Diverculitis

• Diverculitis

- Diverculum is an outpouching of bowel mucosa most commonly found in the sigmoid colon

- Diverculitis is the inflammation or perforation of the diverculum

- Meckel’s diverculum is a congenital disorder characterized by outpouching of the distal ileum near the cecum. It mimics signs if appendicitis

- Risk factor

§ Increasing age

§ Lack of fiber

§ Stress

- Etiology: Trapped undigested food in the divercula

- Clinical Manifestations

§ Most people are asymptomatic for years

§ Abdominal pain

§ Alternating diarrhea and constipation

§ Gas formation, flatulence

§ Fever

§ Abdominal distension

§ May mimic signs and symptoms of apendicitis

- Diagnostics

§ History: diet, bowel movement, pain

§ Physical examination: abdominal tenderness, rebound tenderness,

§ Ultrasound

§ Barium enema

§ Rectal exam with sigmoidoscopy

- Management

§ Antibiotics such as Ampicillin and Cephalosphorin

§ Analgesic: Meperidine (Demerol) prn

§ Anticholinergics (propantheline) to reduce colonic contractions

§ Laxative and stool softener prn

- Nursing Interventions

§ In acute stage, decreasing the gastric motility is the primary concern

§ Bed rest

§ Diet from NPO advancing to what the client is able to tolerate emphasizing on inclusion of foods high in fiber (add fiber gradually as it may increase gas formation)

§ Watch out for complications such as bowel obstruction, perforation, peritonitis, hemorrhage