NURS 6501 GASTROINTESTINAL AND HEPATOBILIARY DISORDERS MODULE 3 Scenario 4: Diverticulitis A 54-year-old schoolteacher is seeing your today for complaints of passing bright red blood when she had a bowel movement this morning.

NURS 6501 GASTROINTESTINAL AND HEPATOBILIARY DISORDERS MODULE 3

Scenario 4: Diverticulitis

A 54-year-old schoolteacher is seeing your today for complaints of passing bright red
blood when she had a bowel movement this morning. She stated the first episode
occurred last week. The episode today was accompanied by nausea, sweating, and
weakness. She states she has had some LLQ pain for several weeks but described it as

“coming and going”. She says she has had a fever and abdominal cramps that have
worsened this morning.
Diagnosis is lower GI bleed secondary to diverticulitis.
Question:
1.     What can cause diverticulitis in the lower GI tract? 
Your Answer:
The patient in the case study has diverticulitis. Diverticulitis develops when a part of the
colon weakens leading to pouches and protrusion in the wall of the colon. Several factors
can cause diverticulitis. One of them is aging. The risk of a patient developing diverticulitis
increase significantly as one ages. The other cause of obesity. The risks of diverticulitis
increase significantly with excessive weight gain. An imbalance between the bacterial
flora in the colon has also been attributed to diverticulitis (Peery et al., 2021). For
example, an imbalance between Clostridium coccoides and Escherichia have been
identified to cause diverticulitis in most of the patients.
            Diet also plays a role in the development of diverticulitis. Patients with a history of
low fiber diet have an elevated risk of developing the disorder as compared to those who
take fiber rich diet. Low fiber diet results in too much volume within the colon, hence,
increasing the risk of diverticulitis. The other cause is physical inactivity. Physical
inactivity affects intestinal microbiome as well as increases the risk of diverticulitis-
associated risk factors such as obesity. Genetics also contributes to diverticulitis.
Accordingly, people born to families with a history of diverticulitis are increasingly at a
risk of developing the disorder. However, the direct link between the exposure and
development of diverticulitis is inconclusive. The use of certain medications has also been
shown to increase the risk of diverticulitis. For example, NSAIDs and steroids have been
shown to increase the risk of diverticulitis due to their effect on gastrointestinal
physiology. Lifestyles such as smoking also increases the risk(Peery et al., 2021). This can
be seen from the evidence that most of the smokers have a high rate of diverticulitis as
compared to non-smokers.

References

Peery, A. F., Shaukat, A., & Strate, L. L. (2021). AGA clinical practice update on medical
management of colonic diverticulitis: Expert review. Gastroenterology, 160(3), 906-911.e1.
https://doi.org/10.1053/j.gastro.2020.09.059