the

Diverticulitis Signs & Symptoms (And Why They Occur)

hey everyone welcome back to another

lesson this lesson is on the signs and

symptoms of

diverticulitis so we're going to talk

about the signs and symptoms that occur

in diverticulitis and why they occur so

to begin i want to briefly talk about

what diverticulitis is

diverticulitis is a gastrointestinal

disorder involving inflammation of

diverticula

or outpouchings of the colon or large

intestine so what does that all mean

what are diverticula

and what is the large intestine so here

is the gastrointestinal system

including the stomach leading into the

small intestine leading into the large

intestine

now the large intestine here this is

what gets affected

in diverticulitis and i mentioned that

diverticular are outpouchings now if we

were to zoom up

so we can zoom up in this area here we

see it here

so here's the large intestine and we get

these little out pouchings these little

bulges in the large intestine wall

and this is actually due to weakened

bowel walls so as

people get older and due to chronic

issues with constipation and low fiber

diets

the walls of the large intestines become

weak so when

the walls of the large intestine become

weak pressure and contraction

in the large intestine can lead to

little pouches popping out because of

the weakened wall and these are the

diverticula

and these little diverticular become

inflamed

into diverticulitis when a piece of

feces can block

the opening to the diverticula so once

there's a piece of feces that blocks the

opening to the diverticular can lead to

inflammation

and the diverticula can become inflamed

and swollen

in this part of the large intestine

right here the sigmoid colon

is a common place where we can see

diverticulum that will become important

when we talk about

where we see symptoms of diverticulitis

in the next slide

so let's talk about signs and symptoms

of diverticulitis the first one is

abdominal pain this is the most

important most common symptom in

diverticulitis

so i want to briefly talk about where we

have pain in diverticulitis so if we

look straight on

to someone's abdomen this would be the

right side of the patient this would be

the left side of the patient

we actually have to break down the

abdomen into

quadrants so that can help us when

determining location

of the abdominal pain so we break it

down we put a cross

essentially right through the belly

button or the embolicus

so this would be the right upper

quadrant again this is the right side of

the patient right upper quadrant

right lower quadrant left upper quadrant

and left lower quadrant

and again this is important because

we're going to use these terms when we

describe

where the pain occurs in diverticulitis

and in fact the left lower quadrant is

the most common location where we see

abdominal pain in diverticulitis

because again that's where we talked

about the sigmoid colon being

and diverticula can form in the sigma

equality become inflamed there and

interestingly the left lower quadrant

that location is more common in western

populations so western populations who

have diverticulitis are more likely to

have abdominal pain in the left lower

quadrant and the reason i say that is

because we can also see

right lower quadrant pain occurring in

diverticulitis as well but we

see this more commonly in asian

populations

and this may appear like appendicitis

your appendix is right here as well

but it's more likely to be

diverticulitis if the pain is lasting

more than three days

so again left lower quadrant is the most

common location where we see abdominal

pain

in diverticulitis and it's even more

common in western populations

and in the right lower quadrant if you

see pain there it's more common in asian

populations with diverticulitis and it

can appear like

appendicitis and the pain is constant

this is a constant pain

and the pain may be diffused so although

i talk about it being in these locations

it may

look like it spreads up into other areas

as well

so again it's constant and if you were

to push on someone's abdomen in one of

these locations it can be tender very

very tender

so again it's constant pain and it's

tender to touch

and the pain may be diffuse if it is a

very severe case of diverticulitis

now the next symptom we're going to talk

about with regards to diverticulitis is

bowel habit changes

so bowel habit changes can either be

constipation and or diarrhea so there

can be

either constipation or diarrhea

constipation is more common

diarrhea can also occur and there could

be a mix of both

so we're going to look at the bristol

stool chart here in a moment just to

describe

what constipation is what diarrhea is so

bristle stool chart type 4

stool would be the normal stool and then

type 1 to type 3 would be

constipated stool and type 5 to type 7

would be the diarrhea so

