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Diverticular disease Cheat Sheet (DRAFT) by

MNT Diverticular disease

This is a draft cheat sheet. It is a work in progress and is not finished yet.

Divert­icular disease

What is it?

Small, permanent hernia­tio­ns/­poc­ket­s/b­ulges along the colon (towards the end of the large intestine)
Common - 1 in 3 over 45 years
Cause isn’t known - thought to be linked to low fibre diet & consti­pation = pressure on colon walls

Termin­ology

Diverticulitis = Infect­ed/­inf­lamed
Diverticulosis = Not inflamed
Divert­icular = the pockets

S/S

often asympt­omatic
Acute abdomen pain/ distention
Altern­ating consti­pat­ion­/di­arrhoea
Divert­icu­litis
Sharp intense pain in the abdomen
N/V
Fever
Cramping and bloating
Blood in stool
Leucoc­ytosis (↑ WBC)
 

Medical Management

Antibi­otics specific to gut bacteria
Anti-i­nfl­amm­atory (Mesalamine (also used in UC)
Antisp­asm­odics for pain & incont­inence (eg. Mebeverine)
Lomotil and Imodium to reduce diarrhoea
Surgical management for who fail medical management

Interv­ention

High fibre diet ≥25–38­g/day
Divert­icu­litis: bowel rest. Low-fibre diet ~10 days. Mostly liquid­s/ONS. No sharp/­fibrous foods TEMPORARY
↑ diet diversity
Adequate fluid intake – avoid consti­pation (1.5–2­L/day)

Strategies

Fibre supple­ments (psyllium)
Stool softeners
Fibre swaps
Flavoured water - tea, lemon, mint, fruit, sugar-free drinks
↑ PA
Avoid caffeine and alcohol
↑ wholeg­rains, fruit, veg, legumes
Legume recipes
Cooking with skin on
Adding seeds
Grated veg
High fibre pasta
slowly increasing fibre
 

Consider

Wt hx
hx of bowel movements
iron stores (if blood in stools)

Example PESS

P
inadequate fibre intake, altered GI function, food/n­utr­ition knowledge deficit
E
no prior education, anorexia from chemot­herapy, inadequate fibre intake

Guidelines & References

PEN Knowledge pathway on Divert­icular disease and Divert­icu­litis (2020)
Handbook p206