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home - Colon - Miscellaneous - Diverticular Disease Written by Dr Sebastian Zeki
Methods GMP
Knows the physiology of intestinal absorption, secretion and motility SCE 1
Understands the biochemical processes occurring within the gut
lumen and at mucosal level

Has awareness of the factors controlling these processes – in
particular the neuro-endocrine influences

Understands the range of mechanisms by which diarrhoea can result
from disturbances in each of these processes

Knows the causes of both acute and chronic diarrhoea
Knows the range of investigations appropriate to determining the
cause of the patient’s diarrhoea and is aware of the range of
therapeutic possibilities

Makes a detailed clinical assessment of patients that present with
either acute or chronic diarrhoea

Recognises the potential need for urgent fluid replacement CbD,
Makes appropriate use of microbiology and other relevant laboratories in reaching a diagnosis

Shows ability to interpret results, reach a diagnosis and formulate a
treatment plan

Reacts appropriately to the urgency of the clinical presentation
Always shows sympathy and understanding especially when the
patient is distressed

Diverticular Disease

Diverticulosis and DiverticulitisAge dependent,50% overall;Diverticulosis F>M; Diverticulitis M>F(esp.obese <40yrs) 95% in sigmoid 35% also have more proximal disease. 4 % of these have diverticula limited to a segment proximal to the sigmoid 7 % of these have diverticula throughout the colon Often have thickening of the circular muscle layer (elastin deposition rather than hyper-trophy), shortening of the taeniae, and luminal narrowing (myochosis)- decreases resist-ance to intraluminal pressure. Right sided diverticulosis more common in asians Vasa recta Risk factors for diverticulosis:Obesity.Lack of fibre.Reduced physical exercise. CharacteristicsDiverticula don’t contain all layers of wall so they are actually false divertica.Diverticula consist of serosal covered mucosa and submucosa herniating through muscle layer.Diverticula usually develop at insertion of vasa recta into the circular muscle layer on each side of the mesenteric taenia and on the mesenteric border of the two antimesenteric taeniae. Written by Dr Sebastian Zeki