What Is Diverticulitis?

Diverticulitis is an inflammation or infection that occurs in the Diverticula, the sacs that form along the digestive tract, especially in the large intestine ( colon ). The condition of the formation of diverticula in the wall of the large intestine is also called Diverticulosis. Diverticula are generally formed in people aged 40 Years and over because their intestines have weakened, and in people who rarely eat fibrous foods, such as vegetables and fruit.


Causes of Diverticulitis
The cause of diverticulitis is not known exactly, but it is thought that due to stool or undigested food is trapped inside the diverticula and clogs the diverticula. This blockage makes the diverticula swell and small tears in the large intestine wall arise. The normal large intestine bacteria in it also grow more than usual and can cause infection.

The formed diverticula also has no known cause. A diet that is low in fiber, constipation , and obesity is thought to be associated with the formation of diverticula in the large intestine.

In addition, there are several factors that can increase the risk of inflammation in diverticula, including:

• Age. The risk of getting diverticulitis will be higher as you age.
• Genetic factors. Genetics is believed to be associated with the occurrence of diverticulitis, as evidenced by diverticulitis that occurs in Asia more dominantly occurring on the right side, whereas in the United States more often occurs on the left side of the abdomen.
• Use of certain drugs. Regular use of aspirin and nonsteroidal anti-inflammatory drugs can increase the risk of diverticulitis.
• Obesity. Excess weight increases the risk of diverticulitis and bleeding.
• Low-fiber diet. In addition to the risk of developing diverticula, eating too little food containing lots of fiber risks creating inflammation in the formed diverticula.
• Smoke. Smoking can increase the risk and complications of diverticulitis.
• Lack of exercise. Exercise can reduce a person's risk of suffering from diverticulitis.

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Symptoms of Diverticulitis
Diverticulitis usually begins with symptoms of diverticulosis, which include:

• Abdominal pain . The pain will be felt just after eating or when moving.
• Constipation, diarrhea, or both.
• Flatulence or stomach feels full of gas.
• Sometimes defecation is accompanied by mucus.

Sometimes diverticulosis can occur without causing symptoms. However, diverticulosis that has undergone inflammation and becomes diverticulitis, will cause symptoms:

• Fever .
• Abdominal pain that is getting worse and more sustained.
• Nausea and vomiting.
• Bloody bowel movements.

Diagnosis of diverticulitis
The first step doctors make to diagnose diverticulitis is to examine the medical history and symptoms experienced by the patient.

Then, the doctor will do a physical examination, especially by examining the abdomen of the patient to detect the location of inflammation or infection in the abdominal cavity. The location of inflammation can be detected with pain when the stomach is pressed. The doctor will also do a digital rectal examination to see if there is bleeding.

The doctor will also do additional examinations to confirm the diagnosis. These additional checks include:

• Blood test. To see the possibility of infection or bleeding in the patient's large intestine, as well as examination of liver function to detect whether abdominal pain is caused by a liver disorder or not.
• Urine test. A urine test is performed to show whether the person has a urinary tract infection.
• Pregnancy test. To ensure that abdominal pain experienced by female sufferers is not caused by pregnancy.
• Faint blood test on stool samples. To check whether the patient's stool contains blood.
• CT scan. To show in detail the bags that have inflammation or infection and confirm the diagnosis. CT scans can also indicate the severity of diverticulitis.

Colonoscopy is not recommended when diverticulosis is inflamed, because the risk of tearing or rupture of inflamed diverticula. A colonoscopy is performed when the doctor wants to evaluate diverticulosis when not inflamed, or the doctor suspects a tumor in the large intestine.


Treatment of Diverticulitis
Handling of diverticulitis is usually done based on the severity of diverticulitis experienced by patients. If the patient experiences mild symptoms and there are no signs of complications, then the type of treatment that is carried out includes:

• The administration of drugs , namely antibiotics to treat infections and painkillers, such as paracetamol .
• A high-fluid and low-fiber diet. This diet is done until the pain has disappeared. When the pain has disappeared, slowly add fiber to the food.

If symptoms that are felt to be getting worse or diverticulitis have experienced complications, then the patient needs to get treatment at the hospital. Handling carried out, among others:

• Infusion of fluids and nutrients. To rest the intestines, patients will be asked to fast for a week. Nutrition and fluids will be given by IV.
• Injection antibiotics , to treat infections.
• Hose insertion into the stomach (NGT), this hose is usually given for feeding, but in the case of diverticulitis it aims to empty the stomach contents.
• Operation. The surgical procedure is performed by a surgeon , in patients who have disorders in the immune system, experience repeated diverticulitis, or complications occur. There are 2 types of diverticulitis surgical procedures, namely:
• Bowel resection and anastomosis. The surgical procedure is performed by removing the inflamed part of the intestine and reconnecting with the healthy part of the intestine (anastomosis).
• Bowel resection with a colostomy. If the inflammation area is large enough, the large intestine and rectum will be difficult to connect, the doctor will perform a colostomy procedure. After removing the inflamed intestine, a hole will be made on the abdominal wall to remove the stool, so that the person does not defecate through the anus.

Complications of Diverticulitis
Diverticulitis can cause serious complications, it can even threaten the lives of sufferers. Some types of complications that may arise include:

• An abscess appears when a collection of pus is formed in the intestinal sac (diverticula).
• Fistulas , appear when abnormal channels are formed between the large intestine and the bladder, vagina, or small intestine.
• Bowel obstruction, which is a narrowing that occurs in the large intestine due to inflammation, which causes blockage of the exit of the stool.
• Perforation and peritonitis, which is an inflammatory condition or infection in the abdominal cavity ( peritonitis ) that occurs due to tearing of the diverticula (perforation), thus spilling intestinal contents into the abdominal cavity.

Prevention of Diverticulitis
There are several ways you can do to prevent diverticulitis, including:

• Eat high-fiber foods. High-fiber foods are beneficial for digestive health and reduce pressure in the digestive tract. Some types of foods high in fiber, including wheat, oatmeal , vegetables, and fruits.
• Drink more water. Fiber works by absorbing water. If there is insufficient consumption of liquid to replace what has been absorbed, constipation can occur.
• Exercise regularly. Exercise can help maintain bowel function and reduce pressure in the large intestine. Perform regular exercise activities for at least 30 minutes every day.

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