Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
How is the diagnosis of diverticular disease made?
Once suspected, the diagnosis of diverticular disease can be
confirmed
by a variety of tests. Barium
X-rays (barium enemas) can be
performed to
visualize the colon. Diverticula are seen as barium filled
pouches
protruding from the colon wall.
Direct visualization of the
intestine can
be done with flexible tubes inserted through the rectum and
advanced into
the colon. Either short tubes (sigmoidoscopes) or longer tubes
(colonoscopes) may be used to assist in the diagnosis and to
exclude other
diseases that can mimic diverticular disease.
In patients
suspected of
having diverticular abscess causing persistent pain and fever,
ultrasound
and CT scan examinations of the abdomen and pelvis can be done
to detect
collections of pus fluid.
What is the treatment for diverticular disease?
Medical treatment
of diverticulitis
Most patients with diverticulosis have minimal or no symptoms,
and do
not require any specific treatment. A high fiber diet and fiber
supplements are advisable to prevent constipation and perhaps prevent the
formation of
more diverticula.
Patients with mild symptoms of
abdominal
pain due to muscular spasm in the area of the diverticula may benefit from anti-spasmodic drugs such as:
Some
doctors also recommend avoidance of nuts, corn, and seeds to
prevent
complications of diverticulosis. Whether these dietary
restrictions are
beneficial is uncertain.
When diverticulitis occurs, antibiotics are usually needed.
Oral
antibiotics are sufficient when symptoms are mild. Some
examples of
commonly prescribed antibiotics include:
Liquid or low fiber foods are advised during acute
attacks of diverticulitis. This is done to reduce the amount of material that
passes through the colon, which at least theoretically, may aggravate the
diverticulitis.
In severe diverticulitis with high fever and pain, patients are
hospitalized and given intravenous antibiotics. Surgery is
needed for
patients with persistent bowel obstruction or abscess not
responding to
antibiotics.
Diverticulitis (Diverticulosis) - Symptoms at Onset of DiseaseQuestion: The symptoms of diverticulitis (diverticulosis) can vary greatly from patient to patient. What were your symptoms at the onset of your disease?
Abdominal pain is pain in the belly and can be acute or chronic. Causes include inflammation, distention of an organ, and loss of the blood supply to an organ. Abdominal pain can reflect a major problem with one of the organs in the abdomen such as the appendix, gallbladder, large and small intestine, pancreas, liver, colon, duodenum, and spleen.
Low blood pressure, also referred to as hypotension, is blood pressure that is so low that it causes symptoms or signs due to the low flow of blood through the arteries and veins. Some of the symptoms of low blood pressure include light-headedness, dizziness, or even fainting if not enough blood is getting to the brain. Diseases and medications can also cause low blood pressure. When the flow of blood is too low to deliver enough oxygen and nutrients to vital organs such as the brain, heart, and kidneys; the organs do not function normally and may be permanently damaged.
Rectal bleeding (hematochezia) refers to the passage of bright red blood from the anus. Rectal bleeding may be moderate to severe and most bleeding comes from the colon, rectum, or anus. Common causes include anal fissures, hemorrhoids, diverticulitis, and more.
Diarrhea is a change is the frequency and looseness of bowel movements. Cramping, abdominal pain, and the sensation of rectal urgency are all symptoms of diarrhea. Absorbents and anti-motility medications are used to treat diarrhea.
Night sweats are severe hot flashes that occur at night and result in a drenching sweat. In order to distinguish night sweats that arise from medical causes from those that occur because one's surroundings are too warm, doctors generally refer to true night sweats as severe hot flashes occurring at night that can drench sleepwear and sheets, which are not related to an overheated environment.
Gas or "intestinal gas" means different things to different people. Everyone has gas and eliminates it by belching or farting (passing it through the rectum).
Constipation is defined medically as fewer than three stools per week and severe constipation as less than one stool per week. Constipation usually is caused by the slow movement of stool through the colon. There are many causes of constipation including medications, poor bowel habits, low fiber diets, abuse of laxatives, hormonal disorders, and diseases primarily of other parts of the body that also affect the colon.
E. coli is the most common cause of bladder infections. Bladder infection symptoms and signs include frequent urination, burning urination, and foul smelling urine. Mild bladder infections may go away by increasing one's intake of fluid. More severe infections may be treated with a few days of antibiotics.
Digestion is the complex process of turning food you eat into the energy you need to survive. The digestive process also involves creating waste to be eliminated, and is made of a series of muscles that coordinate the movement of food.
Duodenal diverticula (extramural or intramural), or duodenal diverticulum, is a pouch that is attached to the first part of the small intestine (duodenum). The cause of extramural diverticula is not clear, however, it may be congenital. Complications caused by duodenal diverticulum include rupture, gallstones, or pancreatitis. Extramural duodenal diverticula has no symptoms. Treatment is generally surgery.
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