Question 1

A patient with a history of diverticular disease asks what can be done to minimize acute symptoms. What will the provider recommend to this patient?&#10;A) Avoiding saturated fats and red meat&#10;B) Consuming a diet high in fiber&#10;C) Taking an anticholinergic medication&#10;D) Using bran to replace high-fiber foods

Accepted Answer

Consuming a diet high in fiber is a well-established recommendation for patients with diverticular disease as it helps to prevent constipation and reduce the risk of diverticulitis. Avoiding saturated fats and red meat may also be beneficial, but a fiber-rich diet is the primary recommendation. Taking an anticholinergic medication or using bran to replace high-fiber foods are not typically recommended for managing diverticular disease.

Question 2

A patient has intermittent left-sided lower abdominal pain and fever associated with bloating and constipation alternating with diarrhea. The provider suspects acute diverticulitis. Which tests will the provider order? (Select all that apply.)

A) Barium enema examination
B) Computerized tomography (CT) scan of abdomen and pelvis
C) Plain abdominal radiographs
D) Rigid sigmoidoscopy
E) Stool for occult blood

B, E

Accepted Answer

A barium enema examination and a rigid sigmoidoscopy are not recommended in the acute setting of suspected diverticulitis as they can exacerbate inflammation and increase the risk of perforation. Instead, a CT scan of the abdomen and pelvis is the preferred imaging study as it is highly sensitive and specific for diagnosing diverticulitis. A stool for occult blood test can also be ordered to rule out other causes of lower abdominal pain and diarrhea. Plain abdominal radiographs are not very helpful in diagnosing diverticulitis.

Question 3

A patient with a history of diverticular disease experiences left-sided pain and reports seeing blood in the stool. What is an important intervention for these symptoms?&#10;A) Ordering a CBC and stool for occult blood&#10;B) Prescribing an antispasmodic medication&#10;C) Referring the patient for a lower endoscopy&#10;D) Reminding the patient to eat a high-fiber diet

Accepted Answer

Left-sided pain and rectal bleeding are common symptoms of diverticular disease and can indicate diverticulitis, a more serious complication. Referring the patient for a lower endoscopy can help diagnose the cause of the symptoms and determine the appropriate treatment. While obtaining a CBC and stool for occult blood may be helpful, it is not as specific as a lower endoscopy. Antispasmodics may provide some relief for cramping, but they do not address the underlying cause. Reminding the patient to eat a high-fiber diet is important for long-term management of diverticular disease, but it is not an immediate intervention for these acute symptoms.

Deck 115: Diverticular Disease