Diverticulitis

The glucocorticoids are administered with caution to patients with renal or hepatic disease hypothyroidism, ulcerative colitis, diverticulitis, peptic ulcer disease, inflammatory bowel disease hypertension, osteoporosis, convulsive disorders, or diabetes. The glucocorticoids... 

Gastrointestinal conditions (irritable bowel syndrome, diverticulitis, hemorrhoids)... 

O Primary peritonitis develops in up to 25% of patients with alcoholic cirrhosis.3 Patients undergoing continuous ambulatory peritoneal dialysis (CAPD) average one episode of peritonitis every 2 years.4 Secondary peritonitis may be caused by perforation of a peptic ulcer traumatic perforation of the stomach, small or large bowel, uterus, or urinary bladder appendicitis pancreatitis diverticulitis bowel infarction inflammatory bowel disease cholecystitis operative contamination of the peritoneum or diseases of the female genital tract such as septic abortion, postoperative uterine infection, endometritis, or salpingitis. Appendicitis is one of the most common causes of intraabdominal infection. In 1998, 278,000 appendectomies were performed in the United States for suspected appendicitis.5... 

An abscess occurs if peritoneal contamination is localized but bacterial elimination is incomplete. The location of the abscess often is related to the site of primary disease. For example, abscesses resulting from appendicitis tend to appear in the right lower quadrant or the pelvis those resulting from diverticulitis tend to appear in the left lower quadrant or pelvis. A mature abscess may have a fibrinous capsule that isolates bacteria and the liquid core from antimicrobials and immunologic defenses. 

The majority of patients harboring colonic diverticula remain asymptomatic throughout their life (asymptomatic diverticular disease) only 20% will develop symptoms and signs of illness [15]. Symptomatic diverticular disease is further subdivided into painful diverticular disease (symptomatic diverticular disease with no inflammation) and diverticulitis (symptomatic diverticular disease with inflammation). Diverticulitis is further subdivided into uncomplicated and complicated diverticulitis [16]. 

Kyle J, Adesola AD, Tinckler LF, De Beaux J Incidence of diverticulitis. Scand J Gastroenterol 1967 2 44-47. 

Disorders of the GI tract (e.g., irritable bowel syndrome or diverticulitis), metabolic disorders (e.g., diabetes), or endocrine disorders (e.g., hypothyroidism) may cause constipation. 

Irritable bowel syndrome, diverticulitis, upper and lower GI tract diseases, hemorrhoids, anal fissures, ulcerative proctitis, tumors, hernia, volvulus of the bowel, syphilis, tuberculosis, lymphogranuloma venereum, Hirschsprung s disease. 

Besides causing loss of appetite and quality of life, longstanding and severe constipation can lead to diverticulosis, diverticulitis and in worst cases perforation of the large intestine with life threatening peritonitis (McConnell et al. 2003). Diverticulosis, irritable bowel syndrome and haemorrhoids are caused by chronic constipation and can lead to bleeding and anaemia. 

Diverticulitis refers to the extension of mucosal pouches outv/ards from the external muscle v/all into the gastrointestinal tract. Diverticulitis is accompanied by colicky pain lasting for a fev/ days. The condition may be accompanied by constipation or diarrhoea and blood in stools. 

Gl - Ulcerative lesions, diverticulitis or ulcerative colitis continuous tube drainage of the stomach or small intestine. 

Speciai risk Use with caution in the following situations Nonspecific ulcerative colitis if there is a probability of impending perforation, abscess, or other pyogenic infection diverticulitis fresh intestinal anastomoses hypertension CHF thromboembolitic tendencies thrombophlebitis osteoporosis exanthema Cushing syndrome antibiotic-resistant infections convulsive disorders metastatic carcinoma myasthenia gravis vaccinia varicella diabetes mellitus hypothyroidism, cirrhosis (enhanced effect of corticosteroids). 

Scopolamine inhibits excessive motility and hypertonus of the Gl tract in irritable colon syndrome, mild dysentery, diverticulitis, pylorospasm, and cardiospasm. Transdermal patch Prevention of nausea and vomiting associated with motion sickness and recovery from anesthesia and surgery in adults. 

Magnesium Oxide (Mag-Ox 400, Others) [OTC] [Antacid, Magnesium Supplement/Magnesium Salt] Uses R lace low Mg levels Action Mg supl Dose 400-800 mg/d daily-qid w/ full glass of HjO Caution [B, +] Contra UlcCTative colitis, diverticulitis, ileostomy/colostomy, heart block, renal insuff Disp Caps 140 mg tabs 400 mg (OTC) SE D, N Inter actions X Effects OF chlordiaz oxide, dicumarol, digoxin, indomethacin, INH, quinolones, tetracyclines EMS Monitor ECG for hypokalemia (flattened T waves) OD Unlikely to cause life-threatening Sxs, but may cause D, constipation, cramps, and abd pain symptomatic and supportive... 

A high-fiber diet is effective in the prevention of constipation and diverticulitis. Claims also have been made that such diets prevent cancer of the colon. Such allegations require further study. 

Since clear advantages accrue from a high-bran diet (a reduction in both constipation and diverticulitis) and since there is no associated toxicity, a bulk-forming laxative is the laxative of choice for constipated patients. 

I Contraindications Hypersensitivity to magaldrate, colostomy or ileostomy, appendicitis, ulcerative colitis, diverticulitis... 

Common complaints are constipation and bloating, usually relieved by increasing dietary fiber or mixing psyllium seed with the resin. Resins should be avoided in patients with diverticulitis. Heartburn and diarrhea are occasionally reported. 

Cat s claw has long been used in South America as an anti-inflammatory, antirheumatic, and contraceptive agent. It is also traditionally used to treat gastrointestinal ulcers, tumors, gonorrhea, dysentery, various skin problems, cancers of the female genitourinary tract, and intestinal disorders. Native South Americans use cat s claw to cleanse the kidneys and treat bone pain. Some Europeans report that it is useful in the treatment of AIDS when used in combination with zidovudine (AZT). The purported usefulness of cat s claw tea in the treatment of diverticulitis, hemorrhoids, peptic ulcer disease, colitis, parasites, and leaky bowel syndrome have fueled demand for the bark in the U.S. 

To reduce diarrhea associated with dysenteries and diverticulitis... 

Examination showed that her lower abdomen was a little distended and very tender, but there were no other abnormalities. Her blood pressure was low at 102/70 mmHg and her temperature slightly raised at 38.5 °C. A blood sample showed normal haemoglobin and red cell number, but a raised white blood cell count. No intestinal obstruction showed on an X-ray of her abdomen. In view of her symptoms and age, a provisional diagnosis of diverticulitis was made. 

Q6 Diverticula occur most often in the sigmoid colon this area of colon is involved in up to 90% of cases of diverticulitis. What is the anatomical position of the sigmoid colon ... 

Q8 Diverticulitis usually occurs after the age of 35 years, particularly in Europeans and North Americans, who have a diet which is relatively low in fibre. What is the effect of dietary fibre on the gut and on the transit of gut contents ... 

Q12 If no treatment is available to patients with diverticulitis and the infection and inflammation continue, what might be the consequence ... 

Q13 Is diverticulitis likely to be a recurrent condition or is Daria now completely cured of her problem ... 

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