Acute diverticulitis as a rare complication can occur following prolonged colonoscopy or colo- noscopic polypectomy, especially in those with additional risk factors such as obesity and smoking.
Although colonoscopy-induced diverticulitis is a rare finding, it is important to consider it as a complication in patients with symptoms after colonoscopy. Potential causes of post-colonoscopy diverticulitis include barotrauma, multiple attempts for intubation, and direct pressure of the scope.
The entity of post-colonoscopy diverticulitis is a relatively rare complication. The clinical presentation can mimic other common symptoms encountered post-colonoscopy. CT scan remains the imaging of choice to diagnose and guide further management. Majority of cases resolve with non-operative management.
Although diverticulitis precipitated by colonoscopy prep or the procedure itself (microperforation from the bowel prep, pressure from the shaft of the instrument or air infused during the procedure, etc.) is plausible, there seems to be little in the literature on this subject.
Complications related to colonoscopy include, but are not limited to, the following: Continued bleeding after biopsy (tissue sample) or polyp removal. Nausea, vomiting, bloating or rectal irritation caused by the procedure or by the preparatory bowel cleansing.
After the test, you may be bloated or have gas pains. You may need to pass gas. If a biopsy was done or a polyp was removed, you may have streaks of blood in your stool (feces) for a few days. Problems such as heavy rectal bleeding may not occur until several weeks after the test.
How often should you have a colonoscopy with diverticulosis? You'll probably need a colonoscopy every 5 to 8 years if you have diverticulosis.
Eating a high-fiber diet, rich in foods such as bran, whole-wheat pasta, apples, pears, raspberries, beans, sweet potatoes, avocados, and vegetables, can help prevent regular flare-ups.
Several drugs are associated with an increased risk of diverticulitis, including steroids, opioids and nonsteroidal anti-inflammatory drugs, such as ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve).
Is it normal to have pain a week after a colonoscopy? No, any pain or discomfort after a colonoscopy should resolve in a day. If you are still in pain beyond a day after your procedure, contact your care team.
How long does a diverticulitis flare-up typically last? After starting treatment, most people should start to feel better in two or three days. If symptoms don't start to get better by then, it's time to call a healthcare provider and get instructions on what to do next.
Up to one-third of patients experience abdominal pain, nausea, or bloating afterward, which may last hours to several days. Fortunately, severe complications including hemorrhage, perforation, and death are rare, with a total incidence of 0.28%.
Lifestyle remains the major culprit behind diverticulitis flare-ups. A high-fat, low-fiber diet commonly followed in Western countries can exacerbate diverticulitis symptoms. Lack of fiber in the diet can cause constipation and strain the bowel.
In contrast to complicated diverticulitis, which requires surgical treatment, uncomplicated acute diverticulitis can improve with conservative management, with colonoscopy recommended to identify accompanying disease, such as cancer [2].
For patients who want to reduce their risk, a reasonable recommendation is to follow an anti-inflammatory diet. For example eating a high amount of green leafy vegetables, dark-yellow vegetables, coffee and tea and low consumption of red meat, processed meat, refined grain and sugary beverages.
Symptoms of diverticulitis may include abdominal pain and tenderness, fever, nausea and constipation and they often are irregular. While patients can develop severe complications from diverticulitis that require surgery, doctors have taken a more conservative approach to treating milder cases.
How is uncomplicated diverticulitis treated? In about 95 out of 100 people, uncomplicated diverticulitis goes away on its own within a week. In about 5 out of 100 people, the symptoms stay and treatment is needed. Surgery is only rarely necessary.
Diverticulitis can be treated and be healed with antibiotics. Surgery may be needed if you develop complications or if other treatment methods fail and your diverticulitis is severe. However, diverticulitis is generally considered to be a lifelong condition.
A CT scan, which can identify inflamed or infected pouches and confirm a diagnosis of diverticulitis. CT can also indicate the severity of diverticulitis and guide treatment.
The First Week after a Colonoscopy
After polyps are removed it can take up to a week for the patient to fully recover. During this time, patients should avoid all strenuous activities, which includes lifting anything over five pounds.
In conclusion, bowel preparation has a profound effect on the gut microbiome and metabolome, but the overall composition recovers to baseline within 14 days.
Bleeding is one of the most common complications of colonoscopy, accounting for 0.3-6.1% of cases[35,36].
Physicians should therefore suspect a CP if a patient has fever, abdominal pain or distention following the colonoscopic examination, even if the patient presents with these symptoms several days after the procedure.