Right Lower Abdominal Discomfort: Diverticulitis Insights

Q: Right Lower Abdominal Discomfort: Diverticulitis Insights

Hello： 1. In terms of location, diverticulitis is also one of the differential diagnoses. 2. Feces can potentially get trapped in the diverticula of the colon. 3. If feces are trapped in the diverticulum and are tightly lodged, it may lead to diverticulitis. <

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Dear Dr.
Tsai,
Thank you very much for your response and guidance in article #185848.
My previous inquiry was regarding a feeling of fullness and occasional sharp pain in my lower right abdomen, which has persisted for nearly five years.
The fullness sensation seems to shift between my lower right abdomen, right flank/back, and right groin.
My bowel movements and urination are normal, and aside from the fullness, I do not have any other specific symptoms.
In your last response, you mentioned, "In males, attention should be given to the colon and urinary system in the lower right abdomen." Recently, I came across the term "diverticulitis," which often presents in the lower right abdomen in Asians, so I would like to ask you the following:
Q1.
In your opinion, could the shifting fullness sensation and occasional sharp pain in my lower right abdomen over the past five years be caused by "diverticulitis"?
Q2.
Is it possible for stool to become trapped in a diverticulum and not move? Or does stool always move with intestinal peristalsis and cannot remain trapped in a diverticulum?
Q3.
If stool can indeed remain trapped in a diverticulum, what kind of intestinal problems or symptoms could arise? Additionally, if stool remains trapped in a diverticulum, what measures can be taken to facilitate its movement out of the diverticulum (e.g., increased water intake, medication, or surgery)?
Q4.
Can an abdominal ultrasound diagnose the presence of diverticula and diverticulitis?
Thank you, Dr.
Tsai.

Axiang, 40~49 year old female. Ask Date: 2022/09/06

Dr. Cai Anshun reply Gastroenterology and Hepatology

Hello: 1.
In terms of location, diverticulitis is also one of the differential diagnoses.
2.
Feces can potentially get trapped in the diverticula of the colon.
3.
If feces are trapped in the diverticulum and are tightly lodged, it may lead to diverticulitis.
Drinking plenty of water, consuming high-fiber foods, and maintaining soft stools can help facilitate the passage of feces trapped in the diverticula.
4.
Ultrasound can only visualize solid organs such as the liver, gallbladder, spleen, and kidneys.
It cannot provide a clear diagnosis for hollow organs like the stomach or intestines; it can only assist in determining whether the pain is related to the colon.
Changhua Hospital cares about your health.
Dr.
Tsai An-shun.

Reply Date: 2022/09/06

More Info

Understanding right lower abdominal discomfort, particularly in the context of diverticulitis, requires a comprehensive approach to diagnosis and management. Your symptoms of persistent discomfort and occasional sharp pain in the right lower abdomen, which have been ongoing for five years, warrant careful evaluation.

Q1: Could my symptoms be caused by diverticulitis?
Diverticulitis occurs when diverticula, which are small pouches that can form in the walls of the colon, become inflamed or infected. While diverticulitis is more commonly associated with the left side of the colon, particularly in Western populations, it can indeed occur on the right side, especially in Asian populations. The migratory nature of your discomfort, along with the occasional sharp pain, could potentially be linked to diverticulitis. However, it is essential to consider other conditions as well, such as appendicitis, hernias, or even gynecological issues in females.

Q2: Can stool get trapped in diverticula?
Yes, stool can become trapped in diverticula, leading to a condition known as diverticulitis. When fecal matter becomes lodged in these pouches, it can cause inflammation and infection. However, in a healthy digestive system, stool typically moves through the colon due to peristalsis (the wave-like muscle contractions of the intestines). If the stool is hard or if there is a lack of adequate fiber in the diet, it may become impacted in the diverticula.

Q3: What are the implications of stool being trapped in diverticula?
If stool remains trapped in a diverticulum, it can lead to several complications, including:
1. Diverticulitis: Inflammation of the diverticulum can cause pain, fever, and changes in bowel habits.

2. Abscess Formation: An infected diverticulum can lead to the formation of an abscess, which may require drainage.

3. Perforation: In severe cases, the diverticulum can rupture, leading to peritonitis, a serious abdominal infection.

4. Fistula Formation: Chronic inflammation can lead to abnormal connections between the colon and other organs.

To alleviate the issue of stool being trapped, increasing dietary fiber, staying hydrated, and regular physical activity are crucial. In some cases, medications such as stool softeners or laxatives may be recommended. If conservative measures fail, surgical intervention may be necessary.

Q4: Can an abdominal ultrasound diagnose diverticula and diverticulitis?
An abdominal ultrasound can provide some information about the presence of diverticula and signs of diverticulitis, such as thickening of the bowel wall or fluid collections. However, a CT scan is generally considered the gold standard for diagnosing diverticulitis due to its higher sensitivity and specificity. A CT scan can reveal the presence of diverticula, inflammation, abscesses, and other complications more effectively than an ultrasound.

Conclusion
Given your symptoms and the duration of your discomfort, it is advisable to consult with a healthcare provider for a thorough evaluation. This may include imaging studies such as a CT scan, blood tests to check for signs of infection, and possibly a colonoscopy to assess the condition of your colon directly. Early diagnosis and management are key to preventing complications associated with diverticulitis or other gastrointestinal disorders. Additionally, maintaining a high-fiber diet, staying hydrated, and engaging in regular exercise can help promote healthy bowel function and potentially alleviate your symptoms.

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