Diverticulitis and Diverticulosis

Question 1

Symptoms and signs of acute diverticulitis?

Answer 1

Left iliac fossa pain
Fever
Diarrhoea
Nausea
Vomiting
Rectal bleeding
Palpable abdominal mass if an abscess formed

Signs:
Left iliac fossa tenderness

Question 2

Management of uncomplicated acute diverticulitis?

Answer 2

Uncomplicated: manage in GP with…
- 5 days oral co-amoxiclav
- Analgesia (EXCEPT NSAIDs and opiods)
- Only clear fluid intake until symptoms improve (usu. 2-3 days)
- Follow up within 2 days

Question 3

Management of severe diverticulitis?

Answer 3

Admit
-NBM or clear fluids only
- IV abx
- IV fluids
- Analgesia
- Urgent CT scan
- Urgent surgery

Question 4

Causes of diverticulosis

Answer 4

Low fibre diet
NSAIDs
Obesity
Older age

Question 5

Which laxatives can be used in diverticulosis?

Which laxatives should be avoided?

Answer 5

USE: Bulk forming laxatives, e.g. isaphgula husk

AVOID: stimulant laxatives, e.g. Senna