Symptoms of diverticulitis of the colon

The article was written by Doctor Mai Vien Phuong - Department of Medical Examination & Internal Medicine - Vinmec Central Park International General Hospital

Colonic diverticulum is a common disease in the elderly, often without symptoms, unless these diverticula become inflamed, also known as diverticulitis.

Urinary tract infections vary in severity, from simple diverticulitis to complex diverticulitis with complications such as abscess, peritonitis (VPM), gastrointestinal fistula and intestinal obstruction. Therefore, the clinical symptoms are also very diverse and non-specific.

Continuous, non-criminal abdominal pain in the left lower quadrant occurs in 70% of cases. Patients often describe dull abdominal pain several days before admission. The incidence of acute abdominal pain within 24 hours was present in only 17% of patients.
This is a remarkable feature that helps us differentiate from other causes of acute abdominal pain. On careful history taking, approximately 1⁄2 of patients will describe a previous similar episode of milder abdominal pain.
Symptoms of vomiting and nausea are present in 20-62% of patients.
About 1/4 to 1/3 of patients have diarrhea and about half of patients have symptoms of constipation.
The group of urological symptoms such as dysuria, urinary urgency, urinary frequency accounted for 10-15%.

Clinical examination noted tenderness in the left lower quadrant of the abdomen with varying degrees of severity occurring in 93%-100%. The patient may have right lower quadrant abdominal pain if the diverticulum is located in the right sigmoid region or in the sigmoid region but extends to the right midline.
Symptoms of generalized VPM appear if the inflamed diverticulum ruptures and is not localized. A soft, painful, indeterminate mass is palpable in 20% of patients. Abdominal distention occurs in about two-thirds of patients.
Fever occurs in 57%-100% of patients with varying degrees of severity, but the degree of fever is less related to the degree of infection. Common is a mild fever of 37.5 - 380C. Approximately 14% of patients have no symptoms of fever.
In complicated UTI, there will be additional groups of symptoms of complications. For example, complications of VPM include toxic infection, resistance throughout the abdomen; Gastrointestinal fistula complications may include fecal incontinence, gas (stomach fistula), fecal discharge in the vagina (diarrhea-vaginal fistula); Complications of intestinal obstruction include abdominal cramps, vomiting, bowel obstruction...

References:
Le Huy Luu, Nguyen Van Hai (2010), "Results of right colonic diverticulum surgery by laparoscopic surgery", Medicine of Ho Chi Minh City, volume 14 (additional to No. 4). ), p.12-15. Ly Minh Tung, Nguyen Van Hai (2011), Clinical features, images, and surgical results for diverticulitis. Aldoori W.H., Giovannucci E.L., Rockett H.R., et al. (1998), "A prospective study of dietary fiber types and symptomatic diverticular disease in men", J Nutr, Vol.128 (4), p.714-719. Ambrosetti P., Robert J.H., Witzig J.A., et al. (1994), "Acute left colonic diverticulitis: a prospective analysis of 226 consecutive cases", Surgery, Vol.115 (5), p.546-550.