Post by Admin on Jan 27, 2024 14:18:11 GMT
Diverticulitis
en.wikipedia.org/wiki/Diverticulitis
Diverticulitis, also called colonic diverticulitis, is a gastrointestinal disease characterized by inflammation of abnormal pouches—diverticula—that can develop in the wall of the large intestine.[1] Symptoms typically include lower abdominal pain of sudden onset, but the onset may also occur over a few days.[1] There may also be nausea, diarrhea or constipation.[1] Fever or blood in the stool suggests a complication.[1] People may experience a single attack, repeated attacks, or ongoing "smouldering" diverticulitis.[2][4][5]
The causes of diverticulitis are unclear.[1] Risk factors may include obesity, lack of exercise, smoking, a family history of the disease, and use of nonsteroidal anti-inflammatory drugs (NSAIDs).[1][2] The role of a low fiber diet as a risk factor is unclear.[2] Having pouches in the large intestine that are not inflamed is known as diverticulosis.[1] Inflammation occurs in between 10% and 25% at some point in time, and is due to a bacterial infection.[2][6] Diagnosis is typically by CT scan, though blood tests, colonoscopy, or a lower gastrointestinal series may also be supportive.[1] The differential diagnoses include irritable bowel syndrome.[2]
Preventive measures include altering risk factors such as obesity, inactivity, and smoking.[2] Mesalazine and rifaximin appear useful for preventing attacks in those with diverticulosis.[2] Avoiding nuts and seeds as a preventive measure is no longer recommended since there is no evidence these play a role in initiating inflammation in diverticula.[1][7] For mild diverticulitis, antibiotics by mouth and a liquid diet are recommended.[1] For severe cases, intravenous antibiotics, hospital admission, and complete bowel rest may be recommended.[1] Probiotics are of unclear value.[2] Complications such as abscess formation, fistula formation, and perforation of the colon may require surgery.[1]
The disease is common in the Western world and uncommon in Africa and Asia.[1] In the Western world about 35% of people have diverticulosis while it affects less than 1% of those in rural Africa,[6] and 4–15% of those may go on to develop diverticulitis.[3] In North America and Europe the abdominal pain is usually on the left lower side (sigmoid colon), while in Asia it is usually on the right (ascending colon).[2][8] The disease becomes more frequent with age, ranging from 5% for those under 40 years of age to 50% over the age of 60.[9][1] It has also become more common in all parts of the world.[2] In 2003 in Europe, it resulted in approximately 13,000 deaths.[2] It is the most frequent anatomic disease of the colon.[2] Costs associated with diverticular disease were around US $2.4 billion a year in the United States in 2013.[2]
Signs and symptoms
Diverticulitis typically presents with lower quadrant abdominal pain of a sudden onset.[1] Patients commonly have elevated C-reactive protein and a high white blood cell count.[10] In North America and Europe the abdominal pain is usually on the left lower side (sigmoid colon), while in Asia it is usually on the right (ascending colon).[2][8] There may also be fever, nausea, diarrhea or constipation, and blood in the stool.[1] Diverticulosis is associated with more frequent bowel movements contrary to the widespread belief that patients with diverticulosis are constipated.[11]
Smouldering diverticulitis
"Smoldering diverticulitis" (SmD) describes a subtype of the disease which is characterized by frequently relapsing symptoms triggered by a "smoldering fire-like" ongoing inflammatory process.[4] Patients have persistent symptoms of uncomplicated diverticulitis, but are refractory to medical management while not progressing to diverticular complications.[5] Approximately 5% of diverticulitis people experience smouldering diverticulitis. [12] Smouldering diverticulitis cases make up 4-10% of diverticulitis surgeries.[13]
en.wikipedia.org/wiki/Diverticulitis
Diverticulitis, also called colonic diverticulitis, is a gastrointestinal disease characterized by inflammation of abnormal pouches—diverticula—that can develop in the wall of the large intestine.[1] Symptoms typically include lower abdominal pain of sudden onset, but the onset may also occur over a few days.[1] There may also be nausea, diarrhea or constipation.[1] Fever or blood in the stool suggests a complication.[1] People may experience a single attack, repeated attacks, or ongoing "smouldering" diverticulitis.[2][4][5]
The causes of diverticulitis are unclear.[1] Risk factors may include obesity, lack of exercise, smoking, a family history of the disease, and use of nonsteroidal anti-inflammatory drugs (NSAIDs).[1][2] The role of a low fiber diet as a risk factor is unclear.[2] Having pouches in the large intestine that are not inflamed is known as diverticulosis.[1] Inflammation occurs in between 10% and 25% at some point in time, and is due to a bacterial infection.[2][6] Diagnosis is typically by CT scan, though blood tests, colonoscopy, or a lower gastrointestinal series may also be supportive.[1] The differential diagnoses include irritable bowel syndrome.[2]
Preventive measures include altering risk factors such as obesity, inactivity, and smoking.[2] Mesalazine and rifaximin appear useful for preventing attacks in those with diverticulosis.[2] Avoiding nuts and seeds as a preventive measure is no longer recommended since there is no evidence these play a role in initiating inflammation in diverticula.[1][7] For mild diverticulitis, antibiotics by mouth and a liquid diet are recommended.[1] For severe cases, intravenous antibiotics, hospital admission, and complete bowel rest may be recommended.[1] Probiotics are of unclear value.[2] Complications such as abscess formation, fistula formation, and perforation of the colon may require surgery.[1]
The disease is common in the Western world and uncommon in Africa and Asia.[1] In the Western world about 35% of people have diverticulosis while it affects less than 1% of those in rural Africa,[6] and 4–15% of those may go on to develop diverticulitis.[3] In North America and Europe the abdominal pain is usually on the left lower side (sigmoid colon), while in Asia it is usually on the right (ascending colon).[2][8] The disease becomes more frequent with age, ranging from 5% for those under 40 years of age to 50% over the age of 60.[9][1] It has also become more common in all parts of the world.[2] In 2003 in Europe, it resulted in approximately 13,000 deaths.[2] It is the most frequent anatomic disease of the colon.[2] Costs associated with diverticular disease were around US $2.4 billion a year in the United States in 2013.[2]
Signs and symptoms
Diverticulitis typically presents with lower quadrant abdominal pain of a sudden onset.[1] Patients commonly have elevated C-reactive protein and a high white blood cell count.[10] In North America and Europe the abdominal pain is usually on the left lower side (sigmoid colon), while in Asia it is usually on the right (ascending colon).[2][8] There may also be fever, nausea, diarrhea or constipation, and blood in the stool.[1] Diverticulosis is associated with more frequent bowel movements contrary to the widespread belief that patients with diverticulosis are constipated.[11]
Smouldering diverticulitis
"Smoldering diverticulitis" (SmD) describes a subtype of the disease which is characterized by frequently relapsing symptoms triggered by a "smoldering fire-like" ongoing inflammatory process.[4] Patients have persistent symptoms of uncomplicated diverticulitis, but are refractory to medical management while not progressing to diverticular complications.[5] Approximately 5% of diverticulitis people experience smouldering diverticulitis. [12] Smouldering diverticulitis cases make up 4-10% of diverticulitis surgeries.[13]