with diverticulitis you can see issues

with constipation so type 1 to type 3

on the bristol stool chart and then with

regards to diarrhea it can be type 5

to type 7 and in diverticulitis

constipation is more common than

diarrhea but you can have

both and it can alternate so there's a

change in bowel habits with

diverticulitis

we can also see nausea and vomiting

occurring in diverticulitis as well

this may be caused by the abdominal pain

so it's a very severe case it could

lead to very severe abdominal pain and

lead to nausea and vomiting

but what is really worrisome when we see

nausea and vomiting in diverticulitis is

obstruction so it could be secondary to

obstruction now what is obstruction

so we looked at this image before of

diverticular becoming inflamed and

becoming swollen

well if the diverticula becomes so

swollen so it's a very severe case of

diverticulitis

they become so swollen that it can

actually block off

the large intestine that would be

obstruction so

no passage of stool would occur and

things would start to back up

so it back up through into the large

intestine into the small intestine and

so on and this can lead to nausea and

vomiting so it is an obstruction

that can cause nausea and vomiting so

again nausea vomiting can occur in

diverticulitis

not often but it can and it could be

caused by abdominal pain but it could be

caused by obstruction where

one diverticula very large eye

particularly becomes very very inflamed

and actually blocks off the large

intestine obstructs it

so no stool can actually pass beyond

that point and it leads to a backup

and eventual nausea and vomiting now

because this is inflammation

diverticulitis

it's inflammation of diverticular we can

see fever

so again it's caused by inflammation so

inflammation can lead to a fever

we can also see where some cases there

can be micro perforations

or even a larger perforation from the

diverticula so the

walls of the diverticular are a bit weak

and if it becomes so inflamed so

enlarged

these little diverticular can actually

break a little hole can form and

feces can actually escape from the large

intestine so

you can get feces bacteria entering into

the sites surrounding the large

intestine this can lead to infection

and lead to a fever as well so these are

very severe cases so you want to make

sure

that you catch these types of

perforations where it leads to

possible abscess or sepsis so

again fever can occur due to

inflammation

but it could also be due to infection so

it could be due to both

inflammation and or infection and then

with the fever we can also see a high

heart rate

so high heart rate is also known as

tachycardia so you can get a

fever with tachycardia and other

symptoms that are very very important to

recognize in diverticulitis is urinary

urgency frequency in dysuria

so what does all of that mean so it

feels like

you need to urinate more often more

quickly so you feel like you really have

to run to the bathroom quick

and then sometimes you have a burning

sensation so it kind of sounds like

a urinary tract infection but it's not

and

the reason this is important is because

it can be confused with a

urinary tract infection a uti so the

reason this happens

is because a diverticula can form in the

sigmoid colon in this area here

and your bladder is in this location as

well

it's actually in front of the large

intestine

so if there's a very very large

diverticula that becomes inflamed it can

actually push

on the bladder and it can make an

individual feel like they have to really

go pee

more often more frequently and can make

them feel like they have to really go

quickly

and it can actually lead to burning

sensation as well so this can be

confused with a urinary tract infection

if you're just to look at these symptoms

but when you look at the whole picture

with a constant abdominal pain

in the left lower quadrant or the right

lower quadrant with fever

and some of those other symptoms we

talked about changes in bowel habits so

then you can actually see that these

symptoms

urinary urgency frequency and disuria

are actually due to diverticulitis

so that is the reason so very important

to recognize this

urinary urgency frequency and dysuria

can look like a urinary tract infection

if those are the only symptoms you see

but

with diverticulitis you're going to have

all those other symptoms we talked about

before you're going to have that

constant abdominal pain with possible

fever

and changes in bowel habits and that

will all tie into diverticulitis so if

you want more information on

diverticulitis please check my full

lesson on that topic

and if you want more information on

other ways to reduce your risk of

diverticulitis please check out my

lesson on that topic as well

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and i hope to see you next time