Can Diverticulitis Cause Urinary Problems

Causes Of Diverticular Disease And Diverticulitis

Diverticular disease is caused by small bulges in the large intestine developing and becoming inflamed. If any of the diverticula become infected, this leads to symptoms of diverticulitis.

The exact reason why diverticula develop is not known, but they are associated with not eating enough fibre.

Fibre makes your stools softer and larger, so less pressure is needed by your large intestine to push them out of your body.

The pressure of moving hard, small pieces of stools through your large intestine creates weak spots in the outside layer of muscle. This allows the inner layer to squeeze through these weak spots, creating the diverticula.

There is currently no clinical evidence to fully prove the link between fibre and diverticula. However, diverticular disease and diverticulitis are both much more common in Western countries, where many people do not eat enough fibre.

What Is The Best Antibiotic For Diverticulitis

If antibiotics are given for uncomplicated diverticulitis, consider amoxicillin/clavulanic acid or an oral cephalosporin plus metronidazole if the patient can take oral therapy. If intravenous therapy is needed cefazolin, cefuroxime, or ceftriaxone, all plus metronidazole or ampicillin/sulbactam alone can be used.

How Is Bladder Diverticulum Diagnosed

As mentioned previously bladder diverticula may be found incidentally while investigating the person for urinary symptoms mentioned above with imaging studies such as ultrasound, CT , MRI and IVU . They may appear as ill-defined masses in the pelvis that are difficult to diagnose or interpret on imaging tests.

Cystoscopy – Diverticula may be visualized on cystoscopy wherein a thin flexible tube illuminated at one end is inserted into the urethra and permits the inspection of the interior of the bladder and diagnose specific conditions. Normally the procedure takes around 10-15 minutes

Urodynamic study – A pressure test is performed to see how well the bladder works and check for blocks in the bladder and urethra and to look for urine leaks

Bladder x-ray – Bladder diverticula can be detected on an x-ray test of the bladder. The test is done by filling the bladder with a dye that shows up well in x-rays, pictures that will outline the diverticula.

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Tests For Diverticular Disease

Normally before further tests can be carried out a bowel cleansing will be required. Bowel cleansing will clear the colon of all faeces which will make it easier to assess the colon in tests. Most cleansing preparations will be taken a few days before a test is carried out and usually consist of a powder which you add to water and drink causing diarrhoea which will empty the contents of your bowel.

After the bowel is empty you may undergo one of the following tests

Natural History Of The Development Of Diverticulitis

• All individuals with diverticulosis: 25 per cent develop diverticulitis after 10 years.
• Initial attack of diverticulitis: 80 per cent can be medically treated 20 per cent develop complications during the initial attack.
• Diverticulitis treated medically: 33 per cent recurrence rate with 90 per cent occurring within 5 years.
• Recurrence of diverticulitis: 36 per cent of recurrences are associated with complications leading to surgery.
• The risk of recurrence: increases in patients aged less than 40 years or with three or more previous episodes.

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What Are The Diet And Nutrition Tips For Diverticulitis

If you develop a mild case of diverticulitis, drink water, broth, and no-pulp fruit juices at first. Some doctors recommend a liquid-only diet, but you may be able to eat low-fiber foods as tolerated. A low-fiber diet may relieve abdominal pain by reducing stool frequency.

Low-fiber foods include:

• Low-lactose dairy products or dairy alternatives

• Refined grains like white bread, rice and pasta

• Vegetables that are peeled and cooked

After 2 to 4 days of a low-fiber diet, gradually increase the amount of fiber in your diet. Aim for 5 to 15 grams of fiber a day until you reach the recommended amount of about 25 to 30 grams of daily dietary fiber. Dietary fiber reduces the risk of diverticulitis. Whole grains, fruits and vegetables are examples of dietary fiber.

Severe diverticulitis flare

Diet tips for a more severe flare of diverticulitis are different. You may not be able to eat or drink anything for several days. In those cases, hospitalization is necessary. To avoid dehydration, you will receive fluids intravenously. When you are well enough to go home, your care team will give you specific diet and nutrition instructions.

As with mild flares, you will gradually increase the amount of fiber in your diet.

What Are The Symptoms Of A Bladder Diverticulum

Very often bladder diverticula do not cause any symptoms and are incidentally detected while investigating urinary symptoms. Diagnosis of bladder diverticula should be suspected in the presence of urinary symptoms in young children or in the setting of prostatic enlargement. Symptoms and signs commonly associated with bladder diverticula include the following:

• Recurrent urinary tract infections due to urine stagnating in the pouch
• Lower abdominal fullness, pain and discomfort
• Stones in the bladder due to urine stagnation in the bladder
• Difficulty passing urine
• Pain and fever due to inflammation of the diverticulum
• Urine flowing backwards into the kidneys

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Beware: There Are Other Diseases That Can Mimic Diverticulitis:

• Early or mild diverticulitis may present similarly to gastroenteritis or a urinary tract infection with mild abdominal tenderness.

• If free perforation with peritonitis occurs, the differential diagnosis includes all causes of acute abdomen .

