6440-W10-D5.docx - Diverticulosis and Diverticulitis Diverticulosis or diverticular disease is the condition of having diverticula in the colon(Wilkins

6440-W10-D5.docx - Diverticulosis and Diverticulitis...

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Diverticulosis and Diverticulitis Diverticulosis or diverticular disease is the condition of having diverticula in the colon (Wilkins, Embry & George, 2015). Diverticulitis is inflammation of the diverticula. Diverticulitis can occur in the small and large intestine or the colon. It can occur at any age when diverticula are present. About 95% of the patients suffer from diverticulitis found in the sigmoid colon (Wilkins, Embry & George, 2015). Signs and Symptoms Patients with diverticulitis may present with fever, malaise, fatigue, nausea and vomiting, diarrhea, and dysuria, tachycardia, hypotension and constant left lower quadrant pain (LLQ) (Wilkins, Embry & George, 2015). Patients may have a history of diverticulosis or diverticulitis. The physical exam may reveal tenderness in the LLQ, abdominal distension and/or a palpable mass (Wilkins, Embry & George, 2015). Pathophysiology The existing concept in which dietary fiber is a protective factor against the formation of diverticula and consequent diverticulitis (Buttaro, Trybulski, Bailey & Sandberg-Cook, 2015). Low fiber diets reduce the amount of intraluminal bulk in the colon, causing muscle hypertrophy as the colon tries to push the bowel matter along. Over time, the wall of the colon is placed under frequent straining and ultimately, the submucosa and mucosa punch through the weakened muscular layer to form thin-walled sacs or diverticula. Diverticulitis occurs when diverticular sac can become inflamed and infected because undigested food deposits and bacteria get trapped in diverticular sacs. If diverticulitis occurs, bacterial invasion arises, and blood supply is mechanically compromised. If untreated, diverticulitis can progress to peritonitis, perforation, sepsis and life-threatening (Buttaro, Trybulski, Bailey & Sandberg-Cook, 2015). Three differential diagnoses Bowel obstruction : Diverticulitis can prevent the passage of stool and cause a blockage in the intestine which leads to a bowel obstruction (Welbourn & Hartley, 2015). Patient may present with bloating, abdominal pain and distention, thin stools, diarrhea and constipation, nausea and vomiting (Welbourn & Hartley, 2014). Ulcerative colitis (UC ): Ulcerative colitis is disease of the colon characterized by chronic inflammation (Adams & Bornemann, 2015). Patients with UC typically presents with fatigue, low grade fever, diarrhea with pus, mucus or blood and abdominal pain which can be sudden or gradual (Adams & Bornemann, 2015). Bacterial gastroenteritis: Bacterial gastroenteritis occurs when bacteria causes an inflammatory infection in colon (Barrett & Fhogartaigh, 2017). Patients with bacterial gastroenteritis may experience symptoms such as mild to severe abdominal cramping, diarrhea, blood in stools, fever, nausea and vomiting (Barrett & Fhogartaigh, 2017). Treatment With an acute diverticulitis attack, hospitalization is suggested for immunocompromised or diabetic patients (Buttaro, Trybulski, Bailey & Sandberg-Cook, 2015). Patients should immediately stop drinking/eating to prevent further strain on the inflamed colon. Hospital management consists of
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