Diverticulitis is an aliment of the colon that affects the inner lining. Approximately 50% of all Americans will experience diverticulitis by the time they reach age 60. Pouches or bulging sacs in the lining become inflamed or infected. The most common site of diverticulitis is the large intestine. A low fiber diet is believed to be responsible for most cases of diverticulitis. Small pieces of feces can become trapped in the pouches and bulging sacs, which then cause the inflammation and/or infection.
Diverticulitis normally responds well to treatment, some patients will have repeated bouts of diverticulitis, very few patients will require surgery to remove the effective section of bowel. (Fox & Stollman, 2010)
Patients with …show more content…
The inflammation in diverticulitis is believed to be the result of fecal material that gets trapped in a diverticulum. The resulting fecal stone, or fecalith, causes pressure and necrosis of the diverticulum. The inflammation progresses and perforates into the mucosa of the colon. A small perforation is easily treated with antibiotics. A large perforation may wall off and create an abscess which can erode into nearby structures such as the small bowel or bladder, anterior abdominal wall, and fecal peritonitis can occur. (textbook)
Patients present with left lower quadrant pain, reiterating the tendency for diverticulitis to affect the sigmoid colon in western countries. The pain can be constant or intermittent, and lack of appetite, or nausea and vomiting can be present. Physical examination of the abdomen reveals localized tenderness but frank rebound or guarding should be negative. Bowel sounds are frequently distant or depressed, if bowel sounds are very active an obstruction may be present, in mild cases the bowel sounds may be normal. The WBC may be elevated and the patient may present with a fever. Occasionally a palpable mass may be felt and may be very painful. Eating exacerbated the pain of left-sided diverticulitis and pain can be lessened with the passage of feces or flatus. Patients may complain of a feeling of being bloated.
Differential diagnoses for diverticulitis include colon cancer, colitis, crohn’s
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On later reflection I realized I could have though about interstitial cystitis, appendicitis and renal calculi. My multiple hypotheses for this patient are presented in Table 1.
The name for these erosions is aphthous ulcers. These erosions, after a while, start to deepen and grow in diameter. Once they reach a certain size, they can be referred to as ulcers. These ulcers can cause scarring and they can also cause the bowel to become stiff and lose its elasticity. As Crohn’s worsens, the bowel becomes obstructed once the passageways narrow enough. This obstruction can cause a buildup of food that is still being digested, fluid and gas that comes from the stomach. This obstruction will then prevent all of those products from entering into the colon. This will cause severe abdominal cramps, nausea, vomiting, and even abdominal distention. If the ulcers located in the walls of the bowel become large or extreme enough, holes can form in the walls of the bowel. Once those holes are formed in the bowel, the bacteria normal to the bowel can then pass through those holes and spread to nearby organs and into the abdominal cavity causing what are called fistulas. These fistulas are like a channel/tunnel that is formed between the ulcer and the adjacent organ. Then when a fistula is created between the affected intestine and the bladder, it is called an enteric-vesicular fistula which can lead to UTI’s and feces being presented during urination. Next, when the fistula is formed between the intestine and skin, it is called an enteric-cutaneous fistula. What this fistula, pus and mucous exit the body through a painful opening found in the skin of the
It is believed that aging has something to do with compromising the muscle tone of the colonic wall; people aged 50 and over are most at risk for diverticulosis and diverticulitis. It is believed that high fat diets and obesity also play a role in developing diverticular disease.
Mindy Perkins is 48 year old woman who presents to the ED with 10- 15 loose, liquid stools daily for the past 2 days. She completed a course of oral Amoxicillin seven days ago for a dental infection. In addition to loose stools, she complains of lower abdominal pain that began 2 days ago as well. She has not noted any blood in the stool. She denies vomiting, fever, or chills. She is on Prednisone for Crohn’s disease as well as Pantoprazole (Protonix) for severe GERD.
