Colon Disease

Diverticulitis is a sometimes painful condition that develops when pouches (similar to a bag) that form in the colon wall (part of the large intestine) becomes inflamed or infected. Most often, diverticulitis can be treated by changes in diet and in case of infection by antibiotic treatment. Diverticulitis occurs when bacteria are trapped inside the diverticulum is formed along the bowel wall, causing infection. Bacteria grow and cause inflammation and increased pressure inside the diverticulum, can cause a small perforation or tear in the intestinal wall. Peritonitis, which is an infection of the lining of the abdominal wall can complicate diverticulitis, if the infection spreads into the peritoneal cavity (abdomen). The reason diverticula occur in the intestinal wall is not fully understood. Doctors believe that diverticula form when high pressure inside the colon pushes weaknesses in the wall of the colon. Uncoordinated colonic movements may also contribute to the occurrence of diverticula. In general, a diet with adequate fiber content makes the stool bulky and easier to be transported through the colon. If the diet is low in fiber, the colon must determine a higher pressure than normal to carry feces, small and high consistency. Also, a diet low in fiber increase the time the stool stays in the intestines, adding to pressure. Pouches may form when increased pressure pushes the colon wall in weak points where blood vessels pass through the colon muscle layer of the blood supply to the colon wall. It is not known why some people who have diverticula (a condition called diverticulosis) diverticulitis and others do not.

Symptoms Symptoms of diverticulitis may last from several hours to several days. These symptoms include: -Sensitivity, cramps or abdominal pain (usually in the left lower abdomen but can occur on the left) which is worse when you move -Fever and chills -Diarrhea or constipation -Nausea and sometimes vomiting -Bloating, fullness, flatulence (wind) -Loss of appetite. Complications of diverticulitis also cause symptoms. If you develop a fistula (a communication) between the colon and vagina or between the colon and urethra, you can remove gas or feces through the vagina or urethra. Other diseases such as irritable bowel syndrome or urinary tract infections can cause symptoms similar to diverticulitis. Symptoms such as rectal bleeding, change in bowel habits, unexplained weight loss may be signs of colon cancer. If any of these symptoms, should be provided to a specialist.

Mechanism fiziopatogenetic Diverticulitis occurs when a diverticulum of the intestine wall (very well resemble a bag) become inflamed or infected. It is not fully understood why 20% of people with diverticulosis (diverticula disease is the emergence colony) are diverticulitis, while the rest do not. Diverticulitis usually affects the left colon (sigmoid colon). Mild attacks of diverticulitis, with few symptoms and signs of infection or inflammation, may heal without treatment. In some cases, your doctor may prescribe antibiotics in the treatment of diverticulitis and a liquid diet to cleanse your colon until the inflammation is removed. If the infection and symptoms are severe, hospitalization is required. Hospital treatment includes resting the colon by putting in intravenous fluids and antibiotics or a diet with intravenous fluid. If severe diverticulitis is not treated, complications such as abscess or fistula may occur. In such cases, surgery is needed. About a third of those with diverticulosis will not have another attack of diverticulitis for a year. Risk Factors The risk of diverticulitis increases with age. The risk for diverticulitis increases in the following situations: Diet low in fiberFamily history of diverticulitis, -Smoking. Studies have shown that people smoke have a higher risk for complications of diverticulitis than the nonsmokers. There was described a certain complication associated with smoking. Call a Doctor Emergency medical advice is recommended if bleeding occur anal and signs of shock, which may indicate that diverticular pouch is bleeding (diverticular bleeding). We recommend consulting a specialist as soon as possible in case of abdominal pain localized to a certain point (as opposed to diffuse abdominal pain), especially if symptoms such as: -Fever or chills -Nausea or vomiting Abnormal changes in bowel-Bloating or abdominal swelling Blood, faeces -Burning when urinating (dysuria) -Abnormal vaginal discharge Talk to your doctor immediately if you experience: -Severe abdominal pain that gets worse -Containing feces in most of the blood. Blood in the stool may be red, brown, or black clots, the pitch -Shoulder pain, possibly due to air in the abdomen caused by intestinal perforation Talk to your doctor if painful cramps do not improve after the elimination of feces or gas or if you remove gas or feces through the urethra during urination. This indicates a fistula between the intestine and urinary tract. Watchful waiting

