Diverticular Disease

Diverticular Disease: Diagnostic Tests

Obligatory medical device diagnostics. Abdominal ultrasonography (ultrasound examination of abdominal organs) – diagnostic method of choice in primary and follow-up diagnosis of acute diverticulitis [guideline: S2k guideline]: An echo-poor, initially asymmetric wall thickening (>5 mm) with abolition of wall stratification, low deformability under pressure, and narrowing of the lumen, The (depending on the extrusion of … Diverticular Disease: Diagnostic Tests

Diverticular Disease: Micronutrient Therapy

An at-risk group indicates the possibility that the disease may be associated with the risk of vital substance (micronutrient) deficiency. The complaint diverticulitis indicates a vital substance (micronutrient) deficiency for: Vitamin B12 Iron Within the framework of micronutrient medicine (vital substances), the following vital substances (micronutrients) are used for the prevention (prevention) of diverticulitis: Probiotics … Diverticular Disease: Micronutrient Therapy

Diverticular Disease: Prevention

To prevent diverticular disease/diverticulitis, attention must be paid to reducing individual risk factors. Behavioral risk factors Diet Low-fiber diet – A low-fiber diet is a major cause of diverticulosis. Here, insoluble fiber (contained in cereals, especially wheat, rye, cereal bran, as well as in most vegetables and fruits) is of particular importance. Due to their … Diverticular Disease: Prevention

Diverticular Disease: Symptoms, Complaints, Signs

The following symptoms and complaints may indicate diverticular disease/diverticulitis: Leading symptoms Pain in the lower abdomen (colicky), usually in the left lower quadrant (left lower abdomen); both spontaneous and release pain, lasting up to several days (approximately 90% of diverticula are localized in the sigmoid) [motion dependence of pain is suggestive of sigmoid diverticulitis; similar … Diverticular Disease: Symptoms, Complaints, Signs

Diverticular Disease: Causes

Pathogenesis (development of disease) True and pseudodiverticula can be distinguished. Diverticula are frequently located in the sigmoid colon (sigmoid diverticulosis). The cause for the formation of diverticula is probably excessive intraluminal pressure (increased intestinal pressure) and increased intestinal motility (→ diverticulosis/change of the colon in the form of small protrusions of the intestinal wall). In … Diverticular Disease: Causes

Diverticular Disease: Therapy

General measures For lower abdominal pain due to acute sigmoid diverticulitis (diverticulitis of the sigmoid colon), cooling (e.g., ice bladder) helps; also spasmolytics (antispasmodic drugs), if necessary. Nicotine restriction (refrain from tobacco use). Limited alcohol consumption (men: max. 25 g alcohol per day; women: max. 12 g alcohol per day). Regular physical activity Aim for … Diverticular Disease: Therapy

Diverticular Disease: Test and Diagnosis

1st order laboratory parameters – obligatory laboratory tests. Small blood count [leukocytosis: > 10-12,000/μl] Differential blood count Inflammatory parameters – CRP (C-reactive protein) [diverticulitis: CRP > 5 mg/100 ml; suspected perforation CRP > 20 mg/100 ml]Note: Inflammatory values often become conspicuous only within 1-2 days. Urine status (rapid test for: pH, leukocytes, nitrite, protein, glucose, … Diverticular Disease: Test and Diagnosis

Diverticular Disease: Drug Therapy

Therapy goals Improvement of the symptomatology Avoidance of complications Therapy recommendations Food restriction for pain relief. NSAIDs should be avoided because of evidence of increased perforation rate and increased recurrence rate (recurrence of disease). Avoidance of antibiotic therapy can be justified under the following conditions: Patients without a fever ≥ 39 °C; and Without risk … Diverticular Disease: Drug Therapy

Diverticular Disease: Medical History

Medical history (history of illness) represents an important component in the diagnosis of diverticular disease/diverticulitis. Family history Are there any diseases in your family that are common? Social anamnesis Current medical history/systemic history (somatic and psychological complaints). How long have you had pain? Do you have abdominal pain? How does the pain occur? Permanent?* Colicky?* … Diverticular Disease: Medical History

Diverticular Disease: Or something else? Differential Diagnosis

Endocrine, nutritional, and metabolic diseases (E00-E90). Diabetes mellitus Food intolerance such as lactose intolerance Porphyria or acute intermittent porphyria (AIP); genetic disease with autosomal dominant inheritance; patients with this disease have a 50 percent reduction in the activity of the enzyme porphobilinogen deaminase (PBG-D), which is sufficient for porphyrin synthesis. Triggers of a porphyria attack, … Diverticular Disease: Or something else? Differential Diagnosis

Diverticular Disease: Complications

The following are the most important diseases or complications that may be contributed to by diverticular disease/diverticulitis: Blood, blood-forming organs – Immune system (D50-D90). Iron deficiency anemia (anemia due to iron deficiency). Mouth, esophagus (food pipe), stomach, and intestines (K00-K67; K90-K93). Abdominal abscess formation Colonic ileus Diverticular hemorrhage (= rupture of the vasa recta) – … Diverticular Disease: Complications

Diverticular Disease: Classification

There is no standard classification for diverticular disease/diverticulitis. In clinical practice, the classification according to Hansen and Stock is suitable Stage Designation Symptomatology Colonoscopy/colonic contrast enema Abdominal CT 0 Diverticulosis – Irritable diverticula Diverticula gas-/KM (contrast medium)-filled I Acute uncomplicated diverticulitis Lower abdominal pain Mucosal redness around diverticular necks/ spicules, bowel wall thickening + possibly … Diverticular Disease: Classification