DIVERTICULOSIS

57 YEARS OLD LADY PRESENTS TO YOUR PRACTICE COMPLAINING OF CONSTIPATION. HER FATHER WAS DIAGNOSED WITH
COLON CANCER AT THE AGE OF 65. HE IS ALIVE AND WELL AND HE IS NOW 90YEARS OLD. YOU SEND HER FOR
COLONOSCOPY AND THE RESULTS COME IN. THE DIAGNOSIS WAS DIVERTICULOSIS. YOU HAVE CALLED HER TO DISCUSS THE
DIAGNOSIS WITH HER
TASK:
EXPLAIN THE DIAGNOSIS AND MANAGE THE PATIENT
ANSWER THE QUESTIONS

YOUR PATIENTS TAKES 2 BEER PER DAY AND THE EXAMINER ASKS YOU TO COMMENT ON THAT.

I read from your notes that your have constipation for a long time. How long have you had this constipation ? 4-6
months?
Constipation only? Yes
I
You have a condition called diverticulosis.
This are multiple small blind sacs
Drawing:

Normally mrs smith..when we eat ..we absorb certain substance

Because you avoid eating fiber in your diet, when we eat are food after of absorbtion
The lack of the fibers ..your feces start to be hard and have constipation
Bowel has high pressure inside to expel this high pressure
The bowel starts to balloon with blind sac – called diverticula
At this stage, we don’t have anything to worry about. But this carries some risk
In the future, we are afraid of trapping of food particle or feces inside this blind sacs which could become infected and
become diverticulitis.
I would to reassure you that it is not a predisposing disease for malignancy. It would not turn into colon cancer like
your dad.
I don’t want to have diverticulitis
You did colonoscopy
I can refer you to a dietician to tell you about healthy food suitable for your condition. This healthy food contains high
fiber like vegetable, fruits, whole meal bread multigrain bread, use fiber cereals…
Try to change your lifestyle with regards to your food h
Exercise – 3 x a week for half an hour.
Drink at least 6-8glasses of water per day. It will improve your bowel motion
If you are still worried, I can refer you to do a barium enema. But we have confirmed your diagnosis already.
They will give you barium enema and they will take series x-ray f

Complication: infection, bleeding – if + bleeding, this does not confirm that it is diverticulitis

Diverticulitis – complication of diverticulosis

Acute:
Chronic

Patient with fever, abdominal pain, nausea and vomiting – Admission

Treatment: antibiotic, rest in bed, NPO, IV fluid, and when he improves, do colonoscopy

If the diagnosis is uncertain in acute cases, do (exploration) laparoscopy