Flexible sigmoidoscopy and colonoscopy Diverticulae can be seen and

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other pathology (e.g. polyps or tumour) can be excluded.

Bloods: FBC (anaemia), " WCC and " inflammatory markers in acute disease.

M: GI bleed: PR bleeding is often managed conservatively with nil by mouth, IV rehydration, antibiotics, blood transfusion if necessary.

Diverticulitis: Nil by mouth, IV antibiotics (cephalosporin and metronidazole) and IV fluid rehydration.

Chronic: High-fibre diet with bulking agent (e.g. methylcellulose). Laxatives may be required if constipation is severe. Encourage high fluid intake. Surgery: May be necessary with recurrent attacks or when complications develop, e.g. severe bleeding or infection. Sigmoid colectomy, Hartmann's procedure, fistulectomy or drainage of pericolic abscesses are some operations performed.

C: Diverticulitis, pericolic abscess, perforation, colonic obstruction, fistula formation (bladder, small intestine, vagina), haemorrhage (caused by vessel erosion).

P: 10-25% of patients will have one episode of diverticulitis. Of these, 30% will have a second episode. 20% of patients will have one or more complication after the first episode of diverticulitis.

Cystoscopy Angiodysplasia

Fig. 9 (a & b) Both figures show severe diverticular disease.

Fig. 9 (a & b) Both figures show severe diverticular disease.

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