Disorders of the Gastrointestinal System, 2nd Edition
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Intestinal obstruction Infection and inflammation may cause significant scarring that can lead to in - testinal obstruction. Complete intestinal obstruction is a medical emergency re- quiring immediate surgical intervention (Pemberton, 2022a). Abscess An abscess is a localized infection that can cause swelling and destruction of tis- sue. A small abscess may be confined to the colon wall and can be resolved with antibiotic treatment or percutaneous drainage. Failure to respond to antibiot- ics may require an incision and drainage of the abscess (Pemberton, 2022a). Perforations and peritonitis Infected perforations can spread in- fection from the colon to the abdominal cavity, causing peritonitis. Symptoms in- clude severe nausea, vomiting, fever, and abdominal tenderness. Perforation with peritonitis is a medical emergency requir- ing aggressive medical care and surgery to treat the infection and remove the damaged portion of the colon (Pember- ton, 2022a). A patient with diverticulosis usually shows no symptoms unless they develop diverticulitis. Diverticulitis includes the following symptoms (Ghoulam, 2019): ● Left lower quadrant pain is the most common, but pain can also occur elsewhere. ● Fever and chills. ● Constipation or diarrhea.
with other conditions. A CT scan is cur- rently the most widely used diagnostic tool and provides the most detailed view of problem areas (Ghoulam, 2019). If diverticulosis produces no signs or symptoms, treatment is not usually neces- sary. However, if signs and symptoms are present, treatment depends on severity. The provider may recommend increasing fiber in the diet or supplementation. This may reduce or prevent symptoms and prevent complications such as diverticu- litis. High-fiber foods include whole-grain cereals, bread, and fruits and vegeta- bles. Fiber products such as bulk-form- ing cathartics, methylcellulose (Citrucel), or psyllium (Metamucil) may be recom - mended by healthcare providers (Ghou- lam, 2019). Some physicians previously recommended that patients avoid nuts; popcorn; and seed products such as sun- flower, pumpkin, and sesame seeds, as it was believed that these could enter and irritate diverticular sacs. However, recent research has demonstrated that these foods do not exacerbate diverticulosis or cause diverticulitis (Pemberton, 2022a). Patients whose disease progresses from diverticulosis to diverticulitis need to take additional measures. Those experienc- ing mild diverticulitis without evidence of perforation need to rest their colons; a liquid diet and stool softeners may be rec- ommended. However, current research has not supported diet restrictions in pa- tients with uncomplicated diverticulitis based on provider discretion (Pemberton, 2022a). Antibiotics may be administered to prevent or control infection (Ghoulam, 2019). Research shows promising results on the effectiveness of probiotics in the prevention of diverticulitis, treatment of symptoms, and prevention of recurrence by restoring altered gut microbiota to as-
● Bloating. ● Bleeding. ● Weakness or dizziness. ● Anorexia.
Diagnosis often depends on a history and physical exam, but imaging may be necessary to confirm a diagnosis, as the signs and symptoms are also associated
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