Digestive Disorder: Diverticulitis Patient History the Patient

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 risk factors for developing diverticulitis are not well-understood at this point in time. 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 fluids, then moving to a clear-fluid diet along with antibiotics may be sufficient to clear up the condition. When pain is severe and the patient is unable to drink liquids, then the patient may need to be hospitalized. If hospitalized, the patient may need IV antibiotics, only intravenous fluids and nutrition, and sucking out the contents of the stomach through a nasogastric tube.

If the patient's condition remains non-responsive to antibiotics, then the patient may need surgery. However, only about 6% of diverticulitis patients need surgery (WebMd, 2010). However, in patients under the age of 40 who have an attack of diverticulitis, elective surgery is an option. One of the patient's main decisions may be the decision whether or not to have surgery to prevent future diverticulitis episodes. Until recently, the treatment protocol for diverticulitis was that two episodes of sigmoid diverticulitis warranted surgical intervention (Martin & Stocchi, 2011).

However, it is important to keep in mind that surgery for diverticulitis has a relatively high morbidity rate, so that prior surgical protocols may be inappropriate. The modern approach is that "surgery for diverticulitis thus needs to be tailored to suit individual presentation; patients presenting with recurrent diverticulitis, severe symptoms or debilitating disease impacting patient's quality of life mandate surgical intervention. Complicated diverticular disease typically prompts intervention to resect a diseased, strictured sigmoid colon, fistulizing disease, or a life-threatening colonic perforation.

Laterally, minimally invasive surgery has been utilized in the management of this disease and recent data suggests that localized colonic perforation may be managed by laparoscopic peritoneal lavage, without resection" (Martin & Stocchi, 2011). Family Member / Caregiver Implications The patient is a stay-at-home mother with a husband and two small children. Her husband was her primary caregiver during her diverticulitis attack. He was responsible for.