Diverticulitis is a common digestive condition characterized by the inflammation of small, bulging pouches (diverticula) that can form in the lining of the large intestine. While many individuals with these pouches, a condition known as diverticulosis, experience no symptoms, inflammation can lead to acute pain and other issues. Although most cases of diverticulitis are mild and resolve with conservative treatment, severe complications can rarely lead to life-threatening situations.
Understanding Diverticulitis
Diverticulosis is the presence of small pouches (diverticula) in the colon without inflammation. These pouches are common, especially in individuals over 50, often forming in the lower large intestine. Diverticulitis occurs when a diverticulum becomes inflamed or infected, often due to trapped stool or food particles leading to bacterial overgrowth and irritation.
Symptoms typically include abdominal pain, most often on the lower left side, ranging from mild to severe. Other common symptoms are nausea, fever, chills, and changes in bowel habits like constipation or diarrhea. These usually indicate uncomplicated diverticulitis.
Life-Threatening Complications
One severe complication is perforation, where an inflamed pouch ruptures, spilling intestinal contents and bacteria into the abdominal cavity. This can quickly lead to peritonitis, a severe inflammation of the abdominal lining that is a medical emergency requiring immediate attention and potentially fatal.
Another serious complication is an abscess, a localized pocket of pus from infection. An abscess causes pain and fever, and if it ruptures, it can also lead to peritonitis. Sepsis, the body’s severe, life-threatening response to infection, can arise from peritonitis or an untreated abscess. Sepsis can cause organ failure and is a major cause of death in severe infections.
Fistula formation involves an abnormal connection between the colon and another organ, such as the bladder or vagina. While not always immediately lethal, fistulas can cause persistent infection, pain, and may lead to more severe conditions if left unaddressed. Additionally, severe inflammation or scarring from recurrent diverticulitis can narrow the colon, causing a bowel obstruction. This blockage prevents the normal passage of food, fluids, and stool, leading to symptoms like abdominal pain, bloating, and inability to pass gas or have a bowel movement.
Factors Increasing Risk of Severe Outcomes
Several factors can increase an individual’s likelihood of experiencing severe or life-threatening diverticulitis complications. Age is a factor, as older individuals are more susceptible to developing diverticula and complications. Individuals with underlying medical conditions, such as kidney failure, a weakened immune system, or those on chronic steroid therapy, also face a higher risk.
Lifestyle choices also play a role. Smoking has been linked to a higher incidence of complicated diverticulitis and less favorable outcomes. Obesity, a sedentary lifestyle, and a diet consistently low in fiber can contribute to the condition’s development and severity. Regular use of certain medications like nonsteroidal anti-inflammatory drugs (NSAIDs) or corticosteroids may elevate the risk. Delaying medical attention for diverticulitis symptoms can allow the condition to progress, escalating the potential for severe complications.
When to Seek Immediate Medical Care
Seek immediate medical attention if you experience sudden, severe abdominal pain that worsens or persists, especially if it is accompanied by a high fever. Persistent nausea and vomiting that make it difficult to keep fluids down are warning signs.
Severe tenderness in the abdomen, particularly when touched, can suggest widespread inflammation or infection. While less common in acute diverticulitis, bloody stools or rectal bleeding should prompt an immediate medical evaluation. An inability to pass gas or have a bowel movement may signal a bowel obstruction, which requires urgent care. Feeling generally unwell, weak, or dizzy are also signs that necessitate prompt professional medical assessment.
Strategies for Prevention and Management
Proactive measures can help prevent diverticulitis flares and reduce the risk of severe complications. Consuming a high-fiber diet promotes regular bowel movements and can help prevent the formation or inflammation of diverticula. Adequate hydration helps fiber function effectively and keeps stools soft. Engaging in regular physical activity benefits bowel health and overall digestive function.
Maintaining a healthy weight helps reduce strain on the digestive system, and avoiding smoking can lower the risk of complicated diverticulitis. Discussing the use of NSAIDs or other medications with a healthcare provider can help manage potential risks. Promptly seeking medical advice for even mild symptoms of diverticulitis is important to prevent the condition from progressing to more serious stages.