Diverticular Disease Process Case Study - Nursing Assignment Help

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Diverticular Disease
Diverticular disease is found to affect the lower part of the large intestine which is called the colon (Dzhalalov, 1957). The large intestine is part of the digestive system and plays a role in moving waste products from the digestive process which includes undigested parts of food, fluid, and old cells from the lining of the GI tract (Dzhalalov, 1957). The large intestine also is responsible for recovery of water and electrolytes, producing and absorbing vitamins, and when the large intestine absorbs water, it changes the waste from liquid to stool and forms feces which is propelled towards the rectum for elimination (Dzhalalov, 1957). The water is absorbed by osmosis then the water is diffused by an osmotic gradient due to the absorption of electrolytes (Azzouz, 2021). The colon has sodium channels that actively absorb sodium as well as potassium is either absorbed or secreted and this is based on the concentration of the lumen at the time (Azzouz, 2021). The active absorption of sodium creates the electrochemical gradient that allows for this to happen (Azzouz, 2021). The electrochemical gradient also allows for chlorine ions to be exchanged for bicarbonate ions (Azzouz, 2021). The colon contains trillions of bacteria that produce required vitamins and protect the patient’s gut (Azzouz, 2021). Fermentation allows the bacteria in the colon to produce substantial amounts of vitamins (Azzouz, 2021). Colonic bacteria produce vitamin K and B including biotin and then absorbed into the blood (Azzouz, 2021). Peristalsis also occurs in the large intestine which is a series of wave-like muscle contractions to help move substances across the digestive tract (Dzhalalov, 1957). The ascending colon then absorbs the rest of the water and nutrients from the undigested parts of food then is solidified to form stool (Azzouz, 2021). The descending colon stores feces which then the sigmoid colon contracts to increase the pressure in the colon resulting in stool being moved to the rectum for elimination (Azzouz, 2021). These functions of the large intestine are important because the water and electrolyte absorption is to concentrate the stool and they also plays a role in metabolism (Dzhalalov, 1957). The wall of the large intestine is made up of simple columnar epithelium cells, which have invaginations and they are the intestinal glands that have an abundance of goblet cells (Dzhalalov, 1957). There are four types of tissue that are in the large intestine and starts with the opening of the bowels is the lumen and inside is the mucosa which is smooth and made up of epithelial cells (Azzouz, 2021). Then surrounding the mucosa is the submucosa and it is made of a layer of blood vessels, nerves and connective tissue which is made up of many types of cells (Azzouz, 2021). Then it is the muscularis, this layer is made up of two smooth muscle layers these are known as the inner circular layer and the outer longitudinal layer (Azzouz, 2021). Finally, the serosa which is a thin layer of connective tissue that contains blood and lymphatic vessels (Azzouz, 2021).

There are also two types of motilities present in the colon; the haustral contraction and mass movement, haustral contractions begin when there is chyme present and moves the food to the next haustra (Azzouz, 2021). These haustra’s give the colon its segmented appearance as well as mixing the chyme to help absorb the water (Azzouz, 2021). Mass movements move the chyme to the rectum faster due to being stronger (Azzouz, 2021). The large intestine adapts to daily deviations from homeostasis by absorbing water and minerals from liquid waste matter, then some of these minerals are secreted from the body into the GI tract to maintain homeostasis in the body (Elson et al., 2002). The large intestine doesn’t only assist in the fluid balance in the body, it also supports the synthesis of mucous (Elson et al., 2002). Mucous contains goblet cells that secrete sticky mucus into the GI tract (Elson et al., 2002). Mucous’ function is absorption and secretion, and it is made up of connective tissue and epithelium cells (Elson et al., 2002).

Diverticular disease causes symptoms of bleeding, inflammation or complications and these conditions occur when small pouches or sacs called diverticula form in the wall of the colon and push outwards through weak spots (Maguire, 2020). Some of these symptoms that the patient might develop from these sacs are constipation, diarrhea, nausea, fever, abdominal pain, or bloating (Maguire, 2020). The alterations in physiological functions that occur during diverticular disease is that inflammation can lead to bowel obstruction which is when there is a blockage in the colon (Maguire, 2020). Some stool that may be able to pass through the colon will be bright red colour or black and tarry which indicates there is a presence of blood (Wan et al., 2021). Another alteration in physiological function that occurs is that the sacs can become inflamed or infected when bacteria become trapped in one of the sacs (Speake et al., 2009). Fistulas can also develop if an infected sac reaches a nearby organ and forms a connection, this happens most often between the large intestine and bladder which can lead to a kidney infection (Speake et al., 2009). The main cause for diverticular disease is a person diet, it usually occurs when the person has a high fat, low fiber diet (Speake et al., 2009).

The process of diverticular disease development would start off with some risk factors like a poor diet, genetics, poor physical activity levels, smoking, obesity, or aging (Maguire, 2020). Then due to these risk factors the patient would become constipated and when you are constipated your muscles try to move your stool that is too hard and become strained (Maguire, 2020). The extra pressure from your muscles causes pressure in the colon therefore making weak spots in the colon (Maguire, 2020). Then in these weak spots in the colon there would be a development of diverticula which are small herniations in the colon wall (Maguire, 2020). Once these diverticula sacs become inflamed or infected the patient will be diagnosed with diverticular disease (Maguire, 2020). If one of these infected sacs ruptures causing intestinal contents to spill into the abdomen cavity it can cause an infection called peritonitis this, then causes inflammation of the tissues that line the abdomen (Speake et al., 2009). Sometimes these inflamed sacs can diminish into the urinary bladder causing a bladder infection and the passing of intestinal

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