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Complications of Diverticulitis

Diverticulosis is very common, being found in more than half of Americans over the age of 60. Only a small percentage of these people will develop the complication of diverticulitis. Diverticulitis can lead to complications such as infections, perforations or tears, blockages or bleeding. These complications always require treatment to prevent them from progressing and causing serious illness. The diverticula may also get infected. This is caused by stool or food that is not broken down and gets trapped, causing swelling and pain. A diverticulum can become infected with bacteria and rupture, causing diverticulitis. Fever, pain, and tenderness of the lower left abdomen are common symptoms. Constipation and diarrhea may also occur.

A fistula is an abnormal connection of tissue between organs or between an organ and the skin. When damaged tissues come into contact with each other during infection, they sometimes stick together. If the tissues heal that way, a fistula is formed. When diverticulitis related infection spreads outside of the colon, the colon's tissue may stick to other tissues in the same area. The most common organs involved are the urinary bladder, skin, and small intestine. The most common type of fistula occurs between the bladder and the colon. This tends to affect men much more than women. This type of fistula can result in a severe infection of the urinary tract, which can last for a long time. This problem can be corrected with surgery which removes the fistula and the affected portion of the colon.

Any scarring that may be caused by infection may cause partial or total blockage of the large intestine. When this occurs, the colon is unable to move the contents of the bowel normally. When the obstruction totally blocks the intestine, emergency surgery is necessary. Partial blockage is not an emergency, however, so surgery may be scheduled in advance. Diverticular disease is diagnosed by having a physical exam, revealing medical history, and diagnostic testing. Because most people do not have symptoms, diverticulosis is often found through tests which are ordered for another ailment.

When taking a medical history, the doctor may ask about pain, symptoms, bowel habits, diet, and current medications. The physical exam usually involves a digital rectal exam in which the doctor inserts a gloved, lubricated finger into the rectum to detect blockage, blood, or tenderness. The doctor may also request to check stool for signs of bleeding and test the blood for signs of infection. X-rays or other, more complicated, tests may be requested by the doctor as well.

A doctor may perform a colonoscopy once inflammation has subsided or the infection has been treated. A colonoscopy is an examination of the large intestine using a flexible viewing tube. These tests are performed to either confirm the presence of assess the severity of diverticula and to rule out the possibility of colon cancer. Colonoscopy or barium enema x-rays usually need to be delayed for several weeks after treatment as they may damage or rupture an inflamed intestine. Exploratory surgery is rarely required to confirm or deny the diagnosis.