Diverticulitis or diverticular disease can develop as a result of the inflammation ordiverticula infection. What is a diverticulum? What are the symptoms of diverticulitis and how to treat it? We take stock with Prof. Zerbib, gastroenterologist and hepatologist.
Diverticulitis: what is a diverticulum?
Before explaining what diverticulitis is, we must first talk about diverticula : “a diverticulum (or” colonic diverticulum “) is a small hernia that we find most often at the level of the wall of the sigmoid colon and the left colon “explains Prof. Franck Zerbib, gastroenterologist and hepatologist.
From Latin “diverticulum” (which means “detour”), the diverticulum is comparable to a “hollow pocket” that forms in the wall of the colon, outwards. This anatomical anomaly is not rare since 50% of French people aged 70 and over are affected: we speak of “uncomplicated diverticulosis”.
Namely: the presence of diverticula (whether there is only one or several dozen!) “Is, in the vast majority of cases, asymptomatic “affirms Prof. Zerbib. They are moreover, more often than not, discovered in a fortuitous way during a colonoscopy carried out for a completely different reason.
In addition (unlike colonic polyps, with which they can be confused), no hereditary factor has been identified concerning the development of diverticula.
Diverticulitis: what are the symptoms?
However, these benign diverticula can become more complicated and inflammation / infection can develop due to several factors:
• Immunosuppression (for example linked to HIV infection),
• A chemotherapy,
• Taking corticosteroid drugsornonsteroidal anti-inflammatory drugs (NSAIDs) which weaken the lining of the intestine and colon.
This is called diverticulitis or “diverticular disease”. It should be noted, however, that only a minority of patients with diverticula will develop diverticulitis. Symptoms of diverticulitis include:
• A sharp pain in the lower abdomen(rather on the left), “comparable to the pain felt in the event ofappendicitis “specifies the specialist,
• A fever (from 38 ° C).
“If you have these symptoms, make an appointment with your general practitioner, advises Prof. Zerbib. He will prescribe a blood test: if the blood count confirms the inflammation, a CT scan of the abdomen. and pelvis will be performed to confirm the diagnosis of diverticulitis. “
Namely: according to the High Authority of Health (HAS) “the diagnosis of diverticulitis, including in patients with a known history of diverticulitis, cannot be confirmed on the only clinical and biological data”. The blood test and the to scan are therefore essential!
How to treat diverticulitis
To treat diverticulitis, antibiotic treatment (amoxicillin and clavulanic acid) may be prescribed. “It is not systematic,” nevertheless specifies the specialist. Indeed: the adoption of a diet without residues (which consists of temporarily removing dietary fiber of his plate – rice, raw fruits and vegetables, bread …) would be just as effective according to the French National Society of Gastro-Enterology (SNFGE).
“Furthermore, diverticulitis should not be confused with chronic pain or colopathy, that’s the whole point of the blood test and the scanner “adds Prof. Zerbib.
Diverticulitis: what are the possible complications?
Diverticulitis can be complicated:
• In abscess (infection localized in contact with the colon),
• In peritonitislocalized or generalized (inflammation and / or infection of the leaflet that surrounds the organs in the belly),
• In fistula (communication of the colon with a neighboring organ: the bladder, the small intestine or the vagina, for example),
• In stenosis (inflammatory narrowing of the diameter of the colon which may follow infection).
In addition, besides infections, diverticula can also bleed (this is hemorrhage), most often in the form of a brutal emission of red blood from the anus – we are talking about rectal bleeding.
“These complications constitute medical emergencies,” says Dr. Zerbib. In the case of complicated diverticulitis, intravenous antibiotic therapy is necessary and surgery (which consists of the removal of the part of the colon where the diverticula concerned are located) is essential.
Can we prevent diverticulitis?
Not really. Thus, according to the Haute Autorité de Santé (HAS): ” no diet cannot be recommended for the prevention of recurrence of diverticulitis “. And according to the French National Society of Gastro-Enterology (SNFGE),” no treatment (cures of probiotics, antibiotics, intestinal antiseptics …) has demonstrated its ability to prevent diverticulitis and recurrence of diverticulitis “.
Thanks to Prof. Franck Zerbib, gastroenterologist and hepatologist, member of the French National Society of Gastroenterology (SNFGE).
Sources:
High Authority of Health (HAS)
French National Society of Gastroenterology (SNFGE)
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