May be present bloating, cramping or mild abdominal pain. This may be caused by certain foods or stress. Through a simple home treatment can solve these drawbacks. If treatment is not helpful or if symptoms worsen, see your physician. Medical specialists recommend Health professionals who can diagnose and prescribe treatment for diverticulitis include: -GP -Physician. If other tests are needed or if symptoms do not respond to treatment or surgery if necessary, we recommend consulting the following specialists: -Gastroenterologist physician -Surgeon. Investigation If a doctor pecteaza diverticulitis requires a physical examination. Depending on your symptoms, it may take one or more tests to determine the cause of these symptoms. The multitude of investigations depends on the severity of symptoms and their duration. Routine tests These tests can be made at any time are abdominal pain or other symptoms. Complete blood counts (counting all blood elements: white blood cells, red blood cells, platelets) revealed the presence of infection or bleeding in the colon, where a small number of red blood cells. Urinalysis may reveal a urinary tract infection. Abdominal radiography may provide clues about the cause of abdominal pain or other symptoms. Looking for a digital rectal exam or a mass sensitivity palpatorie the lower pelvic area. Hemocultul is a stool test that can demonstrate the presence of microscopic bleeding in the stool. Other investigations Depending on symptoms and other tests may be needed. Computed tomography (CT) is necessary if picioneaza an infection (an abscess) in the abdomen or a perforated diverticulum. CT can provide information about other possible causes of symptoms. Barite and barium radiography is used to detect a diverticulum or other possible causes, if pecteaza darnu use a diverticulitis due to risk peritoenala penetration cavity barriers, if there is a perforation. Another substance that has the same function as barriers, but that can dissolve in water can be used instead of barium. Lighted or colonoscopy can be used in case of symptoms that reveal bleeding in the colon. They can be used in detection of stenosis (narrowing) or tumors in the intestine to reveal an

ulcerative colitis or colon cancer. Upper digestive tract investigations are performed to investigate the possibility that the symptoms be caused by a gastric or small bowel disease. Upper gastrointestinal endoscopy is performed to rule out or confirm a cause stomach or upper portion of the small intestine of symptoms. Angiogram (also called arteriogram) locates the source of bleeding, in case of massive bleeding from the gut. Early Diagnosis At present, there is no screening available for diverticulitis. With the age of 50 years, flexible sigmoidoscopy is recommended every 3-5 years or colonoscopy every 10 years as part of a screening for colon or rectum cancer. Both flexible sigmoidoscopy and colonoscopy, involves using a flexible tube with a snap camera ready to end the video to view the large intestine. If this diverticulitis, these examinations often reveal their presence. Treatment - General A severe shortage of diverticulitis can be treated at home, by a diet rich in fiber. However, in some cases, seizures can occur intermittently over a long period (chronic). Treatment of these cases is identical, if no complications arise. Initial treatment Treatment of diverticulitis depends on the severity of symptoms. If the pain is mild, that is possible and liquid intake are not signs of complications, treatment may include: -Drugs such as antibiotics and pain relievers -Changes in diet, initiate a liquid diet or soft diet, a low-fiber, until the pain goes away, then high in fiber. Although some people avoid nuts, seeds, corn, believing that they may remain trapped in diverticula and cause pain, there is no evidence that these foods cause or aggravate diverticulitis. If severe pain, inability to drink fluids or if signs of complications, hospitalization is required. Treatment includes: -Intravenous antibiotics -Fluids and nutrients intravenously administered (not allow any food or liquid hold oral) for 1 week to put at rest the intestines -Keeping the stomach empty, by fitting a tube nazogatric. This is necessary if vomiting occurs or bloating -Surgical treatment for complications of diverticulitis so, and for repeated attacks, that does not get better by changing their diet. Approximately 15-20% of initial attacks of diverticulitis require surgery. Maintenance treatment Treatment of the recovery period after a bout of diverticulitis is intended to prevent a new crisis. Treatment may include: -Gradual increase in fiber content of the diet by increasing the amount of fruits, vegetables, bran bread, and taking fiber supplements

