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Digestive Disorder: Diverticulitis Patient History The Patient Case Study

Digestive Disorder: Diverticulitis Patient history

The patient is a 37-year-old female with a family history of colorectal cancer mandating regular colonoscopies before the age of 40. The patient's diverticulosis was discovered during a routine colonoscopy at age 35. She was asymptomatic for 2 years, but developed diverticulitis at age 37. When she began experiencing significant pain her lower left abdominal area, she suspected diverticulitis, called her gastroenterologist who referred her to the emergency room for a cat scan, which confirmed the diagnosis, and then given a course of antibiotics, which resolved the issue.

Diverticulitis

"Diverticulitis develops when feces become trapped in pouches (diverticula) that have formed along the wall of the large intestine. This allows bacteria to grow and cause an infection or inflammation and pressure that may lead to a small perforation or tear in the wall of the intestine. Peritonitis, an infection of the lining of the abdominal wall, may develop if infection spills into the abdominal (peritoneal) cavity" (WebMD, 2010). It is believed that these diverticula from when high pressure in the colon pushes against weak spots on the colon wall, and low-fiber diets are believed to contribute to causation.

Type and Severity of the Disorder

At this point, the patient's diverticulitis is generally managed by lifestyle modifications. Therefore, her disorder does not appear very severe. However, diverticulitis can be a very severe disease. The first course of treatment for the disease is antibiotics, but non-responsive cases may involve surgery, and those surgeries have a relatively high risk of morbidity.

Risk Factors

The...

A low-fiber diet is one of the risk factors for diverticulitis. Another risk factor, which people cannot control, is family history. For some time, there has been a belief that certain foods are more likely to get trapped in the diverticula, including nuts, seeds, berries, and popcorn. However, there is no evidence that these foods actually contribute to diverticulitis or make diverticulitis worse (Davis & Matthews, 2006).
Managing the Condition

Dietary changes, including an increase in fiber and reduction in red meat in her diet, have seemingly prevented the patient from having a recurrence of diverticulitis. However, what is interesting is that while doctors have long-recommended a high-fiber diet to prevent or manage diverticulitis, the evidence in support of that treatment is not consistent; some studies have found no difference in high-fiber interventions and control groups in recurrent diverticulitis rates (Unlu et al., 2011). However, at this point, the prevention strategies have not resulted in another occurrence of diverticulitis. One of the alternative treatments that the patient may want to consider is using rifaximin in addition to fiber, because that has shown a significant difference in recurrent rates (Maconi et al., 2011).

However, given the patient's young age, it is likely that she will have another recurrence of diverticulitis. If she experiences symptoms again, there are a number of things that she can do to help manage the condition. The initial treatment for diverticulitis is dependent on the severity of symptoms. If the condition is mild, characterized by mild pain and an inability to drink…

Sources used in this document:
References

Davis B.R. & Matthews, J.B. (2006). Diverticular disease of the colon. In M. Wolfe et al., eds., Therapy of Digestive Disorders, 2nd ed., pp. 855-859. Philadelphia: Saunders Elsevier.

Maconi, G., Barbara, G., Bosetti, C., Cuomo, R., & Annibale, B. (2011). Treatment of diverticular disease of the colon and prevention of acute diverticulitis: A systematic review. Dis. Colon Rectum, 54(10), 1326-38.

Martin, S.T., & Stocchi, L. (2011). New and emerging treatments for the prevention of recurrent diverticulitis. Clin. Exp. Gastroenterol., 4, 203-212.

Unlu, C., Daniels, L., Vrouenraets, B.C., & Boermeester, M.A. (2011). A systematic review of high-fibre dietary therapy in diverticular disease. Int. J. Colorectal Dis. doi: 10.1007/s00384-011-1308-3. Retrieved from: http://dx.doi.org/10.1007/s00384-011-1308-3
http://www.webmd.com/digestive-disorders/tc/diverticulitis-topic-overview
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