Toxic Diverticulitis Fact Sheet

Learn more about the symptoms of toxic diverticulitis and find out how to treat it.

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If you have inflammatory bowel disease, or any other form of colitis such as infectious, ischaemic, or radiation colitis, then you are at risk for developing an abnormal dilation of your large intestine (your colon), known as toxic diverticulitis. It is a rare but serious condition, with potentially severe complications. Find out the symptoms to look out for, how toxic diverticulitis can be treated, and how to prevent getting it in the first place today.

What is toxic diverticulitis?

Toxic diverticulitis is the medical term for an acute toxic inflammation of the large intestine (colitis) with pathological enlargement of the colon. When this takes place, the colon can no longer function as it normally would, making it impossible for gas and faces to pass. Aside from being exremely uncomfortable, this side-effect is also very dangerous: if gas and feces gather in your colon for a prolonged period of time, your large intestine may burst. Toxic diverticulitis can be deadly because it puts you at risk for rupture of your colon. As such, toxic diverticulitis is a life-threatening condition that needs immediate treatment.

Related: How the Colon Works

What are the symptoms of toxic diverticulitis?

Toxic diverticulitis usually occurs as a consequence of colitis, or inflammation of the colon. This colitis is most often in the setting of inflammatory bowel diseases like ulcerative colitis or Crohn’s disease. When toxic diverticulitis occurs, the large intestines rapidly expand. The rapid widening of the colon may cause the following symptoms to occur over a short period of time:

·      Painful and distended abdomen

·      Vomiting

·      Fever

·      Bloody diarrhea, or rectal bleeding

·      Rapid heart rate

If the colon ruptures, the patient may then develop an infection throughout the body, shock, and dehydration.

Seek immediate medical help or have someone call 911 if you have severe stomach pain and the above-mentioned symptoms.

What are the risk factors and causes of toxic diverticulitis?

The root cause of toxic diverticulitis is inflammation of the bowel, which cause swelling and irritation in parts of your digestive tract, which causes permanent damage to your large and small intestines. Risk factors for toxic diverticulitis include:

·      Ulcerative colitis

·      Crohn’s disease

·      Infections of the colon which can be caused by C difficile or other infectious causes of colitis.

·      Ischemia, or low blood flow to the colon

·      In rare situations, colon cancer

In addition to the above risk factors, people with a history of any of the following can also develop toxic diverticulitis: recent travel, antibiotic use, chemotherapy, diabetes, organ transplants, kidney failure, and/or suppressed immunity.

How is toxic diverticulitis diagnosed?

If your doctor suspects toxic diverticulitis from the description of your symptoms and the examination, they may go on to order some other tests to confirm their diagnosis, including:

·      Abdominal X-rays

·      CT scan of the abdomen

·      Blood tests 

Related: The New Age Group at Risk for Colon Cancer

What are the complications of toxic diverticulitis?

The dreaded complication of toxic diverticulitis is rupture of your colon. Rupture of the colon is a life-threatening condition. When the intestines burst, intestinal bacteria shoots out into your abdomen, which often leads to fatal infections and septic shock. Other complications of toxic diverticulitis include:

·      Bleeding and blood loss

·      Whole-body infection (sepsis)

·      Abnormal hole in the colon (perforation)

·      Shock

How can I prevent toxic diverticulitis?

Toxic diverticulitiss a complication of inflammatory bowel diseases. Therefore, if you have any of the inflammatory bowel conditions, it is very important to follow your doctor’s advice on taking medication, and making healthy lifestyle changes. By following expert advice, you can get your IBD symptoms under control, which will lower the chances of developing permant problems that can cause toxic diverticulitis. 

How is toxic diverticulitis treated?

Treatment of toxic diverticulitis includes:

·      Medicines. Treating the original condition or infection may help reduce toxic diverticulitis. Antibiotics can aid in infection prevention or treatment and anti-inflammatory medication can help inflammation go down. 

·      Bowel rest and decompression. These treatments will get rid of the gas and other substances occupying your colon, so that you can avoid a pressure build-up or even a rupture. 

·      IV fluids. To provide your body with nourishment and avoid dehydration, doctors may give you an IV full of electrolytes and fluids. 

      Surgery. If less invasive treatments don’t reduce the size of the toxic diverticulitis  within 2 to 3 days, you may need surgery to remove part or all of the colon. If you develop septic shock as part of the spectrum of diseases of toxic diverticulitis, you will be admitted to the intensive care unit of the hospital.

Treatment there may include:

·      Mechanical ventilation on a breathing machine

·      Dialysis for kidney failure

·      Drugs to treat low blood pressure, infection, or poor blood clotting

·      IV resuscitation

·      Oxygen

What is the outlook for toxic diverticulitis?

If the condition does not improve with medication and bowel rest, it can be life threatening, in which case a colectomy is usually needed. Unfortunately, with continued bowel inflammation, there is a persistent risk of developing toxic diverticulitis again. 

Related: What a Colon Looks Like