Diagnosing Diverticulitis

Diverticulitis is a medical condition that can affect any portion of the digestive tract. It happens most commonly (but not exclusively) in the large intestine or colon. It occurs when a small, bulging pouch (called diverticula) forms somewhere in the digestive system and then becomes inflamed and/or infected. Diverticula in and of themselves are not uncommon, especially in people older than 40. Seldom do they cause problems and are frequently discovered during routine colon cancer screening tests, although in some case, diverticulitis may be more troublesome.

Prediagnosis signs

The signs and symptoms associated with diverticulitis are common to many gastrointestinal maladies; consequently, the process of diagnosing diverticulitis should start with an examination and consultation with your primary care provider. The more common signs of diverticulitis include lower left abdominal pain that may come on quite suddenly and intensely. Less frequently, the pain may start out as relatively mild and worsen over the course of a few days, with the intensity fluctuating back and forth between severe and mild. The afflicted person may experience change in bowel habits, abdominal bloating, nausea and vomiting, diarrhea, constipation, fever and rectal bleeding (in rare cases).

Diagnostic testing

In confirming the diagnosis of diverticulitis, one of a few different approaches may be employed, ranging from the minimally invasive all the way up to endoscopy. The choice of treatment will depend upon the location and severity of the diverticulitis. Regardless of which method is chosen, the physician will probably order some standardized lab tests to look for signs of infection or issues not related to the gastrointestinal tract.

The minimally invasive option for diagnosing diverticulitis involves one of a couple of different technologies. Computerized axial tomography (CAT) scan with oral and/or intravenous radiopaque contrast is a common diagnostic tool. It routinely identifies 98 percent of diverticulitis cases. It can be used for diverticulitis in any part of the digestive tract and has the added advantage of eliminating the risk of bowel perforation in severely or chronically inflamed colon walls.

A second minimally invasive diagnostic tool is the barium enema or lower GI series. This involves introducing barium sulfate contrast into the lower intestine via the rectum, holding the contrast in place with a balloon-tipped catheter and then using an X-ray fluoroscope to monitor the movement of the contrast through the large bowel. This method allows for contrast visualization of abnormalities in the intestines.

Colonoscopy offers the most invasive but also the most accurate diagnostic tool. This is where a flexible endoscope is introduced into the lower gastrointestinal tract via the rectum. The physician can then directly view the colon and assess any abnormalities that might be detected. The primary drawback to colonoscopy is that it is contraindicated in cases where the bowel may be chronically or severely inflamed, due to the potential for intestinal perforation.

When to suspect diverticulitis

There are a number of factors that increase your risk of developing diverticulitis. Most commonly, the condition can develop with age and may be higher if there is a family history of certain genetically linked gastrointestinal conditions. Smoking, obesity, a low-fiber diet and insufficient exercise may all contribute to developing diverticulitis. If you experience the common signs and fall into one of these risk categories, seek a medical assessment immediately.

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