diverticulitis

Question 1

Saclike herniation of the lining of the bowel that extends through a defect in the muscle layer

Answer 1

diverticulum

Question 2

Can occur anywhere in the small intestine or colon BUT most commonly in the sigmoid colon
Exception: Those with Asian heritage develop _______ in the Right colon

Answer 2

diverticula

Question 3

– Multiple diverticula present without inflammation or symptoms
Very common in developed countries; prevalence increases with age

Answer 3

diverticulosis

Question 4

predisposing factors for diverticulosis?

Answer 4

decreased intake of dietary fiber

Question 5

when food and bacteria retained in the diverticulum produce infection and inflammation
Can lead to perforation or abscess formation
If occurs at less than 50 years of age – may be related to obesity
May occur as an acute attack or may persist as an infection

Answer 5

DIVERTICULITIS

Question 6

Abscess, fistula formation, obstruction, perforation, peritonitis and hemorrhage

Answer 6

symptoms of diverticulitis

Question 7

Will often be proceeded by chronic constipation

Answer 7

diverticulosis

Question 8

Generally mild
Bowel irregularity – intervals of diarrhea, nausea, anorexia, bloating, abdominal distention
If bowel is repeatedly inflamed, results in narrowing in bowel, cramps, narrow stools, increased constipation and increased risk for obstruction
Weakness, fatigue and anorexia

Answer 8

s/s of diverticulosis

Question 9

acute onset of mild to severe pain in left lower quadrant with nausea, vomiting, chills and leukocytosis
If left untreated: can result in peritonitis and septicemia

Answer 9

diverticulitis

Question 10

diverticulosis is diagnosed with?

Answer 10

colonoscopy

Question 11

diverticulitis is diagnosed with?

Answer 11

CT with contrast to reveal abscesses
x ray -reveal free air under diaphragm if perforation is present
labs: CBC: WBC infection, ESR inflammation

Question 12

when is a colonscopy contraindicated in diverticulitis?

Answer 12

if it is acute bc it can cause perforation

Question 13

what are complications associated with diverticulosis?

Answer 13

Peritonitis, abscess formation, fistulas, bleeding

Question 14

Symptoms are less pronounced in an older adult
May not have abdominal pain until infections occurs
Overlook blood in the stool because they cannot see it due to visual changes, physical inability to inspect stools, or fear of knowing what blood is from

Answer 14

gerontological considerations for diverticulosis

Question 15

Rest, analgesic meds, antispasmodic agents
Clear diet until inflammation subsides
High fiber, low fat diet: increases stool volume, decreases colonic transit time, increases intraluminal pressure
Antibiotics x 7-10 days
Bulk-forming laxative
NO seeds

Answer 15

treatment for diverticulitis outpatient

Question 16

Inpatient hospitalization: For older adults, immunocompromised or taking corticosteroids
NPO, IV fluids, NG suctioning if vomiting or distention, put on bowel rest
Broad spectrum antibiotics x 7-10 days
Opioids or other analgesics for pain
Oral intake increased as: symptoms subside
Antispasmodic agents:
Propantheline bromide: antimuscarinic agent for cramps, stomach spasms and intestines
Oxyphencyclimine (Daricon) – antimuscarinic and anticholinergic
To have normal stools: add bulk preparations like psyllium, stool softeners like docusate, and suppositories like bisacodyl
Probiotics: to restore normal flora

Answer 16

acute diverticulitis management