The principal symptoms of Crohn’s disease are diarrhea and abdominal pain. Other symptoms include abdominal cramping and tenderness (often in lower right area), abdominal distention, fever, fatigue, and rectal bleeding. Bleeding may be serious and persistent, leading to a low red blood cell count or anemia. As the disease progresses, malnutrition, dehydration, electrolyte, imbalances, increased peristalsis, and pain around umbilicus may occur. Another symptom to be
The Disease have always been cured through the hospital system, medication, however, recently it has begun a movement stated we should depend less on our medication. Base on statics publish for the center for disease as of 2012, about half of all adults—117 million people—had one or more chronic health conditions. One of four adults had two or more chronic health conditions. Among those disease diversities is one the disease. Diverticulitis is a disease when pouches form in the wall of the colon. If these pouches get inflamed or infected, it is called diverticulitis. Therefore, diverticula have always been a serious disease in the United States; thus there has been several of a reason for causing the disease. Research has dictated
Colitis refers to inflammation of the inner lining of the colon. There are numerous causes of colitis including infection, inflammatory bowel disease Crohn's disease, and ulcerative colitis. Symptoms of colitis depend upon the cause and may include abdominal pain, cramping, diarrhea, with or without blood in the stool. These symptoms have incapacitated Ms. Barber-Burks from holding
Pathophysiology: Diverticulitis, is characterized by inflamed diverticuli and increased luminal pressures that cause erosion of the bowel wall and thus microscopic or macroscopic perforation into the peritoneum. A localized abscess develops when the
BIOLOGICAL MECHANISM: The condition of diverticulosis occurs when small areas of tissue form pouches in the large intestine or colon called diverticulum, or diverticula (plural). Diverticula may occur due to the lack of bulk forming and bacteria producing fiber, resulting in an imbalance of certain intestinal bacteria, increasing internal pressure on the intestinal tissue due to poor stool formation, constipation, or straining to pass stools. In the paper Low-Residue Diet in Diverticular Disease: Putting an End to a Myth it was stated that “fiber is an important energy substrate for the colonic epithelium because of its fermentation by colonic microbes to short-chain fatty acids, which in turn play a role in mucosal growth and colonic blood flow” (Tarleton, DiBaise 2011). Poor tissue health and increased internal pressure may cause the intestinal tissue to herniate causing diverticulum to form. Diverticulitis can occur when material or bacteria becoming trapped inside the diverticulum, and inflammation
The most symptoms of ulcerative colitis are abdominal pain and bloody diarrhea mixed with pus, blood and mucus. Individuals may become very sick and weak, they can suffer form anemia, weight loss, loss of appetite, rectal bleeding, loss of body fluids and nutrients, skin lesion, joint pain, and growth failure specially in children according to the extent of the disease. Just how risk factors have a different affects on everyone symptoms are also different. A quarter of the patients only have the disease only have mild symptoms while others suffer from fevers, bloody diarrhea, nausea and severe abdominal cramps. Complications may also occur outside the colon such as arthritis, inflammation of the
DS is a 57-year-old white female whit a history of diverticulitis who presents to the clinic for an evaluation of abdominal pain. She stated that she began experiencing left lower quadrant pain last night that worsened through the night and into this morning. The pain is described as dull, occasionally cramping, rated 7/10 in severity. The patient also stated that this pain is similar to previous episodes of diverticulitis. The patient stated that she took Gas-X this morning with little relief. She was able to move her bowels yesterday and this morning, both reportedly normal. The patient denied any fever, chills, chest pain, shortness of breath, nausea, vomiting, diarrhea, melena, hematochezia, or any other symptoms. At this time, there were
The abdominal cavity is the largest hollow space in the human body and contains the liver, pancreas, spleen, kidneys and adrenal glands, and the digestive tract. The cavity is lined by a thin, silk-like membrane called the peritoneum which covers the inside wall of the abdominal cavity and every organ or structure contained in it. A common affliction of the abdominal cavity is peritonitis, which is an inflammation of the peritoneum membrane caused by the introduction of a fungal or bacterial infection in an otherwise sterile environment. The infection is often caused by an abdominal injury that creates a rupture (perforation) within the abdominal cavity, or may arise from a complication of an underlying medical condition. The infection can
A colovesical fistula (CVF) is a connection from the colon to the urinary bladder. It can occur due to surgery or trauma around this area of the body that caused the opening. This allows fecal matter to move from the colon to the bladder, which can lead to possibly painful infection. It can also cause morbidity and death, and is usually secondary to urosepsis, which is a UTI complication. It is more common in men, as female patients have a uterus, which blocks passage between the colon and bladder. It is also more common in patients from 55 years to 75. It can be diagnosed clinically, but some form of imagining or scanning is usually reqired to determine the severity and origin of the fistula. Patients may exhibit: pneumaturia, fecaluria, suprapubic pain, dysuria, hematuria, urgency, and gross hematuria (many of these symptoms can cause infection).
The term Inflammatory Bowel Disease (IBD) is a general name given to a few disorders that all fall under the category of inflamed intestines (they become red and swollen.) This is usually due to a reaction the body causes against its own intestinal tissue. The two most common types of Inflammatory Bowel Disease are Ulcerative Colitis (UC) and Crohn’s Disease (CD). Crohn’s disease can affect any part of the gastrointestinal tract; however, it more commonly affects the small intestine or colon.