Common alternative conditions that can clinically mimic diverticulitis include small bowel obstruction, primary epiploic appendagitis, acute cholecystitis, appendicitis, ileitis, ovarian cystic disease, and ureteral stone disease.
The signs and symptoms of diverticulitis include: Pain, which may be constant and persist for several days. The lower left side of the abdomen is the usual site of the pain. Sometimes, however, the right side of the abdomen is more painful, especially in people of Asian descent.
Aim: Caecal diverticulitis (CD) is an uncommon condition which can be misdiagnosed as acute appendicitis due to similar clinical presentations. Further, its management varies among medical centres.
Primary colon carcinoma is the main consideration in the differential for findings of diverticulitis on CT (Fig. 10) because it may present with eccentric or circumferential wall thickening, varying degrees of inflammation, and signs of obstruction. Perforated colon carcinoma may mimic diverticulitis.
The risk of having colorectal cancer after an episode of acute diverticulitis is 44-fold higher than that of an age- and gender-adjusted reference population.
How often should you have a colonoscopy with diverticulosis? You'll probably need a colonoscopy every 5 to 8 years if you have diverticulosis.
Background. Computed tomography (CT) scans are commonly used to diagnose acute diverticulitis, but there are overlapping features between diverticulitis and colorectal cancer (CRC) on imaging studies. Hence, colonoscopy is typically recommended after an episode of acute diverticulitis to rule out underlying malignancy.
Abdominal and Pelvic CT: A CT scan is the best test to diagnose diverticulitis. It can also help determine the severity of the condition and guide treatment. You may receive an intravenous (IV) injection of contrast material. You may also drink an oral contrast material one hour before your scan.
Probiotics combined with mesalazine have also emerged as an alternative potential therapeutic strategy in preventing recurrent attacks of diverticulitis. One series reported that treatment with mesalazine and/or lactobacillus casei induced remission in 88% of their patients at a median follow-up of 2 years.
A multi-slice CT, which involves a 10 mm collimation, has 98% accuracy in diagnosing acute diverticulitis. This also allows for sensitivity and specificity to be 97% and 98%, respectively. Clinicians are also able to reliably diagnose the complications of acute diverticulitis using CT imaging ( Fig. 2 ).
Symptoms of diverticulosis and diverticulitis are similar to other conditions, such as appendicitis, ovarian cyst, peptic ulcer, Crohn's disease, and irritable bowel syndrome – so the doctor may do tests such as x-rays, ultrasound, or endoscopy to make the right diagnosis.
Symptoms of diverticulitis
However, the pain associated with diverticulitis is constant and severe, rather than intermittent. It is most likely to occur if you have previously had symptoms of diverticular disease, and develops over a day or two.
There are many other conditions that have similar symptoms to diverticulitis. Some of the more common ones include appendicitis, hernia, inflammatory bowel disease (Crohn's disease or ulcerative colitis), pain from ovulation, ovarian cyst, or pelvic inflammatory disease.
Diverticulitis stool characteristics
Color: The stool may be bright red, maroon, or black and tarry, which indicates the presence of blood. Stools may contain more mucus than normal. Odor: The stool odor may be increasingly foul compared to the typical smell.
Symptoms of diverticulitis tend to be more serious and include: more severe abdominal pain, especially on the left side. high temperature (fever) of 38C (100.4F) or above. diarrhoea or frequent bowel movements.
Diverticulitis is treated using diet modifications, antibiotics, and possibly surgery. Mild diverticulitis infection may be treated with bed rest, stool softeners, a liquid diet, antibiotics to fight the infection, and possibly antispasmodic drugs.
Percutaneous therapy
However according to the American Society of Colon and Rectal Surgeons (ASCRS) radiologically guided percutaneous drainage is usually the most appropriate treatment for patients with a large diverticular abscess as it avoids the need for emergency surgery and possibility of a colostomy34.
Ciprofloxacin, levofloxacin, metronidazole, amoxicillin-clavulanic, and moxifloxacin are typically prescribed to treat infection related to diverticulitis.
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.
The prevalence of diverticulitis and diverticular bleeding has also been increasing[4]. Diverticulosis of the colon is often diagnosed during routine screening colonoscopy.
Most patients with acute sigmoid diverticulitis are treated medically; surgery is only indicated when diverticulitis is either not amenable or is refractory to medical therapy (algorithm 1) [5-8]. Approximately 15 percent of patients will require surgery for diverticular disease [7].
If you're having an acute attack of diverticulitis, your doctor may suggest either a low fiber diet or a clear liquid diet to help relieve your symptoms. Once symptoms improve, they may recommend sticking with a low fiber diet until symptoms disappear, then building up to a high fiber diet to prevent future flares.
Rest, taking over-the-counter medications for pain and following a low-fiber diet or a liquid diet may be recommended until your symptoms improve. Once your symptoms improve, you can slowly return to soft foods, then a more normal diet, which should be one that includes many high-fiber foods.
Depending on recovery, the colostomy can be either permanent or temporary.
If you've had two or three episodes of diverticulitis, your doctor may recommend an elective procedure called sigmoidectomy, in which the affected part of the colon—called the sigmoid colon—is removed to help prevent a recurrence.