Diverticulitis coli (inflammation of the colon udposninger)

Definition and causes

Divertikler is udposninger of the mucous membranes through muscles of the colon. To be correct, is actually a false divertikler, since genuine divertikler is rare and contains all colon layers. We are talking aboutdivertikuloseWhen we have many false divertikler. As a rule, localized to the colon last third.

Divertikler rarely seen in the young, with around. 5% of 40-year-olds and in up to 80% of 85-year-olds.

Sometimes there is inflammation in divertiklernes wall, and the condition called diverticulitis. If inflammation occurs in divertiklernes surroundings, they talk aboutperidivertikulitis.

There is no consensus on how divertikulose and diverticulitis occurs. But divertiklerne (the illegitimate divertikler) occurs probably caused by a defect in tarmvæggens muscles simultaneously with a high pressure inside the colon. This means that the mucous membranes are squeezed out through the muscles. It seems that there is a correlation between lifetime intake of fiber-poor diet and the development of divertikler.

It is expected to occur by diverticulitis, the stools accumulate in udposning and has become an excessive bacterial growth, which may cause damage to divertikelvæggen and further lead to inflammation in this.

It is only 10-20% of people with divertikulose, which will develop diverticulitis.

Symptoms of diverticulitis

Divertikulose is usually without symptoms but can sometimes give a feeling of bloating and abdominal pain usually localized to the lower left part of the abdomen (which is where the last third of the colon is located). Diverticulitis provides always symptoms, but these will depend on how quickly it develops, and if there are complications. There is the following symptoms:

Pain and tenderness in the lower left part of the abdomen.
Fever.
Hosp. lifted or partially lifted bowel function (see tarmslyng).
Hosp. affected the general condition and vomiting.

Strong sudden pain, affected the general condition and vomiting seen in the development of complications (see later).

Precautions and diagnosis

You can probably prevent divertikulose and hence diverticulitis by adopting a diet rich in fiber. If you only develop diverticulitis, one should always be treated by a doctor. But during prolonged symptoms of the colon should always consult a doctor, especially if you are over 50-60 years, a view. to be examined for cancer of the colon.

Divertikulose and diverticulitis best detected by an X-ray contrast with the large bowel or by a kikkertundersøgelse (colonoscopy or sigmoideoskopi). Hosp. we must do a CT scan with contrast.

Treatment of diverticulitis

Treatment of divertikulose in case of symptoms are the same as constipation and irritable colon, including stools aids. Diverticulitis with fever treated with antibiotics. In cases where treatment has no effect, or in case of complications, the operation will be considered.

Select and complications

Diverticulitis may have an acute process with relatively quickly developed pain, fever and vomiting. Due. the strong inflammatory bowel wall can raise up, and it can lead to complete narrowing (stenosis) with tarmslyng to follow or perforation (hole through the intestinal wall of the abdominal cavity) possibly. causing peritonitis.

In cases of large perforations can get stools out in the belly with very severe peritonitis to follow. There can also be seen abscesdannelse (formation of abscesses) in the intestine.

Diverticulitis may also have a more chronic course, there is less violent but still at risk for complications. Here are longer-lasting pain, lower temperature and constipation or diarrhea. There may also be abscesses or fistulas (abnormal channels between the gut and, for example. Formation of skin inflammation) with discharges through the skin or bladder (high risk of the latter when the bladder is in close relation to the lower colon, and this leads blærebetændelse).

After chronic diverticulitis seen to scarring and subsequent shrinkage and possible. narrowing (stenosis) of the intestine to follow. Since throat by chronic diverticulitis is rarely total, are symptoms of this less than the throat by the pressing process.

Complications of the acute and chronic course are conflicting, however, and both types can be rarely seen bleeding. It must be said that the vast majority of diverticulitis has a mild uncomplicated process.