversial and alcohol, coffee, and caffeine have not shown to be risk factors. Vegetable intake, a strict vegetable diet, and increased fiber intake decreases the risk of development of diverticular disease, as well as diverticulitis. Physical activity also seems protective. Despite these evidences, the risk factors and pathophysiology progression from asymptomatic diverticular disease to diverticulitis have been inadequately studied. This subject is reviewed in more detail in this manuscript.
Topics: Diverticulitis; Female; Humans; Intestines; Male; Risk Factors
PubMed: 18936649
DOI: 10.1097/MCG.0b013e318188adb1 -
MMW Fortschritte Der Medizin Jun 2017
Review
Topics: Abdomen; Abdominal Pain; Administration, Oral; Anti-Bacterial Agents; Disease Progression; Diverticulitis; Humans; Insurance, Health; Male; Middle Aged; Nausea; Ultrasonography
PubMed: 28608069
DOI: 10.1007/s15006-017-9790-3 -
Radiologic Clinics of North America Jul 1989Diverticulitis can be detected accurately by computed tomography (CT) and staged according to an established system that is meaningful to both radiologists and surgeons.... (Review)
Review
Diverticulitis can be detected accurately by computed tomography (CT) and staged according to an established system that is meaningful to both radiologists and surgeons. Diverticulitis limited to the wall of the sigmoid colon or small diverticular abscesses contained within the pericolic mesentery generally respond well to antibiotic therapy; larger abscesses must be drained. CT-guided catheter drainage is an effective method to treat these large diverticular abscesses. Overall management is simplified since one-stage sigmoid resection can be performed electively on a nonseptic patient. High-risk patients may be spared surgery entirely in selected cases.
Topics: Diverticulitis; Humans; Tomography, X-Ray Computed
PubMed: 2657852
DOI: No ID Found -
Digestive and Liver Disease : Official... Jul 2004Diverticular disease, and particularly diverticulitis, has increasing incidence in industrialised countries. Diverticular disease can be classified as symptomatic... (Review)
Review
Diverticular disease, and particularly diverticulitis, has increasing incidence in industrialised countries. Diverticular disease can be classified as symptomatic uncomplicated disease, recurrent symptomatic disease, and complicated disease. Conservative or medical management is usually indicated for acute uncomplicated diverticulitis. Indications for surgery include recurrent attacks and complications of the disease. Surgical treatment options have changed considerably over the years along with the inventions of new diagnostic tools and new surgical therapeutic approaches. Indications and timing for surgery of diverticular disease are determined mainly by the stage of the disease. In addition to this major factor, the individual risk factors of the patient along with the course of the disease after conservative or operative therapy do play a big role in decision-making and treatment of this disease. In this context, the purpose of this article is to review the surgical treatment of diverticulitis with regard to indications, timeliness of operative intervention, operative options and techniques, and special circumstances.
Topics: Digestive System Surgical Procedures; Diverticulitis; Diverticulitis, Colonic; Humans
PubMed: 15285520
DOI: 10.1016/j.dld.2004.03.001 -
Southern Medical Journal Jan 2000We report the case of a 56-year-old man with episodic right lower quadrant abdominal pain. Preoperative evaluation included computed tomography (CT) showing a right...
We report the case of a 56-year-old man with episodic right lower quadrant abdominal pain. Preoperative evaluation included computed tomography (CT) showing a right lower quadrant phlegmon consistent with cecal diverticulitis or appendicitis. The patient was treated with a short course of bowel rest and antibiotics. Four weeks later, he had an appendectomy. The patient was found to have chronic appendiceal diverticulitis and recovered uneventfully. Histopathologic studies revealed herniated mucosa through the muscular layer associated with chronic inflammation and marked fibrosis. These findings represent appendiceal diverticulitis. Diverticulosis of the appendix is believed to be uncommon and roentgenologic diagnosis of appendiceal diverticular disease is rarely made. We discuss the diagnosis and CT findings of appendiceal diverticulitis and present a thorough review of the literature.
