Diverticular disease is an inflammatory disease that occurs in diverticula caused by muscle contraction of the colon (Painter, 2013). Diverticular disease, namely the presence of multiple pseudo diverticles, is asymptomatic in 80% of patients. Diverticulitis is acute inflammation in the diverticle without or with perforation. (Sjamsuhidajat, 2007).
Diverticular disease is usually caused by lack of fiber intake in the body. The cause of diverticula is thought to be due to food factors. Clinical and experimental studies have involved low-fiber diets as prominent radiologic factors. A diet lacking vegetable fiber is thought to predispose to the emergence of diverticula due to impaired colonic motility. There is evidence that diverticula sufferers cause excessive contractile responses to food and hormonal stimuli. Diverticula can occur anywhere in the small intestine or sigmoid colon. Diverculosis occurs when there are several diverticula without inflammation or symptoms. This case is most often found in older people over the age of 80 years. Low dietary fiber intake is a major predisposing factor. Diverticulitis occurs when food and bacteria that are held in the diverticulum cause infection and inflammation which can inhibit discharge and result in perforations or abscesses. Diverticulitis can occur in the form of an acute attack or as a hidden chronic infection. Predisposition is likely to be congenital if the disorder appears in individuals under 40 years of age. (Brunner, 2016)
Clinical manifestations of diverticulitis include abdominal pain and tenderness, constipation, mild distension, fever, and leukocytosis. The period in the abdomen, rectum or vabina can usually be palpated and diarrhea can also occur. Irritable symptoms of urinary vesicles due to pyuria (frequency, dysuria, and urgency) often caused by periods of inflammation that affect the urinary vesica or fistula development into the urinary vesicles. Bleeding from the diverticulum arises as sudden rectum bleeding is dark red or bright red. Usually without pain or can be accompanied by mild cramps. Sometimes bleeding can be massive, which causes hemorrhagic shock or death. Diverticulum bleeding rarely presents with acute diverticulitis. The differential diagnosis includes appendicitis, adnesal inflammatory disease, ovarian carcinoma, prostatitis, sigmoid carcinoma and various types of inflammatory colitis, ischemic, infectious. If the sigmoide colon is excessive and folds towards the right lower quadrant, diverticulitis in this area can mimic appendicitis. Barium enema is an important diagnostic examination, but is usually postponed during the acute stage. After the acute attack subsides, intestinal preparations are performed with a gentle cleansing enema rather than laxative. Radiographic criteria for the diagnosis of acute diverticulitis have changed in the past year. The pattern of sharp jagged sawtooths with diverticulum in lumen narrowing, criteria that are commonly used in the past, are no longer proof of proper inflammation. (Sabiston, 1994)
Diverticulosis is the presence of multiple pseudo diverticles, which are asymptomatic in 80% of patients. Complaints and signs include pain attacks, obstipation, and diarrhea by disorders of sigmoid motility. On examination, mild local tenderness and sigmoid often can be felt and felt as a solid structure. There is no fever or leukocytosis if there is no inflammation. General conditions are not disturbed and systemic signs also do not exist. The barium radiograph appears diverticular with local spasm and wall thickening which causes narrowing of the lumen. (Sjamsuhidajat, 2007)
According to Brunner, 2016
Diverticulitis is acute inflammation in the diverticle without or with perforation. Inflammation is usually caused by fecal retention in it. High pressure in the sigmoid which plays a role in the occurrence of diverticles. Perforations due to diverticulitis cause limited peridiverticulitis, abscesses, or general peritonis. The most important differential diagnosis is left colon carcinoma or gynecologic abnormalities. (Sjamsuhidajat, 2007)
According to Brunner, 2016
Nursing Diagnosis for Diverticulitis
