14738 Meckels Diverticulum

Overview

Meckel's diverticulum is a small pouch that some people are born with in the lining of the lower part of the small intestine. It's a leftover from normal development before birth. For most people, it causes no problems at all, but in some cases it can lead to bleeding, pain, or a blockage in the intestine.

It's the most common birth-related pouch in the digestive system, but it's still uncommon overall – about 2 out of every 100 people have it.

It can affect anyone, but symptoms are more likely in children under 10. Men and boys are slightly more likely than women and girls to develop complications.

Symptoms

Common symptoms

• No symptoms at all (most common)
• Painless bleeding from the rectum, often bright red or dark red
• Belly pain around the belly button
• Nausea and vomiting
• Bloating or a feeling of fullness

Symptoms in children

• Painless, bright red or dark red blood in the stool
• Stomach pain that may feel like appendicitis
• Sometimes no pain at all, only bleeding

Symptoms in older adults

• Less likely to have bleeding than children
• Crampy belly pain from a partial blockage
• Vomiting, constipation, or trouble having a bowel movement
• Inflammation of the pouch can cause fever and tenderness

Causes

Main causes

• Meckel's diverticulum forms before birth when a small tube (the vitelline duct) that connects the intestine to the yolk sac fails to fully disappear. It is not caused by anything a parent did or didn't do during pregnancy.

Risk factors

• Being male (men are more likely to have symptoms)
• Being under 10 years old (for complications)
• A diverticulum that is longer than usual
• Having certain types of tissue inside the pouch (such as stomach or pancreatic tissue)

When to see a doctor

See a doctor urgently if:

• If you or your child have heavy bleeding, sudden severe pain, or signs of shock, call your local emergency number immediately.

Book a routine appointment if:

• If you notice blood in your stool or have unexplained belly pain, make an appointment with your doctor as soon as convenient.

Diagnosis

Doctors use imaging tests to see the pouch and rule out other causes. The most specific test is a Meckel scan, which uses a tiny amount of radioactive material to show the pouch. Ultrasound, CT scans, and endoscopy can also help. Sometimes it is found by accident during surgery for another reason.

Tests that may be done

• Meckel scan (a special nuclear medicine test)
• Ultrasound of the belly
• CT scan (computed tomography)
• Endoscopy (a thin tube with a camera into the digestive tract)
• Blood tests to check for anaemia (low red blood cells) if there has been bleeding

What to expect at your appointment

Your doctor will ask about your symptoms and examine your belly. If bleeding is a concern, a Meckel scan may be arranged. You may be referred to a gastroenterologist (a doctor who specialises in the digestive system) for further evaluation.

Treatment

If Meckel's diverticulum is discovered by chance and causes no symptoms, no treatment is needed. If it causes symptoms such as bleeding, blockage, or inflammation, surgery to remove the pouch is usually the recommended approach. Your healthcare team will explain the best option for you or your child.

Self-care at home

• Keep a note of any symptoms, especially any blood in the stool, and tell your doctor promptly.
• Drink plenty of fluids and eat a balanced diet to keep your bowels regular.
• Rest when you have pain or discomfort, but try gentle movement when you feel well.
• After any surgery, follow your surgeon's advice about activity and wound care.

Medical treatments

Treatment for a symptomatic Meckel's diverticulum often involves surgery to remove the pouch. If there is active bleeding, a blood transfusion may be needed in the hospital. If there is infection or inflammation, antibiotics may be prescribed. For those without symptoms, no medical treatment is required.

When is surgery considered?

Surgery is usually recommended when the diverticulum causes symptoms like significant bleeding, a bowel blockage, or inflammation. In many cases, it can be done with minimally invasive (laparoscopic) techniques, which means a shorter recovery with smaller cuts. For people without symptoms, surgery is rarely needed.

Living with this condition

Most people don't need to change their daily routine. If you've had symptoms and surgery, you can usually return to normal activities after recovery. It helps to know the warning signs so you can get help quickly if symptoms return.

Lifestyle tips

• Learn about your condition so you know what symptoms to watch for.
• Keep regular check-ups if your doctor suggests them.
• Tell any new doctor that you have (or had) Meckel's diverticulum.
• After surgery, gradually ease back into exercise and heavy lifting only after your doctor says it's safe.

Diet and exercise

Eat a diet with plenty of fibre (fruits, vegetables, whole grains) and drink enough water to avoid constipation. Gentle exercise like walking is generally good for everyone. After surgery, follow your surgeon's specific advice about diet and activity during recovery.

Mental health and emotional wellbeing

Living with a condition that could suddenly cause symptoms can be stressful or worrying. It's normal to feel anxious. You can talk to your doctor about these feelings, and if stress or anxiety affects your daily life, consider speaking with a mental health professional or counsellor.

Prevention

Meckel's diverticulum cannot be prevented because it is present from birth. What you can do is recognise symptoms early and seek medical care when they appear, which helps avoid serious complications.

Vaccines

There is no vaccination for Meckel's diverticulum.

Screening programmes

There is no routine screening test for Meckel's diverticulum in healthy people.

Complications

If left untreated

• Intestinal blockage (a twist or obstruction in the bowel)
• Heavy bleeding that can lead to anaemia (low red blood cells)
• Inflammation of the pouch (diverticulitis), which can become infected
• A hole in the intestine (perforation), which is a medical emergency

Long-term outlook

The outlook is very good. Most people with Meckel's diverticulum go through life without any symptoms. For those who do have symptoms, surgery is highly successful and most people recover fully without long-term health problems.

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