American Medical Association Family Medical Guide - American Medical Association [503]
To treat diverticulitis, your doctor will probably prescribe oral antibiotics to take for 7 to 10 days. He or she may recommend a liquid diet to give your colon time to heal. If the abdominal pain continues, your doctor will admit you to a hospital and you will be given antibiotics intravenously (through a vein). Immediate surgery usually is not necessary unless the diverticula continue to bleed or if peritonitis or an intestinal obstruction (see page 759) develops. To treat bleeding diverticula, your doctor may recommend a procedure using angiography (see page 110) to inject a substance into the artery to make the blood clot. In some cases, surgery is necessary to stop the bleeding.
If you are not passing gas or stool, the contents of your stomach and intestine will be sucked out through a long tube and you will be given fluids intravenously. If the swelling in your abdomen doesn’t subside, you may have an intestinal obstruction. In rare cases, doctors perform a temporary colostomy (see page 776). After the inflammation has subsided (usually within a few weeks), the colostomy will be closed and the affected section of the colon removed (colectomy; see page 776). Diverticulosis and diverticulitis usually recur unless the entire colon has been removed.
Intestinal Polyps
Polyps are mushroomlike growths that can develop in the large intestine, either singly or in groups. Most polyps are benign (noncancerous). Two types of polyps occur in the large intestine—adenomatous polyps and hyperplastic polyps. Adenomatous polyps are the most likely to grow large (bigger than ½ inch) and become cancerous.
In rare cases, people can have hundreds of polyps in their colon (familial polyposis; see next page). The cause of polyps in the intestine is unknown, but the incidence increases with age. If the polyps are large, they can cause an intestinal obstruction (see page 759).
Symptoms
Intestinal polyps seldom cause symptoms, but they may cause slight bleeding from the rectum or blood in the stool. You may be pale and tired or have other symptoms of anemia (see page 610) if the polyps cause excessive bleeding. In rare cases, if the polyps have caused an intestinal obstruction, symptoms can include abdominal pain and vomiting.
Polyps and Colon Cancer
Because some types of polyps can become cancerous if they are not removed, doctors recommend testing in people who are at risk of having polyps. You should have a diagnostic procedure called colonoscopy (see page 767) on the following schedule:
• Every 5 years if you have been diagnosed with adenomatous intestinal polyps.
• Every 10 years starting at age 40, or 10 years younger than the age at which colon cancer in a first-degree relative (parent, sibling, or child) was diagnosed.
• Every 10 years starting at age 50 if you have no history of polyps or colon cancer.
Noncancerous and cancerous polyps
Polyps are growths in the inner lining (mucosa) of the wall of the colon and are usually made up of normal cells. When a polyp becomes cancerous, its cells grow and multiply abnormally. The abnormal cells may grow into the next layer of the wall of the colon (the submucosa). If the cancerous cells continue to multiply unchecked, the cells may invade blood vessels and metastasize (spread) throughout the body.
Diagnosis
Because intestinal polyps usually cause no symptoms, they are often diagnosed by chance from tests performed for another reason. To diagnose intestinal polyps, a doctor performs a procedure called colonoscopy (see page 767) to examine the colon. If just the lower third of the colon is examined, the procedure is called sigmoidoscopy (see page 144). A doctor may also order a barium X-ray (see page 767) of the colon.
Treatment
Intestinal polyps are usually removed through the colonoscope during a colonoscopy. If the polyp is very large, your doctor may be able to remove