Divertikuliit

Divertikuliit, or diverticulitis, is the inflammatory or infectious complication of diverticulosis of the colon. It occurs when one or more diverticula, small pouch-like outpouchings in the colonic wall, become inflamed. Most cases affect the sigmoid colon, but other sections of the colon can be involved.

Diverticula form when the inner lining of the colon protrudes through weak spots in the muscular layer, often as a result of increased colonic pressure. Risk factors include age, a diet low in dietary fiber, obesity, smoking, and certain medications such as nonsteroidal anti-inflammatory drugs. Many people with diverticulosis never develop diverticulitis.

Symptoms typically include lower-left abdominal pain that is steady and persistent, often with fever, chills, and changes in bowel habits such as constipation or diarrhea. Nausea may occur, and abdominal exam may reveal localized tenderness. Bleeding is less common with diverticulitis than with diverticulosis.

Diagnosis relies on clinical presentation and supporting tests. Blood tests frequently show elevated white blood cell count and inflammatory markers. The preferred imaging test is a CT scan of the abdomen and pelvis with contrast, which can confirm inflammation and identify complications such as abscess. Ultrasound may be used in some cases.

Treatment depends on severity. Uncomplicated diverticulitis is often managed as an outpatient with oral antibiotics, analgesia, and a gradual return to normal diet; some guidelines allow observation without antibiotics in selected patients. Hospitalization is needed for complicated disease, persistent fever, severe symptoms, or suspected perforation and may require IV antibiotics, bowel rest, abscess drainage, or surgical treatment such as resection in exceptional cases.

Prevention focuses on a high-fiber diet, adequate fluids, regular physical activity, weight management, and cautious use of NSAIDs. Most patients recover fully, though recurrence can occur.