Diverticulitis is a treatable and curable condition that is relatively common, especially in the United States. Cases can range from mild to severe, but in most cases it is mild, with treatment being nothing more than rest, a liquid diet, and antibiotics. However, if diverticulitis is not properly diagnosed and cared for, it can lead to serious health problems, as complications occur in 25 percent of those diagnosed. The diverticular pouch could rupture and send bowel matter into the abdominal cavity (peritonitis), leading to blood infections and organ failure. Surgery may be required in more severe cases.
Misdiagnosis and Missed Diagnosis of Diverticulitis
Eighty-five percent of diverticulitis cases that are uncomplicated will respond well to treatment and one-third remain symptom free after health is restored. With such high response rates, it is heartbreaking to think that victims of a misdiagnosis or missed diagnosis needlessly suffer as their condition worsens over time. Diverticulitis is typically diagnosed based upon results from a CT scan, but misinformation from technical errors or unusual complications in the gastrointestinal tract can play a part in medical professionals mistaking diverticulitis for other abdominal issues such as irritable bowel syndrome or colon cancer. Incorrectly diagnosing a patient with an ailment is a misdiagnosis and can lead to serious consequences. Inappropriate treatment prescribed could have adverse effects on the patients’ health, all the while their condition worsens.
In some cases, doctors fail to diagnose a patient with any medical condition. Not only does this result in the patient not receiving care, but the amount of time lost from not getting the correct treatment can mean the difference between confronting a highly-treatable condition, like diverticulitis, or a life-threatening disease. If diverticulitis is not diagnosed in a timely manner, common treatment could be ineffective and more intense treatment options such as surgery, which may not have been needed before, is the only option. A missed diagnosis subjects the patient to unnecessary risks.
What is Diverticulitis?
Diverticulitis caused when diverticula (small pouches that can form in the lining of the digestive system) become infected. Having these diverticula present in the muscular wall of the colon is known as diverticulosis, a condition that is generally asymptomatic, and may not cause any concerning medical issues. However, if the diverticula becomes infected or inflamed, the result is diverticulitis. No one knows exactly what causes the diverticula to become inflamed, but theories suggest that a low fiber diet, age, and obesity are all contributing factors.
Signs and Symptoms – What You Doctor Should Look For
Diverticulitis produces many symptoms that are similar to other conditions. Listed below are common symptoms that doctors should take into consideration when determining what tests to administer to see if diverticulitis is the root cause:
- Pain in the lower left side of stomach that worsens during movement
- Loss of appetite
- Rectal bleeding that is bright red
Diagnosing Diverticulitis – Did Your Doctor Run The Correct Tests?
Since abdominal pain is a common ailment in general, symptoms of diverticulitis can indicate other illnesses in the body. These include:
- Inflammatory Bowel Disease (Crohn’s disease and ulcerative Colitis)
- Bowel obstruction
- Perforation by a foreign object (toothpick or fishbone)
- Trauma to the rectum
- Colon cancer
- Pelvic Inflammatory Disease
By running the correct tests, the doctor should be able to distinguish between one of these many conditions and diverticulitis. Initially your doctor should perform a physical exam and inquire about your medical history. Revealing bowel movement patterns, facts about diet, and current medications help your doctor determine what diagnostic procedures are best to administer. The following are common techniques in diagnosing diverticulitis:
- Blood test
- CT Scan
- Barium Enema
While choosing the right test to perform is very important, interpretation of the results from these tests are just as vital. Testing that is done at an off-site facility places patients at the mercy of lab technicians, medical staff, and radiologists. Technical factors from a CT scan may depict misleading images that in are turn misinterpreted by the radiologist, who creates and reads the report. Doctors, who are unaware of the errors made in the lab, use these tests to determine what illness you have, the severity, and the treatments required.
Treatment – Did Your Doctor Explain Your Options?
In most cases of diverticulitis the condition is simple and patients respond well to medications without surgery. The two most common antibiotics include a combination of ciprofloxacin and metronidazole or amoxicillin/clavulanic acid monotherapy. At home treatments such as a clear liquid diet are prescribed. In some cases diverticulitis can worsen; inabilities to tolerate fluids, severe abdominal pain, and a temperature over 100 deg. require immediate medical attention. There are many indicators that a patient is suffering from complicated diverticulitis such as peritonitis, uncontrollable sepsis, abdominal abscess, perforation, fistula formation, and intestinal obstruction. If a patient is not responding positively to earlier prescribed medical treatment, that could also indicate the diverticulitis is more advanced.
Approximately 15 – 20 percent of patients with diverticulitis have complications that require surgery. Abscesses located in the abdominal area need to be drained. Perforation (a hole in the wall of an organ) surgery is needed to repair the tear and in some cases, a small part of the colon may need to be removed. A patient who is suffering from peritonitis requires surgery immediately in order to clean out the abdominal cavity. Blood transfusions may be needed as well. If left untreated, peritonitis can be fatal. Colon resection is performed to correct fistula (an abnormal pathway between two organs), and to correct any intestinal blockage.
Diverticulitis increases with age; at a time when the body is more prone to infection and unable to bounce back as it once did. Even though diverticulitis is easily treated, it is not always easily detected. Abdominal symptoms often mimic other conditions, some of which may not be as serious. If diverticulitis is missed in the initial diagnosis, chances are it can worsen over time and in some cases peritonitis can occur.
As a patient, we place our faith and complete trust in the competency of doctors, nurses, lab technicians, and other medical staff and expect a certain standard of care, When that trust is broken, or that standard of care is not met, not only are we left with a lack of respect for the medical community, we are left with worsening symptoms as a direct result of a misdiagnosis/ missed diagnosis.
Answer the following questions to determine if you are a victim of misdiagnosis/missed diagnosis of diverticulitis.
- What did your doctor do after you explained your symptoms?
- What tests were administered? Did your doctor explain why that test was done?
- Was your medical history taken?
- How do you know your tests results are accurate?
- Were lab test results sent to another facility?
- Where was that facility located?
- How do you know if the information was relayed back correctly?
- How many episodes of diverticulitis did you have? Was surgery recommended?