Common Signs and symptoms seen
Diverticulitis is a digestive disorder marked by irritated or infected pouches called diverticula in the colon or the lining of the large intestine (Strate & Morris, 2019). When weak places in the intestinal wall break away under strain, such as from a low-fiber diet, such pouches form.
Common symptoms and signs of diverticulitis, especially in older adults, include severe and chronic stomach discomfort on the left side. The condition is also characterized by tenderness, bloating, and cramps accompanying such discomfort (Barbaro et al., 2022). Certain individuals may have gastrointestinal disturbances such as diarrhea or constipation. Others can observe blood in their stool. Fever, chills, nausea, and vomiting are also symptoms of a more serious infection of diverticulitis.
Screening assessment tools
Diverticulitis has no specialized screening assessment tool like other disorders. A healthcare practitioner can apply assessments to determine a person’s risk of diverticulitis, such as medical history, to inquire about a patient’s medical history, which may include a family history of diverticulitis, other medical issues, and medications (Barbaro et al., 2022). A physician may also use a physical exam performed to look for evidence of abdominal discomfort, distention, or tumor. Imaging studies can also be used to examine for diverticula or other abnormalities in the colon; imaging tests such as a computed tomography (CT) scan or colonoscopy may be employed (Strate & Morris, 2019).
Physicians may also employ a range of tools to judge the level of severity of diverticulitis in patients who have been given the diagnosis (Strate & Morris, 2019). Clinical scoring systems, like the Alvarado or Hinchey scores, can be used to gauge the severity of diverticulitis and inform treatment choices. A complete blood count, a C-reactive protein test, and an erythrocyte sedimentation rate test are a few examples of laboratory tests that can be done to look for indications of infection and inflammation.
Recommended diagnostic tests (if any)
Diverticulitis can be diagnosed using a number of procedures, especially in older persons. Blood tests must be done, along with medical and family history. In looking for indications of infection or inflammation, a complete blood count (CBC) may be conducted. An infection may be present if white blood cell levels are elevated (Strate & Morris, 2019). The most frequent imaging test for diagnosing diverticulitis is a computed tomography (CT) scan of the abdomen and pelvis. The colon and any inflamed or diseased diverticula can be seen in great detail. The abdomen can also be assessed using ultrasonic technology (Barbaro et al., 2022). Even though it is less thorough than a CT scan, it can nonetheless yield useful data.
Colonoscopy and Flexible Sigmoidoscopy are additional options. Such tests may be performed to rule out other illnesses or complications, as well as to look for diverticula. An X-ray test in which a liquid containing barium is administered to coat the inside of the colon can be used to see the colon and locate the diverticula (Strate & Morris, 2019). Stool and urine testing are critical diagnostic tools for diverticulitis. In ruling out other causes of gastrointestinal symptoms, stool tests are performed, while urinalysis may be performed to rule out urinary tract infections or other related conditions.
Treatment plans, both pharmacologic and non-pharmacologic, are based on current clinical practice guidelines.
The pharmacological treatment of diverticulitis based on current clinical practice guidelines is using antibiotics and managing pain. Ciprofloxacin and metronidazole, or amoxicillin-clavulanate, are the main antibiotics used to treat infection (Strate & Morris, 2019). Analgesics or non-steroidal anti-inflammatory drugs (NSAIDs) are recommended to treat pain caused by diverticulitis.
The recommended non-pharmacological treatment of diverticulitis based on current clinical practice guidelines includes lifestyle modification. Consuming a diet with clear liquid and high fiber and regular exercise helps to treat diverticulitis (Barbaro et al., 2022). Smoking cessation, managing weight, and stress are vital in treating diverticulitis, especially in older people.
References
Barbaro, M. R., Cremon, C., Fuschi, D., Marasco, G., Palombo, M., Stanghellini, V., & Barbara, G. (2022). Pathophysiology of diverticular disease: From diverticula formation to symptom generation. International Journal of Molecular Sciences, 23(12), 6698. doi:10.3390/ijms23126698
Strate, L. L., & Morris, A. M. (2019). Epidemiology, pathophysiology, and treatment of diverticulitis. Gastroenterology, 156(5), 1282-1298.e1. doi:10.1053/j.gastro.2018.12.033
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