1.Compare and contrast the pathophysiology between diverticular disease (diverticulosis) and diverticulitis.
a.Diverticulosis is described by the presence of sac-like protrusions, diverticula, which form when colonic mucosa and submucosa herniated through defects in the muscle layer of the colon wall. Diverticula are developed from age-related degeneration of the mucosal wall and segmental increcreses in colonic pressure resulting in the bulging at the weak points. The weak points in the colon wall is where arteries penetrate
the tunica muscularis to nourish the mucosal layer, (McCance, K.L. & Huether, S.E., 2019). It can occur anywhere in the gastrointestinal tract, and most common in the left and right colon. Diverticulosis is an asymptomatic diverticular disease. Diverticulosis is more common in people over the age 60 years old. The rate of diverticulosis increases with age. It is also caused by a high-fat, low-fiber diet. The presence of diverticula usually does not cause any symptoms, nor needs to be treated.
However, diverticulosis can lead to diverticulitis. b.Diverticulitis is the inflammation and infection in one or more diverticula. The diverticula is formed the same way as seen in diverticulosis, when the
colonic mucosa and submucosa herniated through defects in the muscle layer of the colon wall. The difference between diverticulosis and diverticulitis is that diverticulitis is the formation and periodic inflammation
of out-puchings (diverticula) in the intestinal wall. Predisposing factors are
similar to diverticulosis which include older age, and lack of dietary fibers. Factors also include genetic predisposition, obesity, smoking, lack of physical activity, and medications such as non-steroidal anti-inflammatory drugs (NSAIDs), (McCance, K.L. & Huether, S.E., 2019). Intestinal mucosal inflammation are seen in patients with segmental colitis that is associated with diverticular disease, ( Strate, L. L., & Morris, A. M., 2019) . Alterations in the gut microbiota are implicated in the pathogenesis of many intestinal disorders such as diverticulitis. Diet and lifestyle factors may stimulate alterations in the gut microbiome that lead to mucosal inflammation and diverticulitis, ( Strate, L. L., & Morris, A. M., 2019 ). 2.Identify the clinical findings from the case that supports a diagnosis of acute diverticulitis. a.Diverticulosis is asymptomatic, but when it becomes complicated and progresses to acute diverticulitis symptoms include cramping pain that is seen in the lower left abdomen, diarrhea, constipation, distention, and fever, (McCance, K.L. & Huether, S.E., 2019). Occult blood in the stool is another symptom of diverticulosis. In our case study, the patient is experiencing lower quadrant pain of the abdomen, with constipation, nausea, vomiting and a low-grade fever. Her abdomen is distended and her stool is positive for occult blood. All these clinical findings are consistent with acute diverticulitis. The CT scan of her abdomen showed This study source was downloaded by 100000829216747 from CourseHero.com on 09-23-2022 07:55:01 GMT -05:00
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