Diverticulitis

Dr. Sulaiman Bin Yusof

MbChB (Sheffield) M.Med (Surg) FRCSEd (Gen Surg)
蘇萊曼·尤索夫博士

Diverticulitis occurs when small pouches (diverticula) that form in the digestive tract, typically in the colon, become inflamed or infected.

These pouches develop when weak spots in the intestinal wall bulge outward. When inflammation or infection occurs, patients may experience severe abdominal pain, changes in bowel habits, and other digestive symptoms that can affect daily activities.

Symptoms of Diverticulitis

Abdominal Pain: Persistent pain typically occurs in the lower left abdomen, though some patients experience pain on the right side. The pain often intensifies over several days and may worsen with movement.

Fever: Body temperature may rise above 38°C, indicating the presence of infection. This commonly appears alongside other digestive discomfort.

Nausea and Vomiting: These symptoms often accompany severe abdominal pain and may affect eating habits. Some patients experience loss of appetite for several days.

Changes in Bowel Habits: Patients may experience constipation or, less commonly, diarrhoea. These changes can last several days to weeks.

Bloating: The abdomen may become distended and feel tender to touch. This discomfort often increases after eating.

Blood in Stool: Some patients notice bright red blood in their stool or on toilet paper. This symptom requires prompt medical attention to determine its cause.

Causes and Risk Factors

Several factors contribute to the development of diverticulitis, and recognising these can aid in prevention. Common causes include:

  • Age

    The risk increases for individuals over 50 years as the intestinal walls naturally weaken with age. The prevalence rises significantly in those over 65 years old.

  • Low-Fibre Diet

    Regular consumption of low-fibre foods increases pressure within the colon, leading to diverticula formation. This risk factor is particularly common in Western diets.

  • Obesity

    Excess weight places additional strain on the digestive system and increases inflammation risk. A BMI over 30 particularly correlates with higher incidence.

  • Sedentary Lifestyle

    Lack of regular physical activity affects bowel motility and overall digestive health. Extended periods of inactivity can worsen symptoms.

  • Smoking

    Regular tobacco use weakens intestinal walls and increases inflammation risk throughout the body. Smokers often experience more severe symptoms during flare-ups.

Types of Diverticulitis

Diverticulitis manifests in different forms that require specific treatment approaches.

Acute Diverticulitis

Sudden onset of inflammation or infection of diverticula. Symptoms develop rapidly and may range from mild to severe, often appearing within 48 hours. Treatment typically involves antibiotics and temporary dietary modifications to allow the bowel to heal. Some patients recover within a week with appropriate treatment.

Chronic Diverticulitis

Long-term, recurring inflammation that can lead to persistent symptoms. Patients experience repeated episodes of acute diverticulitis with varying intensity, often several times per year. This form may require long-term management strategies and lifestyle modifications. Regular medical monitoring helps prevent complications.

Complicated Diverticulitis

Development of serious complications such as abscess formation, perforation, or fistula. This type requires immediate medical intervention and often surgical treatment. Recovery periods vary depending on the specific complication and treatment approach, typically ranging from several weeks to months.

Diagnostic Methods

Physical Examination

The doctor checks for abdominal tenderness and other physical signs. This examination helps determine the location and severity of inflammation while ruling out other conditions. The doctor also assesses vital signs and overall health status.

Blood Tests

Laboratory analysis checks for signs of infection and inflammation. These tests measure white blood cell count and other markers that indicate the presence and severity of infection. Results typically return within 24 hours and guide treatment decisions.

CT Scan

This imaging test provides detailed views of the intestinal wall and surrounding tissues. CT scans help identify complications such as abscesses or fistulas and guide treatment decisions. The procedure requires oral or intravenous contrast material for optimal imaging.

Colonoscopy

This examination occurs after acute symptoms resolve, typically 6-8 weeks later. The procedure allows direct visualisation of the colon to assess the extent of diverticular disease and rule out other conditions. Preparation involves complete bowel cleansing the day before.

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Treatment Options

Non-Surgical Treatment
Antibiotics

Oral or intravenous antibiotics target bacterial infection. Treatment duration typically ranges from 7-14 days, depending on symptom severity. The medication type and delivery method depend on infection severity and patient factors.

Dietary Modifications

A clear liquid diet allows bowel rest during acute episodes. Gradual reintroduction of solid foods occurs as symptoms improve, with emphasis on high-fibre foods once inflammation resolves. This process typically takes 2-3 days.

Pain Management

Over-the-counter or prescription medications help control abdominal pain. These medications are used temporarily until acute symptoms subside. The choice of pain relief depends on pain severity and patient tolerance.

Surgical Treatment
Bowel Resection

This involves removing the affected sections of the colon using either traditional or laparoscopic surgery. It is typically performed for recurring episodes or complications such as fistulas or strictures. The choice of surgical technique depends on the extent of the disease and individual patient factors.

Primary Bowel Anastomosis

After removing the diseased portion of the colon, the healthy sections are reconnected. Recovery usually requires 4–6 weeks of limited activity. The success of the procedure depends on the condition of the tissues and the surgical method used.

Temporary Colostomy

In severe cases or when complications arise, a temporary opening (stoma) is created in the abdomen to divert waste. This is usually reversible, with closure performed after the affected area has healed. The colostomy is generally in place for three months to a year.

Prevention and Management

Regular physical activity, maintaining adequate hydration, and following a high-fibre diet help prevent diverticulitis episodes.

A diet rich in fruits, vegetables, and whole grains promotes regular bowel movements and reduces pressure within the colon. Patients benefit from establishing regular eating patterns and avoiding prolonged sitting.

Weight management through healthy lifestyle choices reduces the risk of complications.

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Dr. Sulaiman Bin Yusof

MbChB (Sheffield)

M.Med (Surgery)

FRCSEd (General Surgery)

蘇萊曼·尤索夫博士

Dr. Sulaiman Yusof is a distinguished Senior Consultant in colorectal and general surgery, boasting over 15 years of expertise. His passion lies in minimally invasive techniques, particularly robotic surgery, where he has achieved remarkable success using the Da Vinci Xi system. Dr. Sulaiman is dedicated to delivering high-quality, personalized, and empathetic care, always striving for the best outcomes for his patients.

Education & Specialist Training
  • MbChB(Sheffield)
  • M.Med(Surgery)
  • FRCSEd(General Surgery)

Dr. Sulaiman’s journey began at the University of Sheffield, where he graduated in 2002. He honed his skills during his house officer and basic surgical training in the UK before returning to Singapore. There, he completed his Advanced Surgical Training at Changi General Hospital and earned the Joint Speciality Fellowship in General Surgery in 2013.

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    Singapore 217562

    Frequently Asked Questions

    Does diverticulitis require long-term dietary restrictions?

    After recovering from acute episodes, most patients resume a normal diet. A high-fibre diet and adequate fluid intake support long-term digestive health. Individual tolerances may vary, and patients should adjust based on their experience.

    What is the recovery time after diverticulitis surgery?

    Recovery time depends on the procedure type. Laparoscopic surgery typically requires 2–3 weeks for most activities, while traditional surgery may take 4–6 weeks. Patients should avoid strenuous physical activity until cleared by their doctor.

    How often do diverticulitis episodes recur?

    Recurrence rates vary among individuals. About 20% of patients experience a second episode within 5 years. Adherence to dietary and lifestyle recommendations influences recurrence frequency.

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