An episode of acute diverticulitis which is unfortunately the most common complication of developing those bulging pouches in the colon called diverticula can be excruciatingly painful. Acute diverticulitis is also regrettably one of the most common acute diseases of the colon in the U.S. and other countries where a diet low in fiber is the norm.
Acute diverticulitis begins when harmful bacteria generated by bits of undigested food or fecal material lodge in one or more diverticula and create infection. Infection leads to inflammation, which can rapidly lead to the formation of abscesses, a perforated colon.
When the infected material spills out from the colon into the abdominal cavity, life-threatening peritonitis, which is an inflammation of the peritoneal tissue that lines the abdominal cavity, can occur. Peritonitis requires immediate surgery to clean and treat the peritoneum. Other unpleasant and dangerous complications that can arise from acute diverticulitis are that the colon can become constricted, thus stopping the bowels from moving as they should, and the abnormal connections between organs known as fistulas can develop.
Fistulas that develop as a result of acute diverticulitis occur when colon tissue leaks out through the diverticula and attaches to tissue of other organs, including skin. Fistulas from acute diverticulitis happen most often between the bladder and the colon, where they can cause serious and long-lasting urinary tract infections. For some reason, fistulas develop less frequently in women than in men. Recurrent attacks of diverticulitis can leave scars that narrow and obstruct the colon.
Acute diverticulitis can strike without warning. Patients who have shown no prior evidence of having developed diverticula can experience acute diverticulitis. Symptoms of acute diverticulitis include fever, nausea, vomiting, chills, cramping, and constipation. Because these symptoms can become severe very quickly, people experiencing them should seek capable medical help immediately.
However, because fever, nausea, vomiting, chills, cramping, and constipation can all indicate diseases other than acute diverticulitis, it’s essential that the patient is correctly diagnosed when acute diverticulitis is the cause to prevent serious and potentially life-threatening complications.
When treatment is begun immediately, acute diverticulitis can often be successfully treated with antibiotics that kill the harmful bacteria. However, when antibiotics aren’t enough, a physician may insert a needle attached to a catheter into the abscesses in infected diverticula to remove pus and other infected matter. And when that technique doesn’t resolve the situation, surgical intervention becomes necessary.
Traditionally, acute diverticulitis has been considered primarily a disease of patients over 50 years old but a rare diagnosis in a young adult who is experiencing intense abdominal pain. However, diverticulitis may be a more severe illness in younger patients, in immune-compromised patients, in patients with significant co-morbid conditions, and in patients taking anti-inflammatory medications. In young patients, the apparently increased severity may be a consequence of delayed diagnosis.
However, the incidence of diverticulosis, also called diverticular disease, does clearly increase with age. 60% of people older than 80 will experience diverticulitis and a large number of these will experience it in its acute form.