Which of the following mechanisms can facilitate the development of diverticulosis into diverticulitis?
A. Treating constipation with chronic laxative use, leading to dependence on laxatives.
B. Chronic constipation causing an obstruction, reducing forward flow of intestinal contents.
C. Herniation of the intestinal mucosa, rupturing the wall of the intestine.
D. Undigested food blocking the diverticulum, predisposing the area to bacterial invasion.
Correct Answer: D. Undigested food blocking the diverticulum, predisposing the area to bacterial invasion.
Undigested food can block the diverticulum, decreasing blood supply to the area and predisposing the area to invasion of bacteria. Diverticulitis typically results from micro- or macroscopic perforation of a diverticulum, which may or may not result from obstruction (e.g., by a fecalith). Increased intraluminal pressures or inspissated (thickened and condensed) food matter, with resultant inflammation and focal necrosis, ultimately result in diverticular perforation.
Option A: Chronic laxative use is a common problem in elderly clients, but it doesn’t cause diverticulitis. Medications associated with an increased risk of diverticular bleeding or diverticulitis include nonsteroidal anti-inflammatory drugs, opiates, and steroids.
Option B: Chronic constipation can cause an obstruction—not diverticulitis. The risk of diverticulitis and bleeding is significantly higher in patients with obesity or larger waist circumference. Smokers have been noted to have an increased incidence of diverticular abscess formation or perforation.
Option C: Herniation of the intestinal mucosa causes an intestinal perforation. Inflammatory diseases of the bowel such as Crohn’s disease and ulcerative colitis can also lead to perforation, especially Crohn’s, which is characterized by full-thickness inflammation of the bowel wall.
No comments:
Post a Comment