Diverticular disease is usually caused by lack of fiber intake in the body. The cause of diverticula is thought to be due to food factors. Clinical and experimental studies have involved low-fiber diets as prominent radiologic factors. A diet lacking vegetable fiber is thought to predispose to the emergence of diverticula due to impaired colonic motility. There is evidence that diverticula sufferers cause excessive contractile responses to food and hormonal stimuli. Diverticula can occur anywhere in the small intestine or sigmoid colon. Diverculosis occurs when there are several diverticula without inflammation or symptoms. This case is most often found in older people over the age of 80 years. Low dietary fiber intake is a major predisposing factor. Diverticulitis occurs when food and bacteria that are held in the diverticulum cause infection and inflammation which can inhibit discharge and result in perforations or abscesses. Diverticulitis can occur in the form of an acute attack or as a hidden chronic infection. Predisposition is likely to be congenital if the disorder appears in individuals under 40 years of age. (Brunner, 2016)
Clinical manifestations of diverticulitis include abdominal pain and tenderness, constipation, mild distension, fever, and leukocytosis. The period in the abdomen, rectum or vabina can usually be palpated and diarrhea can also occur. Irritable symptoms of urinary vesicles due to pyuria (frequency, dysuria, and urgency) often caused by periods of inflammation that affect the urinary vesica or fistula development into the urinary vesicles. Bleeding from the diverticulum arises as sudden rectum bleeding is dark red or bright red. Usually without pain or can be accompanied by mild cramps. Sometimes bleeding can be massive, which causes hemorrhagic shock or death. Diverticulum bleeding rarely presents with acute diverticulitis. The differential diagnosis includes appendicitis, adnesal inflammatory disease, ovarian carcinoma, prostatitis, sigmoid carcinoma and various types of inflammatory colitis, ischemic, infectious. If the sigmoide colon is excessive and folds towards the right lower quadrant, diverticulitis in this area can mimic appendicitis. Barium enema is an important diagnostic examination, but is usually postponed during the acute stage. After the acute attack subsides, intestinal preparations are performed with a gentle cleansing enema rather than laxative. Radiographic criteria for the diagnosis of acute diverticulitis have changed in the past year. The pattern of sharp jagged sawtooths with diverticulum in lumen narrowing, criteria that are commonly used in the past, are no longer proof of proper inflammation. (Sabiston, 1994)
Diverticulosis is the presence of multiple pseudo diverticles, which are asymptomatic in 80% of patients. Complaints and signs include pain attacks, obstipation, and diarrhea by disorders of sigmoid motility. On examination, mild local tenderness and sigmoid often can be felt and felt as a solid structure. There is no fever or leukocytosis if there is no inflammation. General conditions are not disturbed and systemic signs also do not exist. The barium radiograph appears diverticular with local spasm and wall thickening which causes narrowing of the lumen. (Sjamsuhidajat, 2007)
According to Brunner, 2016
- Often there are no symptoms that are problematic, chronic constipation often begins the course of the disease.
- Irregular bowel movements, occasionally accompanied by diarrhea, nausea and anorexia, and abdominal bloating or distension.
- Cramps, narrowed stool size, and increased constipation or sometimes intestinal obstruction.
- Weakness, fatigue, and anorexia.
Diverticulitis is acute inflammation in the diverticle without or with perforation. Inflammation is usually caused by fecal retention in it. High pressure in the sigmoid which plays a role in the occurrence of diverticles. Perforations due to diverticulitis cause limited peridiverticulitis, abscesses, or general peritonis. The most important differential diagnosis is left colon carcinoma or gynecologic abnormalities. (Sjamsuhidajat, 2007)
According to Brunner, 2016
- Mild to severe acute pain in the lower left quadrant.
- Nausea, vomiting, fever, chills and leuocytosis.
- If not treated with peritonitis and septicemia.
Nursing Diagnosis for Diverticulitis
- Acute pain r / t outward / protruding out of the mucosa and sub-mucosa in the gastrointestinal tract, characterized by the client complaining of abdominal pain, the client appears nervous.
- Constipation r / t narrowing of the colon secondary to thickening of the muscle segment and structure characterized by the client saying bloating of the abdomen, feeling nauseous, distended stomach , rather hard.
- Imbalanced nutrition: less than body requirements r / t a decrease in appetite for pain is characterized by only eating half a meal.
- Disturbed sleep pattern r / t feels pain in the abdomen, characterized by nervous.
- Anxiety r / t pain, characterized by the client seemed anxious.
