K57.0-5/K57.8-9
DESCRIPTION
Colonic diverticulosis becomes increasingly common with age. Acute diverticulitis is suspected in patients with lower abdominal pain (typically in the left lower quadrant). The pain is usually constant and is often present for several days prior to presentation. Nausea and vomiting are often present due to a bowel obstruction or an ileus due to peritoneal irritation. Changes in bowel habits can be observed.
Diverticulosis can be complicated by haemorrhage or diverticulitis. Acute diverticulitis is inflammation of diverticulae usually accompanied by polymicrobial infection. Acute diverticulitis is defined as complicated when there is bowel obstruction, abscess, fistula, or perforation.
GENERAL MEASURES
Increase dietary fibre intake.
MEDICINE TREATMENT
Total duration of antibiotic therapy is 10 days, depending on clinical response.
Uncomplicated diverticulitis:
- Amoxicillin/clavulanic acid, oral, 875/125 mg 12 hourly.
If unable to tolerate oral therapy:
- Amoxicillin/clavulanic acid, IV, 1.2 g 8 hourly.
REFERRAL
- Acute diverticulitis with clinical deterioration or failure to improve on medical therapy.
- Peritonitis.
- Complicated diverticulitis (to a centre which can perform colonic surgery).
- Massive haemorrhage.