Diverticulitis Symptoms 101: What is It, Causes, Symptoms, and How to Prevent

Hey guys, in this article we're going to talk about diverticulitis a lot of people always ask me but what is diverticulitis and a lot of patients come in they have diverticulitis and never heard

of it they want to know what it is and there's a little confused about things so this article we're

going to go over diverticulitis alright so definition first of all I'm going to take a little a little

 dance academy lesson as usual okay so this is you can't see that right there so this is a crude

drawing of the colon and the colon is the portion of the bowels the last portion of the bowels
which basically might throw this little thing here which moves the liquid stool which comes

into here this is the small bowel goes into what we call the cecum and then it goes up the

ascending colon across the transverse colon and down the descending colon along this sigmoid

 colon because it's shaped like an S and then out the rectum okay and that would be the anus

down there so basically the colon removes a lot of water from the stool that comes in liquid
here this part here and then it's liquid and it's the water gets removed of some electrolytes get

 removed and then it becomes solid somewhere over here and then goes out the infamous

poop chute hood down there right so what happens in diverticulitis never have seen like a

little inner tube and the inner tube gets a little weak spot in it right and you have a little blip

right where I'm going to go and draw right here okay so this is what happens you see this little blip right here oh what a mouth over there so the wall of the colon basically gets a weak spot

and you have a like a little outpouching okay a little bubble and that's a diverticulum and

diverticula with a a e is singular and diverticulum actually I've seen there two diverticulitis

that's not senior anyway I don't know it is multiple but anyway that reticula I think is maybe

anyway here we go so there's lots of them over here and generally they happen in this sigmoid

 colon like this sometimes it can happen in the a sitting : I'm going to talk about the ones
here we'll talk about the ones here in a second so when these little things here they can

happen and generally maybe you have some pain for a short period of time you have one of

those things from your lips develop they can do nothing they can just sit there all the time

and you can never have any problems with them or what could happen is they get blocked

okay I'm gonna go little drawing in my internal drawing you see the neck of them are the base

 of those things they're blocked off okay and what is in the colon besides poop bacteria and so

 bacteria gets in these things and they get trapped there's no place to go so then bacteria what does what they do best and proliferate right and then we have a little little thing there be

nothing there it bursts okay or it gets it's actually has micro perforations and that is

diverticulitis okay i ts means inflammation but diverticulitis is when you have a diverticulum

that particular by themselves are not infected they can be be not infected and then you can

have a diverticulitis which is infected they can have just usually just one gets infected and you

Micro perforations and then we have like a little bit of a continuum where I talked about last time or from will say divert let's see we'll have micro if I was good I've done this before

perforation to gross rupture and once again we have a continuum okay something like this so

we have where are we micro perforation you can't even read because I have terrible

handwriting and then on this little continuum here we have gross perforation or gross rupture

of the colon so that would be where you just have a big ol hole whoops you just have a big ol

blowout you know I'm saying you have a big blowout like that and you just have stool spill

into the abdomen bad news you couldn't get that and then in the in the meantime we have

maybe a little bit of spillage but not a lot and we can form what's called an abscess okay an
abscess is something like this where you have the book you have a micro perforation like this

 or a small blowout and the body walls it off and all this stuff in here is bacteria the bacteria

gets caught in there but the body contains it and it doesn't go everywhere and so you can get

fevers and chills and get sick but that is part of the continuum okay I just want to do that the

 little definition there and then we'll talk about the symptoms and things so a particular this is

 basically an infection in the colon but after you have these little diverticula they get ruptured
you can have micro perforation you can have a small like a slightly bigger perforation with

abscess or you have gross rupture and most of the time you have this micro perforation which

 is treated with antibiotics but I'll go over that side so symptoms associated with diverticulitis

 are pain abdominal pain and most of the time so if I go like this this is the left side and this is

 the right side okay so most of the diverticulitis happens on the left side you can have it over

here it's just not very common okay you can have diverticula over here they're less common

more mostly the diverticular over here bleed so we generally talked about deputy guys we're

talking about left side so left sided lower abdominal pain is generally what's going on so you you know down here into what's the right side right side is appendicitis we talk about right side

 abdominal pain with fevers and chills we think of appendicitis left side abdominal pain with

fevers and chills we generally think about diverticulitis okay so if you have progressing of

