CLINICAL MANIFESTATIONS

Diverticulosis
 Asymptomatic, multiple diverticula are present s̅ inflammation
 Chronic constipation
 Bowel irregularity (c̅ intervals of alternating constipation and diarrhea)
 Anorexia or nausea
 Bloating or abdominal distention

Diverticulitis
 Acute onset of pain in the left lower quadrant
 Change in bowel habits
 Rectal bleeding
 Blood in the stool (Hematochezia)

COMPLICATIONS DIVERTICULITIS
can cause serious complications if left untreated, and most of the complications are brought
about by the perforation of the intestinal wall, resulting in leakage of waste material into the
abdominal cavity.
Acute Diverticulitis
 Abscess formation- due to the accumulation of pus in the diverticula
 Peritonitis- inflammation of the tissue lining of the abdominal cavity, which is caused by
the spilling of waste material resulting from the perforation in the intestinal wall.
Chronic Diverticulitis
 Fistula formation
 Colovesicular fistulas (between the colon and bladder)
 Colovaginal fistulas (between the colon and vagina)
ASSESSMENT & DIAGNOSTIC FINDINGS
 Bristol Stool Chart- medical aid designed to classify stools.

 Colonoscopy- permits visualization of the extent of diverticular disease

 Complete Blood Count (CBC)- revealing an elevated WBC, elevated erythrocytes
sedimentation (ESR); if the patient has frank blood in the stool
 Barium Enema- shows narrowing of the colon and thickened muscle masses, this test is
contraindicated in cases of acute inflammation because of the possibility of bowel
perforation.
 Abdominal CT Scan- used to confirm diverticulitis; it can also reveal perforation and
abscesses.
 Abdominal x-rays- may demonstrate free air under the diaphragm if a perforation has
occurred
NURSING MANAGEMENT
I. Nutrition
 Create a daily weight chart and food and fluid chart. Calculate caloric intake. (same
scale and the same time; early in the morning)
Rationale: Effectively monitor the patient’s daily nutritional intake and progress in
nutritional goals

 Give clear fluids if tolerated.

Rationale: During hospitalization, the patient may be put in NPO or require insertion of
an NGT to promote the rest of the stomach and to maintain adequate fluid balance.

 Avoid food that triggers. (Nuts and popcorn)

Rationale: This food may trigger diverticulitis attacks in some patients.

 Inform the patient to avoid drinking alcohol.

Rationale: Alcohol causes irritation to the GI tract.

II. Constipation
 Encourage fluid intake of 2 L/day (within limits of the patient’s cardiac and renal
reserve)
Rationale: This helps soften the stool and make it easier to pass.

 Suggests foods that are soft and high in fiber. (spinach, cereals, carrots)
 25g per day (women)
 38g per day (men)
Rationale: Increases the bulk of the stool and facilitates peristalsis, thereby promoting
defecation.
 If not contraindicated, advise the patient to increase fluid intake by at least of at least
2L per day.
Rationale: Increasing oral fluid intake prevents bloating that may happen c̅ a high fiber
diet.

 Encourage daily intake of bulk laxatives (Psyllium); Stool softeners for elderly
patients.
Rationale: Helps propel feces through the colon.

 Encourage physical mobility and exercise as tolerated

Rationale: This helps improve abdominal muscle tone and increases bowel peristaltic
movement.