Diverticulitis occurs when small pouches, known as diverticula, that form in the lining of the digestive system become inflamed or infected. These pouches are commonly found in the lower part of the large intestine (colon). When blood vessels within the wall of a diverticulum rupture, it can lead to painless bleeding in the lower intestinal tract, often involving a significant amount of blood.
Causes of bleeding in Diverticulitis
Diverticula form when the inner layer of the intestinal wall pushes through the outer layer, causing blood vessels in these pouches to become stretched and bent. This makes them more susceptible to injury, leading to potential bleeding.
Symptoms of Diverticular Bleeding
Diverticular bleeding typically occurs suddenly and without pain, often appearing as bright red or maroon blood that is not fully mixed with the stool. In contrast, dark stool indicates bleeding higher up in the digestive system, where the blood has been digested. Since diverticula are in the lower part of the intestine, bleeding from them does not present in this way.
Treatment of Diverticular Bleeding
Diverticular bleeding often resolves spontaneously. However, in cases of significant blood loss, intervention is necessary. If the bleeding does not stop on its own, a doctor will perform a thorough evaluation to locate the source and manage the bleeding, often using a colonoscopy. Patients experiencing substantial blood loss may present with low blood pressure and rapid heart rate, indicating the need for urgent care. In such situations, blood transfusions may be required.
When to Seek Medical Attention
If you experience bleeding accompanied by faintness, severe blood loss, or vomiting blood, it is crucial to seek emergency medical attention immediately. In less urgent cases, it is important to discuss any bleeding with your healthcare provider, especially if it is frequent or persists for more than a day.
How to prevent Diverticulitis bleeding?
Managing Severe Diverticular bleeding
Diverticular bleeding usually resolves on its own with rest. However, in cases of severe or frequent bleeding, medical intervention may be required. Hospitalization may be necessary to monitor the patient, while minimally invasive techniques are often used to stop the bleeding. A colonoscopy is commonly performed to identify and treat the source of bleeding. Additionally, angiography can be used to both locate the source of the bleeding and deliver substances through the blood vessels to control it. If other measures are unsuccessful and the bleeding remains severe, surgery to remove part of the colon may be needed.
Preventing Future Bleeding Episodes:
- Avoid straining during bowel movements: Straining can cause diverticula to rupture, leading to inflammation or infection.
- Quit smoking and maintain a healthy weight: Both smoking and obesity are linked to increased risk of diverticular complications.
- Engage in aerobic exercise: Regular physical activity helps maintain a healthy gut microbiome, which may reduce the risk of diverticular issues.
- Report any bleeding or pain to your doctor immediately to ensure timely treatment.
Blood Loss Treatment
Chronic blood loss requires identifying and addressing the source of bleeding, along with treating any resulting iron-deficiency anemia. In cases of sudden significant blood loss, such as diverticular bleeding, treatment may include:
- Fluids: To maintain blood volume and hydration.
- Blood transfusions: To quickly restore red blood cell levels.
- Oxygen: To ensure adequate oxygen delivery to tissues.
- Iron supplements: To help the body produce new red blood cells.
Eliana Oberman
