Diverticulosis vs Diverticulitis: Pain or No Pain?

Hey everyone, I'm Dr. Jamal. I'm here to talk about divert ticulitis, what it is, how we diagnose it, and how we treat it. We're also going to talk about who develops it and who doesn't. So, let's break it down. Imagine the human colon is a soft pliable tube and it's a large tube. Over time, these little pouches develop from the outer wall and these pouches are protruding outwards. Now, food can get stuck in them and the process itself is a silent process. Around 60% of adults actually have these and don't even know it. These can often be found in CT scans and even in colonoscopies. And the condition is called diverticulosis. Sometimes they can even cause painless bleeding. But when the pouches become inflamed or infected, that condition is called diverticulitis. So, how do we diagnose it? If you develop pain in the left quadrant, lower portion of your abdomen, then that is a strong sign of diverticulitis. But there are other organs in that part of the body that this can also mimic like constipation or acute gynecologic issues. So what usually patients will do is they'll present to the emergency department because the pain is very severe. And that's when a CT scan of the abdomen and pelvis will be used to determine whether this is gynecologic, whether this is a kidney stone or diverticulitis. And a CT scan is usually pretty good at picking up other things as long as contrast or die is used. Once we diagnose diverticulitis, we classify it as either complicated or uncomplicated. In complicated diverticulitis, there's usually an abscess, which is a collection of pus or a perforation. In uncomplicated diverticulitis there is no perforation or abscess formation and in those cases we will actually observe the patient and control their pain especially with medicines like acetaminophen Tylenol. However, if the patient is immune suppressed, pregnant over the age of 80, has complications like the absess or perforation then they're likely going to need to come in for IV antibiotics. This group also includes patients with liver disease or kidney disease. There have been several proposed risks to explain why some individuals develop diverticulitis and diverticulosis and others do not. Physical activity has been found to show an improvement in diverticulosis development rates. Furthermore, a high BMI of 30 or more has also been linked. There's still a lot of debate between nuts and other types of seeds and it seems that the recent evidence shows that these are