• It is important to recognize that any disease process that leads to colonic perforation, the most important of which is perforated colon cancer, mimics diverticulitis. This is especially important as both disease processes are more likely to occur in older adults.

What Other Clinical Manifestations May Help Me To Diagnose And Manage Diverticulitis

• Diverticulitis can present with symptoms ranging from mild left lower quadrant tenderness to peritonitis.

• Elderly patients and those who are immunocompromised may have very mild symptoms because of a lack of inflammatory response

• Patients may present with complications of diverticulitis causing their initial symptoms. For example, a colovesical fistula may cause flatus or stool to pass from the patients urethra. In this case, a history of repeated and hard to eradicate UTIs may also be present.

• Another complication is an entero-colonic fistula, which may present with episodes of diarrhea or electrolyte abnormalities

• Patients may present with symptoms of bowel obstruction if the inflammation from diverticulitis has caused a colonic stricture.

• Although, in all of the mentioned scenarios, the patient normally gives a history of an episode of abdominal pain, the patient may not have sought medical attention for this and the complication may be the initial presenting symptom.

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Diverticulitis Symptoms And Complications

Diverticulitis symptoms will be suffered by at least 30% of people who have diverticula pouches in their large intestine.

Diverticulosis or the formation of pouches of intestinal lining which push through weak spots in the muscle wall of the colon is very common as we age, with 50-70% of all eighty year olds having these little bubble-like sacs on the outside of their large intestine.

Can Diverticulitis Affect Your Heart

Diverticular diseases are found to be associated with acute coronary syndrome which includes a list of disorders caused due to low blood supply to the heart. Both diverticular disease and cardiovascular problems belong to two different systems of the body and the link between them appears quite ambiguous.

Research suggests that chronic inflammation can lead to arterial atherosclerosis and other cardiovascular problems. Hence, in some conditions, diverticular problems can affect the healthy functioning of your heart.

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Diverticular Disease And Urinary Tract Infections Link

dan71214

I was recently diagnosed with Diverticular disease which happened incidentally as i was having a CT scan for suspected kidney stones. Soon after the scan i had really bad bloating, cramping pains down my left flank which radiated to the right and my abdomen, high temperature , very fast heart rate and generally feeling awful and unable to eat for a week. I was being investigated for a urinary tract infection of which i have had several this year . Apparently this is very unusual as i am male and relatively young < 40 and otherwise healthy. Given the severity of my symptoms i was admitted to hospital where i was on 3 IV antibiotics and a drip for 3 days followed by a week of amoxicillin. Thank goodness the antibiotics did the trick as dr was worried i was sliding into a sepsis situation.

What i am wondering is if there is a link between the diverticular disease and the urinary tract infection. It seems logical to me that given how close the bowel and bladder are to each other one could cause the other. Has anyone had a similar experience and/or any tips? It has been a month since my hospital admission and i am keeping my diet very strict and so far have had no big issues with my bowel and my urine seems clear so far.

thanks for your tips

Structure And Function Of Urinary Bladder In Brief

The urinary bladder is the lower part of the urinary tract. The urinary tract consists of the kidney, ureter , the urinary bladder and urethra . The urine formed in the kidney travels down the ureter into the bladder, a hollow muscular organ which temporarily stores the urine until the person gets the urge to empty the bladder. The urine is then passed out via the urethral opening.

When viewed under a microscope, the bladder is made up of four layers. From inside to out these are namely the inner mucosal lining of the bladder made up of a special epithelium called transitional epithelium. External to the epithelial layer is the connective tissue layer called the submucosa. Outer to the submucosa is the thick muscle layer of the urinary bladder, which is then covered by the fourth and final layer of peritoneum or serosal layer.

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How Do You Diagnose Diverticulitis

To diagnose diverticulitis, your doctor will ask about your symptoms, your health history, and any medications and supplements you take. During a physical exam, your doctor will likely check your abdomen to see if you have tenderness. A digital rectal exam is a screening exam your doctor may use to check for pain, masses, rectal bleeding and other problems.

These tests can also determine if you have diverticulitis:

• Barium enema: This X-ray procedure examines your colon. After a barium mixture is slowly instilled into the colon, a radiologic technologist takes a series of X-rays. A barium enema is a lower GI series.

• Blood tests. A high white blood cell count is a sign of infection.

• Colonoscopy: This imaging procedure examines the lining of your colon and rectum using a thin, flexible instrument called a colonoscope. The camera on the colonoscope transmits pictures of the inside of your colon to a video screen.

• CT scan: This imaging test uses X-rays and a computer to make layered images of a body area, in this case your colon. CT scans provide more detail than regular X-rays.

• Video capsule endoscopy: With this noninvasive imaging test, you swallow a vitamin-sized capsule that contains a camera. The camera takes photos as it travels through your digestive tract including images of the colon wall.

What Causes Diverticular Disease

It has not yet been confirmed what exactly causes diverticular disease but researchers and scientists do have a number of theories.

