PSW 162 Assignment: Diverticulitis Management and Community Resources

This assignment is a teaching resource focusing on diverticulitis, a common condition characterized by inflammation or infection of pouches in the intestine. It details the disease's pathophysiology, including risk factors like aging, obesity, and diet, and the common symptoms such as abdominal pain, fever, and altered bowel habits. The assignment outlines management strategies for both uncomplicated and complicated forms of the disease, including dietary modifications (fiber-rich foods, increased fluid intake), non-absorbable antibiotics, probiotics, pain relievers, and physical activity. For complicated cases, it suggests intravenous antibiotics, drainage of abscesses, and surgical interventions like bowel resection. Furthermore, the resource identifies a relevant community resource: a personal support worker, offering assistance to clients and families dealing with diverticulitis. The resource includes cited references in APA 6th edition format.

The common management measures for an uncomplicated form of the
disease include:
Alteration of diet: the fiber-rich diet decreases the risk and improves the
condition of diverticulitis. Therefore, common fiber rich food that must be
incorporated in the diet include fruits, vegetables, whole grain. These
foods soften waste materials and reduce the obstructions when it passes
through the colon. As the fibers work by absorbing water, plenty of water
and fluids are required to consume for improving the health condition.
The recommended rights 20-35 g per day (Rezapour, Ali & Stollman,
2018).
Non-absorbable antibiotic: Mesalazine is one such antibiotic that can treat
irritable bowel disease by reducing the substances that cause
inflammation, diarrhea and tissue damage. The common side effects of
the disease include abdominal pain, influenza and skin rash (Rezapour, Ali
& Stollman, 2018). Therefore, patients with the disease must be provided
with non-absorbable antibiotic after considering the side effects of it.
Probiotic can be an effective measure for improving the bowel movement
by reducing inflammation.
Tylenol can be given as a pain reliever to the patients.
Physical activity promotes normal bowel function and reduces the
pressure within the colon. Therefore, the recommended schedule for the
exercise will be 30minutes every day (Ng, Moe, & Wijesuriya, 2019).
Management measures for the complicated form of the disease are the
following:
Intravenous antibiotic: in a complicated situation, an intravenous
antibiotic is effective since the intravenous antibiotics have a
bioavailability of the intravenous antibiotic is 100%, unlike the oral
antibiotics where the bio-availability is 30 to 40%. Therefore, the efficacy
of the antibiotics will be improved in the case of intravenous
administration.
Insertion of a tube to drain an abdominal abscess
The surgery includes primary bowel resection where the diseased part is
eliminated and reconnects the healthy segments (Ng, Moe, & Wijesuriya,
2019). Therefore, it allows the normal bowel movement.
Bowel resection with colostomy where surgeon colostomy was conducted
in a reversed process and bowel was reconnected (Li et al., 2016).
Diverticulitis
DIVERTICULITIS: MANAGEMENT COMMUNITY RESOURCES
REFERENCE:
• The community resource that community member
can contact for additional information will be a
personal support worker. Personal support worker
enables elderly individuals and ill individuals to
complete their daily activities by providing them
adequate literary and supporting to gain skills.
Therefore, family members of the client and client
can achieve safe and comfortable along with proper
mental and physical wellbeing by through client-
centered care.
•
Acuna, S. A., Wood, T., Chesney, T. R., Dossa, F., Wexner, S. D., Quereshy, F. A., ... & Baxter,
N. N. (2018). Operative strategies for perforated diverticulitis: a systematic review and
meta-analysis. Diseases of the Colon & Rectum, 61(12), 1442-1453.
https://www.ncbi.nlm.nih.gov/pubmed/30371549
Alghamdi, M. H., Khadaroo, R. G., & Fathimani, K. (2017). Complicated Sigmoid
Diverticulitis Presenting as Severe Necrotizing Soft Tissue Infection. Surgical Infections Case
Reports, 2(1), 14-16. https://www.liebertpub.com/doi/10.1089/crsi.2016.0057
Canadian Digestive Health Foundation. (2020). Health & Lifestyle - Canadian Digestive
Health Foundation. Retrieved 10 March 2020, from https://cdhf.ca/health-lifestyle/
Diamant, M. J., Schaffer, S., Coward, S., Kuenzig, M. E., Hubbard, J., Eksteen, B., ... &
Kaplan, G. G. (2016). Smoking is associated with an increased risk for surgery in
diverticulitis: a case control study. PloS one, 11(7).
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0153871
Li, D., Baxter, N. N., McLeod, R. S., Moineddin, R., & Nathens, A. B. (2016). The decline of
elective colectomy following diverticulitis: a population-based analysis. Diseases of the
Colon & Rectum, 59(4), 332-339.
https://www.ingentaconnect.com/content/wk/dcr/2016/00000059/00000004/art00015
Ng, Z. Q., Moe, K. S., & Wijesuriya, R. (2019). Routine Colonoscopy After Acute
Diverticulitis: is it Warranted?. Surgical laparoscopy, endoscopy & percutaneous
techniques, 29(6), 462-466.
https://www.ingentaconnect.com/content/wk/slept/2019/00000029/00000006/art00012
Rezapour, M., Ali, S., & Stollman, N. (2018). Diverticular disease: an update on
pathogenesis and management. Gut and liver, 12(2), 125.
https://pubmed.ncbi.nlm.nih.gov/28494576/
COMMON SYMPTOMS
In the western world, Diverticulitis is considered as the most common condition
identified through colonoscopy. Diverticulitis is considered as the infection or
severe inflammation of the pouches that form within the intestine. These pouches
are considered as diverticula. These pouches are usually observed in the lower part
of the large intestine. The pathophysiology of Diverticulitis is obstruction of the sac
by fecalith that in response to the irritation of mucosa trigger low-grade
inflammation along with congestion. Generally, complicated diverticulitis is
characterized by fistulas, perforation and abscesses (Acuna et al., 2018). The other
classification of the disease includes Symptomatic uncomplicated diverticular
disease, segmental colitis related to diverticulosis.
• The common risk factors for the disease include ageing, obesity, smoking lack of
exercise, high animal fat with low fiber and consumption of steroids, opioids and
non-steroidal anti-inflammatory drugs (Rezapour, Ali & Stollman, 2018).
• Approximately 25% of the individuals with disease experience abscess, blockage
of small intestine and peritonitis. 50% of Canadians over the age of 80 years
usually develop diverticulosis and approximately 15 to 20% of the population
experience diverticular bleeding in Canada (Canadian Digestive Health
Foundation, 2020).
• Every year, approximately 400 Canadians die due to the complications
associated with diverticular disease and in 3309 cases, individuals require
lifesaving surgeries. The direct cost of the disease in Canada per year is of $88.6
million.
Majority of the individuals with diverticulitis exhibit no symptoms and no
development of complications. However, without a complication, the clinical
symptoms may be associated with a low fiber diet. The common symptoms
observed in the patients include
• abdominal pain,
• infection,
• fever, the elevation of the white cell count of the individuals suffering from the
disease (Alghamdi, Khadaroo & Fathimani, 2017).
• The patients with the disease exhibit severe scarring of intestine along with
bowel narrowing. The symptoms are noticeable when severe and intense pain
experienced by individuals. The intense pain may contribute to nausea as well as
vomiting. The massive perforation of the bowel followed by blood in stool of the
individuals (Diamant et al., 2018). The bowel obstruction can lead to
constipation, thin stool, severe bloating and diarrhea. Since the symptoms are
similar to other severe diseases such as irritable bowel disease, blood urine and
feces examination is a suitable means of identifying whether patients have an
infection or not. Likewise, a CT scan is a suitable means of identifying infected