What are the expected outcomes for diverticulosis and diverticulitis

What is the prognosis of Diverticulosis and Diverticulitis

Diverticular disease and diverticulitis are gastrointestinal conditions affecting the large intestine, or colon. They involve the development of small pouches or pockets on the intestinal lining, which can become inflamed or infected.

Three primary conditions associated with the development of these pouches in the colon include diverticulosis, diverticular bleeding, and diverticulitis. Symptoms of diverticular disease typically include lower abdominal pain and bloating, whereas diverticulitis is characterized by severe abdominal pain and fever with a temperature of 100.4°F or higher.

Outlook for Diverticulosis and Diverticulitis

Diverticulitis recurs in approximately 20% to 30% of patients, with roughly one-third experiencing a repeat episode despite non-operative treatment, often within one year. Long-term fiber supplementation can prevent recurrence in over 70% of cases. Co-existing inflammatory bowel disease (IBD) is common among patients experiencing recurrent attacks. Even after colonic resection, the recurrence rate remains low, at around 1%.

Complications of Diverticulitis

Diverticulitis can result in serious complications, often stemming from tears or perforations in the intestinal wall. When this happens, intestinal waste material can leak into the abdominal cavity, leading to various complications as outlined below:

Abscess: The most common complication involves the formation of an abscess within the colon. Abscesses are pus-filled cavities or lumps in the tissue and are typically treated with percutaneous abscess drainage (PAD). In cases where pus surrounds inflamed tissue, drainage may be necessary, possibly requiring surgical intervention to clean the area and remove a portion of the colon.

Fistula: Another common complication is the development of a fistula, which are abnormal tunnels connecting different parts of the body, such as the intestine and abdominal wall or bladder.

Peritonitis: In rare instances, infected diverticula (pouches in the colon) can rupture, spreading infection into the abdominal lining, a condition known as peritonitis.

Intestinal obstruction: Severe scarring from infection can lead to partial or complete blockage of the large intestine, which is a medical emergency. Complete blockage can cause tissue decay and eventual rupture, leading to peritonitis.

Prevention and management of diverticular disease often involve dietary changes, including a high-fiber diet to improve symptoms and prevent complications. A balanced diet with at least five daily servings of fruits, vegetables, and whole grains is recommended.