Diverticular disease

Diverticuli can occur throughout the gastrointestinal tract but prove to be most common in the colon where they exist as small sac-like herniations of mucosa through the muscular wall, typically at the site of penetrating blood vessels. Duodenal, jejuna, and ileal diverticuli can occur with Meckel's diverticulum forming a special congenital abnormality present in 2 percent of the population. Meckel's diverticuli are particularly notable since they may contain acid-producing gastric mucosa and lead to enteral ulcer formation. Colonic diverticuli are generally pain free but with the development of inflammation and/ or obstruction of their mouth, severe abdominal pain and infection may result. Peridiverticular abscesses, obstruction, colonic distension, bleeding, and altered bowel habit (diarrhea, constipation) are not uncommon. Painful diverticulosis classically presents as recurrent left lower quadrant colicky pain without evidence of inflammation. Like chronic pancreatitis, diverticular disease can produce pain which is episodic and which can have life-threatening consequences if ignored. Bleeding diverticuli are the most common sources of lower gastrointestinal tract bleeding113 and segmental colonic resection has the highest success rate at stopping bleeding. However, effects on pain are unclear. Reports of pain do not always correlate with observable pathology and symptoms can be nonspecific. A European surgical consensus panel was not able to definitively state when surgery was indicated for symptomatic reasons and called for RCTs.114 The poorly absorbed antibiotic rifaximin, normally used to treat traveller's diarrhea, has also been demonstrated to treat and prevent recurrences of symptomatic diverticular disease in controlled trials and large clinical series.115,116 Similar results have been noted with use of the anti-inflammatory mesalazine (mesalamine).117

Managing Diverticular Disease

Managing Diverticular Disease

Stop The Pain. Manage Your Diverticular Disease And Live A Pain Free Life. No Pain, No Fear, Full Control Normal Life Again. Diverticular Disease can stop you from doing all the things you love. Seeing friends, playing with the kids... even trying to watch your favorite television shows.

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