Diverticulitis

Diverticulitis is inflammation or infection of small pouches (diverticula) that can form in the wall of the colon, most often in older adults. Most cases are mild, but some can lead to serious complications requiring urgent treatment.

• Abdominal pain, most often in the lower left side, though it can occur elsewhere depending on which part of the colon is affected
• Fever
• Nausea and changes in bowel habit, such as constipation or diarrhoea
• Bloating
• Severe pain, high fever, or a rigid abdomen can indicate a complication such as perforation or abscess, requiring urgent care

• Diverticula (small pouches in the colon wall) are common with increasing age and are thought to relate partly to a low-fibre diet, though not everyone with diverticula develops diverticulitis.
• Diverticulitis occurs when one or more of these pouches becomes inflamed or infected, sometimes due to trapped stool or bacteria.
• Risk is increased by older age, obesity, smoking, physical inactivity, and a diet low in fibre.

• Suspected clinically based on the characteristic pattern of lower abdominal pain and fever, particularly in an older adult.
• Blood tests typically show signs of infection or inflammation.
• Abdominal imaging, such as CT scan where available, confirms the diagnosis and identifies any complications, such as abscess or perforation.

Mild diverticulitis without complications is often managed with oral antibiotics and a temporary period of reduced dietary fibre or fluids-only diet to rest the bowel, followed by gradual return to a normal, high-fibre diet.

More significant cases, or those with complications such as abscess or perforation, require hospital admission for intravenous antibiotics, and sometimes a procedure to drain an abscess or, in severe cases, surgery.

Pain relief is given, though NSAIDs are generally avoided in acute diverticulitis, as they may increase the risk of complications.

After recovery, a high-fibre diet is generally recommended to help prevent future episodes.

• Eat a diet high in fibre, including fruits, vegetables, and whole grains, which may reduce the risk of diverticulitis.
• Maintain a healthy body weight and engage in regular physical activity.
• Avoid smoking.
• Seek prompt medical assessment for new or worsening lower abdominal pain, particularly with fever.