-Consumption of 6-8 glasses of water daily -Regular consultation with your doctor who will monitor the patient's condition. In case of diverticulitis, reassessment is recommended after 2 days of starting treatment to confirm relief. It is recommended that a colonoscopy or barium swallow is a test from 6 weeks of starting treatment once symptoms were under control. These examinations are required to search for other possible diseases such as colon cancer or inflammatory bowel disease. Treatment if the condition gets worse In some cases may be complicated diverticulitis. Complications of diverticulitis include: -Abscess -Perforation -Intestinal obstruction In these situations, you need surgery to remove the affected part of intestine. Surgical treatment (without being made emergency as with complications) may be required if 2 or more attacks of diverticulitis, which usually indicate a higher risk for subsequent seizures. Prophylaxis Diverticulitis can be prevented by: -Fiber diet A sufficiently liquid consumption -Regular exercise. Treatment Home treatment may be helpful in relieving symptoms of diverticulitis or reduce the risk for future attacks of diverticulitis. To reduce abdominal pain caused by mild diverticulitis are recommended: -Application of a warm bed pillows or stomach cramps and abdominal pain may improve light -Relaxation techniques (such as breathing slowly and deeply in a quiet room, meditation or biofeedback) may help reduce the abdominal pain intensity -Medicinal pain relievers (against pain) without a prescription such as ibuprofen or acetaminophen (paracetamol) -If symptoms do not improve and pain increased in intensity, it is advisable to consult a specialist. To improve bowel disorders are recommended: A diet rich in fiber. Grain breads and cereals, rice, vegetables and fresh fruits should be part diet that is rich in fiber such A healthy program with eating at certain times, without difficulty eliminating feces, 6-8 glasses of water drunk daily -Try not to use laxatives to regulate bowel movements. Medications To stop the infection and relieve symptoms often use drugs. Medication Choices

Antibiotics such as metronidazole and ciprofloxacin are used to treat diverticulitis. Drugs are sometimes necessary prescription pain relievers, in cases where antialgicele not prescribed were not effective. Food for Thought Drugs are not used to prevent future attacks of diverticulitis. Prevention depends on increasing the amount of fiber in your diet and a regular schedule in terms of bowel movements. Surgery Treatment consists of surgical removal of the portion affected diverticulitis of the colon. Surgical treatment decision is taken in the following situations: Partial obstruction of the colon, or a stricture (narrowing) Repeated crisis diverticulitis. Surgical treatment of the affected portion of the colon is recommended often as a result of repeated attacks of diverticulitis -Increased risk for complications (such as people younger than 40 who have a history of diverticulitis attacks) Repeated anal-bleeding -Fistula (abnormal communication) occurred between colon and adjacent organ (joined), most commonly the bladder, uterus or vagina -Cancer risk. Surgical treatment of diverticulitis, which involves removal of a portion of the colon, it is necessary in case of complications, including: -Perforation (rupture) of a diverticulum in the abdominal cavity, especially if an abscess is already present. In some cases, the abscess can be drained without the need for surgery -Spread of infection in the abdominal cavity (peritonitis) -Bowel obstruction Spread of infection through blood-to other parts of the body (sepsis) -Severe bleeding does not resolve (stop) despite treatment. Approximately 15-20% of initial attacks of diverticulitis require surgery because of perforation, intestinal obstruction or ineffective medical treatment to stop the infection. Survival rate after surgery is not urgently needed is 99%, and the necessary emergency when there is a perforation is 70%. Surgery involves removing the affected portion of the colon (colectomy partial) followed by the remaining portions anastomosis (reconnecting the two ends). Depending on the severity and nature of symptoms, it may take one or more surgeries to correct the problem. When you need more than one surgery, the person will wear a colostomy during the intervention. A colostomy consists of a surgical procedure in which the upper intestine is connected to an abdominal opening (anus against nature). Faeces are removed through this opening, in a special bag. Colostomy is removed when the anastomosis is made. Surgical Options

As surgical treatment of diverticulitis, partial colectomy involves removal of the affected portion of intestine. Food for Thought In cases of people with mild symptoms who wish to try lifestyle changes long term, may not need surgery. In case of diverticulitis with repeated seizures, surgery is recommended. Other treatments In some cases of diverticulitis, abdominal abscess can heal on their own. Otherwise, surgical drainage is needed. This is done by inserting a needle through the skin to drain fluid from the abscess and infectious. Computed tomography (CT) help guide the needle to the abscess. Sometimes, it takes installing a drain in the abscess. May be necessary sometimes put at rest the colon. This is achieved by complete restriction only diet and fluids and nutrients intravenously. Nazogastric tube is mounted to eliminate digestive juices in the stomach. After 2-3 days of rest of the colon, it can begin a soft diet. If the obstruction was resolved, no need for surgery. Otherwise, it still rest the colon. If it does not solve any obstruction, consider surgical removal of the diseased colon. The alternative treatment of diverticulitis using probiotics that contain live microorganisms in food. Probiotics help maintain the natural balance of intestinal microflora in a way that is beneficial to health. Studies have shown that probiotics are effective in treating mild and moderate cases of ulcerative colitis, as well as diarrhea or irritable colon. http://colonic-inertia.blogspot.com/2012/01/colon-disease.html