Wednesday, 4 December 2013

Diverticulitis: The Types

Diverticulitis is defined as a condition of inflammation of the small, bulging sacs or pouches of the inner lining of the intestine that bulge outward through weak spots as a result of small pieces of stool (feces) trapped in these pouches. In most cases, the disease is found in the large intestine (colon). According to the statistic, approximately, About 10 percent of Americans older than 40 have diverticulosis.
In the examination of the data fom January 2004 to June 2005 of 796 consecutive patients referred for total colonoscopy to 17 physicians included age, gender, presence and localization of diverticula. This population was compared with a cohort of 133 consecutive patients who were admitted for colonic diverticular bleeding, showed that the prevalence of colonic diverticula increased from less than 10% in adults under 40 to about 75% in those over 75 years. Of these patients, nearly one third presented with right-sided involvement(1).
I. Types of Diverticulitis(2)
1. Uncomplicated and Simple Diverticulitis
In most case, simple, uncomplicated diverticulitis respond to conservative therapy with bowel rest and antibiotics, accotding to the study of data between 2007 and 2009 of a total of 103 patients consecutively enrolled at the first attack of uncomplicated right colonic diverticulitis. 40 patients underwent an outpatient management regimen consisting of oral antibiotics (for 4 days), and 63 patients underwent an inpatient management regimen that included bowel rest and intravenous antibiotics (for 7-10 days), researchers found that outpatient management with short-term oral antibiotic therapy for the treatment of uncomplicated right colonic diverticulitis is as effective as inpatient management in regard to preventing disease recurrence(3).

2. Complicated Diverticulitis
In complicated diverticulitis, antibiotics are found to be less effective, with no evidence supporting their routine use(4). But other study of patient with right colonic diverticulitis classified according to treatment modality; 135 patients (85.4%) underwent conservative treatment, including antibiotics and bowel rest, and 23 patients (14.6%) underwent surgery. The mean follow-up length was 37.3 months, and 17 patients (17.5%) underwent recurrent right-sided colonic diverticulitis, found that conservative management with bowel rest and antibiotics could be considered as a safe and effective option for treating right-sided colonic diverticulitis. This treatment option for right-sided colonic diverticulitis, even if the disease is complicated, may be the treatment of choice(5).

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