Of the various possible explanations for the cause of diverticula, the evidence is strongest for a low fibre diet. However, the jury is still out on whether bran and fibre can be effective in treatment for uncomplicated DD or even prevent complications.

Dietary fibre contained in vegetables and fruits help to keep food bulky as it travels along the digestive tract. A diet low in fibre is less bulky and the muscles of the large intestine struggle to move the intestinal content. The extra strain involved is the likely cause of thickening of the intestinal muscles. The large intestine with thickened muscles takes on a corrugated shape. When the muscles contract, the intestine forms compartments and the compartments increase, this in turn forces out a diverticulum. This is the most widely held view of how low levels of fibre in the diet lead to the formation of diverticula.

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What Causes Bladder Diverticulum Symptoms And Treatment

Bladder diverticulum is a condition that someone can be born with or it can be acquired later on in life. While the congenital form rarely requires any specific treatment, those who acquire bladder diverticulum later often need some kind of medical care.

The condition presents as a pouch on the bladder wall. In the case of congenital bladder diverticulum, some of the bladder lining pokes through a weak section of the bladder wall. In children, there is usually just one pouch. However, with acquired diverticulum, there is often more than one pouch, so it is called bladder diverticula.

Is A Urethral Diverticulum A Common Condition

No, its relatively uncommon, although its diagnosed more often today. Now doctors have better imaging techniques available to explore the problem when patients report pain in this part of the body.

Still, its believed that some cases are not properly diagnosed because the condition is relatively rare, and the doctor doesnt always think of it. UDs are seen most often in women between the ages of 30 and 60.

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Question: Can Diverticulitis Affect The Bladder

• How long should you stay on a low fiber diet after diverticulitis?

Diverticular disease can affect the bladder in subtle ways. Presented herein is a case of a chronic abscess secondary to diverticulitis presenting as irritable vesical symptoms overlooked for several years. The value of pelvic computerized tomography in the diagnosis is stressed.

Diagnosing Diverticular Disease And Diverticulitis

Diverticular disease can be difficult to diagnose from the symptoms, alone because there are other conditions that cause similar symptoms, such as irritable bowel syndrome .

As a first step, your GP may recommend blood tests to rule out other conditions such as coeliac disease or bowel cancer.

In some cases, you may be offered treatment for IBS and diverticular disease at the same time.

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Why Have I Got Urinary Problems

It may be difficult to believe that urinary problems can be one of the diverticulitis symptoms and complications as they are not directly involved with the bowel.

It can happen however because the inflamed part of the bowel can be in contact with the bladder making passing water more painful and causing you to go more often.

As mentioned above urine infections can be a sign that a fistula has formed between the bladder and the bowel.

What Should You Tell The Family About The Patient’s Prognosis

• In general, the prognosis after an episode of uncomplicated diverticulitis is good.

• For patients treated with antibiotics in whom colectomy was avoided, the recurrence rate may be as high as 20%, with about 5% requiring emergent surgery during a subsequent hospital admission.

• As diverticulitis is a disease in which the incidence increases with age, many patients are elderly and may have coexisting health problems. These are risk factors for poor outcome and may also make surgery itself riskier.

• Patients who require emergency surgery generally have a worse prognosis, with a major post-operative complication rate of 30-40% and a mortality rate of up to10% .

• Patients who do need a colostomy during emergent surgery have to undergo a second major abdominal surgery to reverse the colostomy. Some elderly patients are deemed too unfit to undergo this electively, which leads to long-term colostomies and the complications that accompany this.

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What Is A Urethral Diverticulum

The urethra is the tube through which urine leaves the bladder and exits the body when a person urinates. The tube is only about 4 cm long in women. A condition known as urethral diverticulum occurs when an unwanted pocket or sac forms along the urethra. Because of its location, it can become filled with urine or even pus. This can lead to infections and other problems.

What Are The Complications Of Diverticulitis

If you donât treat it, diverticulitis can lead to serious complications that require surgery:

• Abscesses, collections of pus from the infection, may form around the infected diverticula. If these go through the intestinal wall, you could get peritonitis. This infection can be fatal. Youâll need treatment right away.
• Perforation or tearing in the intestinal wall can lead to abscesses and infection because of waste leaking into the abdominal cavity.
• Scarring can lead to a stricture or blockage of the intestine.
• Fistulas can develop if an infected diverticulum reaches a nearby organ and forms a connection. This most often happens between the large intestine and the bladder. It can lead to a kidney infection. Fistulas can also form between the large intestine and either the skin or the .
• Stricture, which happens when the colon narrows in the affected area.

If you have severe bleeding, you may need a blood transfusion.

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What Is The Difference Between Diverticulitis And Diverticulosis

Diverticulosis just means the formation of the sacs or pouches in the large intestine. Most people have no symptoms of diverticulosis and are not even aware that they have diverticula pouches. Approximately twenty five percent of these people have some symptoms .

The word diverticulitis is used when the diverticula become inflamed leading to worse symptoms. The ending ‘itis’ means inflammation.

The symptoms of diverticulosis are lower abdominal pain , constipation, diarrhea, bleeding,wind and bloating. The symptoms tend to come and go.