Diverticulitis is a condition characterized by the inflammation of small, bulging pouches that can form in the lining of the digestive tract. While these pouches, known as diverticula, most commonly develop in the lower left side of the colon, a distinct variant known as right-sided diverticulitis occurs when they form and become inflamed in the ascending colon or cecum.
Understanding Right Side Diverticulitis
Right-sided diverticulitis specifically involves these inflamed pouches located in the right side of the large intestine, including the cecum and ascending colon. This form of diverticulitis shows a higher prevalence in Asian populations, contrasting with the Western world where left-sided diverticulitis is more common. It also tends to affect younger individuals compared to the typical age group for left-sided disease. Anatomically, right-sided diverticula are sometimes “true” diverticula, meaning they contain all layers of the colon wall, which may contribute to a lower frequency of perforation compared to the “false” diverticula often found on the left side.
Recognizing the Signs
Individuals experiencing right-sided diverticulitis often present with distinct symptoms that can sometimes mimic other abdominal conditions. The most common symptom is abdominal pain, typically localized to the lower right quadrant of the abdomen. This pain can be constant and may persist for several days.
Accompanying symptoms can include nausea and vomiting, though these may be less common than in other conditions like appendicitis. Fever is also a reported sign, occurring in a notable percentage of patients. Changes in bowel habits, such as constipation or, less commonly, diarrhea, may also be present. It is important to seek medical attention if these symptoms arise, especially if the abdominal pain is sudden, severe, or worsening.
Diagnosis and Treatment Approaches
Diagnosing right-sided diverticulitis often begins with a physical examination, where tenderness in the lower right abdomen is a common finding. Blood tests may reveal elevated inflammatory markers, such as leukocytosis (an increase in white blood cell count) and C-reactive protein (CRP) levels, indicating inflammation within the body. These laboratory findings, while suggestive, do not definitively confirm the diagnosis.
Imaging techniques play a central role in confirming the diagnosis and differentiating right-sided diverticulitis from other conditions, such as acute appendicitis. Computed tomography (CT) scans are considered the most precise diagnostic tool, providing detailed images that can identify inflamed diverticula, assess disease severity, and help exclude other pathologies. Ultrasound can also characterize the condition by showing features like diverticular wall thickening and surrounding echogenic fat.
Treatment approaches for right-sided diverticulitis vary depending on the severity of the condition. Most uncomplicated cases can be managed conservatively with rest, pain relief, and bowel rest. Antibiotics are frequently prescribed to address any infection. Patients with mild, uncomplicated diverticulitis may be safely discharged on oral antibiotics after CT scan evaluation.
Surgical options are considered for severe, complicated, or recurrent cases, or when the diagnosis remains uncertain and conditions like appendicitis cannot be ruled out. Surgical interventions may include diverticulectomy, which is the removal of the inflamed pouch, or in some instances, a right hemicolectomy, which involves removing part of the right colon. Surgical drainage may be necessary for large abscesses that do not resolve with conservative treatment.
Living With and Preventing Recurrence
Long-term management of diverticulitis often involve dietary and lifestyle adjustments. A high-fiber diet is generally recommended to promote regular bowel movements and reduce pressure within the colon, which can help prevent the formation of new diverticula or the inflammation of existing ones. Foods rich in fiber include fruits, vegetables, whole grains, beans, and legumes. Increase fiber intake gradually to avoid discomfort.
Adequate hydration is also a significant factor, as drinking plenty of fluids helps fiber work effectively by softening stool and easing its passage through the digestive system. Regular physical activity further supports bowel health and can help prevent constipation. Maintaining a healthy weight and avoiding habits like smoking and heavy alcohol consumption are additional lifestyle factors that can reduce the risk of diverticulitis recurrence.
While past advice sometimes suggested avoiding nuts, seeds, and popcorn, current research indicates these foods do not increase the risk of diverticulitis and are often good sources of fiber. It is always prudent to monitor symptoms and seek medical attention if new or worsening abdominal pain, fever, or other concerning signs develop after an initial episode.