Diverticular Disease

Constipation and lower abdominal pain with intermittent and unpredictable crampy. The patient with diverticulitis presents fever and peritoneal irritation (absent bower sons). The patient with diverticular bleeding presents bloody feces.

Ethiology

The diverticular disease results from a deformation acquired in the colon (sigmoid colon), when occurs the lining dilatation. It is more common in people older than 40 and in industrialized countries. Its prevalence it’s increased by a low-fiber diet with consequent increased constipation.

Pathology and Pathogenisis

A.    Diverticulosis

Individuals with genetic disease involving the connective tissue, as Ehlers-Danlos and Marfan Syndrome, are characterized by the disease appearance on a younger age. The decrease of fibers become harder the feces propulsion, causing vigorous muscular contraction of the colon wall, that can lead to abdominal pain that is the major symptom of the disease. The pain can last several hours or days, and during that period of time it may also occur constipation, diarrhea and flatulence.

B.    Diverticular bleeding

It is painless and arises because the colon intramural arteries are associated to the diverticular sac, leading to the occurrence of rupture and bleeding.

C.    Diverticulitis

It occurs when exists a inflamation on the diverticulum wall, in response to the irritation caused by fecal material. The patient presents abdominal pain, fever, intestinal necrosis and fistula formation.