Topics: Appendectomy; Appendix; Cecal Diseases; Diverticulitis; Humans; Male; Middle Aged
PubMed: 10653074
DOI: No ID Found -
Der Internist Jun 2005Alterations in the colon wall, motility disorders, and certain nutritional habits are the essential factors in the development of colon diverticula. Thus, with advancing... (Review)
Review
Alterations in the colon wall, motility disorders, and certain nutritional habits are the essential factors in the development of colon diverticula. Thus, with advancing age this results in a high incidence in Western industrialized countries. The clinical picture is usually one of symptom-free diverticulosis. Diverticular disease can be associated with minor symptoms, but in complicated cases with diverticulitis and diverticular hemorrhage, it is potentially fatal. Further complications include abscess formation, fistula development, and obstruction. Barium double-contrast imaging exhibits the highest diagnostic sensitivity in diverticulosis but is contraindicated in cases of suspected complicated diverticular disease due to the danger of perforation. In these instances, sonography, computed tomography, or magnetic resonance imaging are performed. For diverticular hemorrhage, coloscopy not only represents a possible diagnostic tool but also a therapeutic option for various techniques of hemostasis. Treatment of diverticulitis and its complications requires careful consideration of conservative and surgical approaches and close interdisciplinary cooperation.
Topics: Diverticulitis; Diverticulum; Humans; Practice Guidelines as Topic; Practice Patterns, Physicians'
PubMed: 15875148
DOI: 10.1007/s00108-005-1403-z -
Journal de Chirurgie Jan 2004Diverticulitis involving the right colon is uncommon in the Occident; only one case for every 300 cases of appendicitis occurs in Western countries compared to a ratio... (Review)
Review
Diverticulitis involving the right colon is uncommon in the Occident; only one case for every 300 cases of appendicitis occurs in Western countries compared to a ratio of 1/40-1/180 in Asia. The preferential localization of diverticula in the right colon among Asiatics is probably due to genetic factors. In Asia as in the West, a right colon diverticulum is more likely to cause hemorrhage than diverticulitis. The peak age of symptoms is 40-45 years and the sex ratio is 1:1. The patient most commonly presents with symptoms suggestive of acute appendicitis, acute localized peritonitis, or, more rarely, a psoas abscess. Clinical exam reveals an inflammatory mass in the right lower quadrant in 30% of cases; diffuse peritonitis, large abscesses, and fistulae are rare. Helical CT scan is the best tool for establishing the diagnosis and also helps to rule out other possible etiologies in the differential diagnosis-particularly a perforated right colon cancer. In noncomplicated cases with convincing evidence for the diagnosis by CT scan, a conservative (non-surgical) treatment with antibiotics is possible; a later stage colonoscopy will rule out other colonic lesions. More commonly, the correct diagnosis is only made after embarking on an appendectomy via a McBurney incision; the surgical strategy thereafter depends on the level of suspicion regarding the diagnosis and the extent and complexity of the diverticulitis. Therapeutic options may be conservative (appendectomy), limited (diverticulectomy, or extensive (ileocecal resection or right hemicolectomy). For complicated disease (abscess, localized perforation), an aggressive surgical approach is warranted. Surgical strategies need to be validated, particularly in the light of the increasing use of the laparoscopic approach for suspected appendicitis.
Topics: Colon; Colonic Diseases; Diagnosis, Differential; Diverticulitis; Humans
PubMed: 15029058
DOI: 10.1016/s0021-7697(04)95288-x -
ANZ Journal of Surgery Oct 2022
Topics: Digestive System Surgical Procedures; Diverticulitis; Diverticulitis, Colonic; Humans; Intestinal Perforation; Jejunal Diseases; Jejunum
PubMed: 35080326
DOI: 10.1111/ans.17511 -
The American Journal of Gastroenterology Apr 2023
Topics: Humans; Diverticulitis; Anti-Bacterial Agents; Diverticulitis, Colonic; Acute Disease
PubMed: 36434810
DOI: 10.14309/ajg.0000000000002073