diverticular disease

Question 1

diverticulum

Answer 1

pouch or pocket in bowel wall

Question 2

diverticulosis

Answer 2

presence of diverticula without inflammation or infection

Question 3

diverticulitis

Answer 3

inflammation and infection of diverticula

Question 4

how to diverticula form

Answer 4

circular muscle layer of large bowel has weak points where blood vessels penetrate it

gaps allow mucosa to herinate through –> diverticula

Question 5

most commonly affected section of bowel

Answer 5

sigmoid colon

Question 6

diverticulosis risk factors

Answer 6

age
low fibre
obesity
use of NSAIDs

Question 7

diverticulosis mx

Answer 7

nothing ifasymptomatic

increse fibre
bulk-forming laxatives
surgery

Question 8

what to avoid in diverticulosis

Answer 8

stimulant laxatives e.g. senna

Question 9

acute diverticulitis presentation

Answer 9

pain LIF 
fever
diarrhoea 
N+V
rectal bleed
abdo mass if abscess
raised CRP and WCC

Question 10

acute diverticulitis Mx - uncomplicated in primary care

Answer 10

• oral co-amoxiclav at least 5 days
• analgesia (avoid NSAIDs and opiates)
• only take clear liquids and avoid solid foods until Sx improve
• follow up < 2days to review

Question 11

acute diverticulitis Mx - complications or severe pain requiring hosp admission

Answer 11

• NBM or clear fluids only
• IV antibx
• IV fluids
• analgesia
• urgent Ix e.g. CT
• urgent surgery if complications

Question 12

acute diverticulitis complications

Answer 12

perforation 
peritonitis 
peridiverticular abscess
large haemorrhage 
fistula 
obstruction