There are several different types of diverticulitis. Each one has its own Symptoms and treatments. The first type of diverticulitis is “diverticulitis uncomplicated in stable patients”. The second type of diverticulitis is “diverticulitis uncomplicated in older or ill patients”, and the third and final type of diverticulitis is “diverticulitis complicated”.
The Symptoms of diverticulitis uncomplicated in stable patients are: abdominal pain, fever, leukocytosis and not being able to tolerate oral fluids due to vomiting. The Symptoms of diverticulitis uncomplicated in older or ill patients are: abdominal pain, fever, leukocytosis, an inability to tolerate oral fluids due to vomiting, and in this type the patient is older than 85 years of age or is ill with another medical condition. The Symptoms of diverticulitis complicated are abdominal pain, fever, leukocytosis, with or without sepsis, and the presence of a perforation, abscess, fistula or an obstruction.
The treatment for diverticulitis uncomplicated in stable patients is to administer oral antibiotics and to place the patient on a clear liquid diet, it is advised not to give morphine (Duramorph) because of the risk of increasing intracolonic pressure. The treatment for diverticulitis uncomplicated in older or in ill patients is to administer intravenous antibiotic and to administer intravenous fluids, in order to give the colon a rest. Therefore it is wise not to give anything at all by mouth. Demerol may be given for pain.
To treat diverticulitis complicated it is desired to stabilize the patient with fluids and also antibiotics. A surgical consultation is necessary if damage to the colon is present. The complicating condition must be dealt with in a speedy fashion to prevent further damage.
Determining which type of diverticulitis is the job of the attending doctor when the individual is seen at the emergency room. Symptoms, medical history and test results are factors used to determine the type. The abdominal pain is common to all three. Other symptoms that are common are nausea, vomiting, as well as either constipation or diarrhea. Age, the presence of an additional medical condition, and complications are to be considered. Certain symptoms are similar for all three types of diverticulitis, so the attending must look for other medical factors and the medical history for a diagnosis.
When making the diagnosis it is also important to keep in mind that other conditions can mimic diverticulitis such as irritable bowel syndrome. Computed tomography (CT) scans, the physical exam of the abdomen, and blood tests to check for elevated white blood cell counts and other signs of infection are important tools for arriving at an accurate diagnosis.
Once the diagnosis is made, a treatment plan can be formulated based on the type of diverticulitis.