Donald Payne maybe over 24-48 hours which is not going Kate not going away getting worse

fevers and chills each but I go see somebody okay if it's real bad just somebody lessons in less

than 24 hours so that's generally the what what folks feel you can have some nausea vomiting you can have diarrhea you can have constipation now let me mention real quick why do we

get these and it is essentially because the colon is having a lot of pressure okay so as you can

imagine the colon is kind of like a muscular tube and it squeezes along the way like this right it

 squeezes everything down so if the squeeze you generate too much pressure in the colon that

you can have that's just like the the weakening of the to the inner tube the wall there's certain

 parts of the colon where the wall is a little bit weaker and that's where you have those little

outpouching things and so I lost my train of thought what was I thinking symptoms so fevers chills nausea vomiting diarrhea constipation either one a physical exam on talked about

physical physical exam same thing when you go the doctor and they press on your belly and if

 they press over here it doesn't hurt and it's a right side and then they press over here and

you're like oh that hurts then it may be some diverticulitis it may be a micro perforation if

they push over here and it hurts over here then that may be a gross rupture that's what we call

 peritonitis and that's because the inside of the abdominal wall tough lining is really really

angry and no matter where you push it hurts over here okay so that's the basically physical

exam for that the laboratory values generally patients have a elevated white blood cell count

and that is because the white blood cells are trying to fight some sort of infection and you

have a rise in white blood cells in the blood and so your doctor will probably get you that and

then typically it doesn't affect the blood so like your hemoglobin or your manic rate doesn't

really get affected however if you have a right-sided diverticulitis or excuse me a right side or

diverticulum over here those often bleed more than they get infected and so sometimes if you have gross blood from the rectum then you may have a diverticulum that is bleeding x-rays I

 gotta let me cheat my cheat sheet here so x-rays typically how its diagnosed is if you have

abdominal pain you go see your family physician or you go to emergency department

generally you get up just in a plane act what we call plane x-ray it looks from back to front and you see the bones and all that stuff you may see some gas but you don't see really the

diverticulum or the infection so much but the cat scan is much better for that so you probably

 get a cat scan if you see nothing on the initial x-ray you get a cat scan and that can show you

 the diverticulum that's about the best way to adult sees it you probably will see diverticulum if

you don't have an infection if you do have an infection that's the best way to see it

diverticulitis and also the abscess which we talked about and then treatment so there's a few

ways we can treat this depending on what is going on so if it's a micro perforation and we

don't think there's spillage of stool into the abdomen and there's not an abscess and it's not
gross spillage then we can generally treat those with antibiotics sometimes you need a little bit

of IV antibiotics say like you stay in the hospital for 24 hours you get the IV antibiotics then

 you feel much better the next day and you go home and you stay on oral antibiotics for about

 eight to eight to fourteen days depending on your severity if you have an abscess so that's a

little different what you do depending on how big the abscess is if it's over two centimeters

you may stick well maybe I shouldn't say stick but you put a needle you place a needle gently into the abscess okay this is done under a radiologic guidance so c2e get a cat scan or an

ultrasound and you can put a needle through the skin after you're not skin into the abscess and

suck out the pus basically that's a fancy way of saying it but that's what you do and you can

get that and sometimes you leave a drain like a tube in that cavity and sometimes you can

suck out the pus and you don't need to leave a drain and so you'd also get antibiotics for that

depending on how big the abscess is depending on where it's located all that stuff you can have

 that done and you may have antibiotics for two weeks to six weeks depending on severity so

then lastly is the surgical treatment so after you have an abscess or you have diverticulitis if

you have a little tiny diverticulitis for you know it's a micro perforation you get a cup you get
 some antibiotics it goes away you feel good it happens again if when you start having it

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happen more than once then you start thinking about well maybe you need that portion of

the colon removed because if it perforates right here now here's the trick now listen to this if

 it perforates and you have gross contamination of stool in the abdomen you may need an

emergent surgery with a removal of the that portion of the colon and a colostomy bag right

you know where you have the bag where you poop into out of your skin into the bag bad news
 nobody wants that so that's the big deal about diverticulitis you have a recurrent recurrently if

you have an emergency surgery for it maybe a colostomy bag now we're definitely surgeons in

 general or moving more towards not doing the bag so much and trying not to do that but if

it's grossly infected there's lots of poop everywhere if you do that and you close it all up you

could have a bad infection so depending on the situation you may end up with that may not but that's the bad stuff okay um so and then so that was kind of like the emergency portion

right if you have have an emergency if you have the gross rupture you get real sick right you

go in the hospital you have emergency surgery on the elective side so you get diverticulitis

and it's micro perforation so you get that a couple times your surgeon and or doctor may

recommend you have that portion of the colon out and on the draw this portion right here

which is generally the sigmoid portion sigmoid colon right here with the little s here the little

s turn that's a sigmoid portion so you get the portion of the colon and when your surgeon goes

 in there they look for all these diverticula and they say okay well there's no diverticular about right here let's go here and so generally that's about the sigmoid colon and then you come

down here and say okay there's no diverticular here this looks pretty good stuff down here

we'll leave that we'll take this portion out and then if you have an elective in elective surgery

you can put these back together and hook you back up the same surgery and you don't have to

have a colostomy bag so that's a good deal so all right that is my spiel on diverticulitis I hope

you like that I hope it makes a little bit more sense hope it helps you to avoid the colostomy

 bag because nobody likes that and yeah you know where to find me dr. buck Parker com I will see you later you.

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