Diverticular Disease

What is Diverticular Disease?

Diverticulosis of the colon is a common condition that affects approximately half of all Americans over age 60. However, they can develop in the colon of patients in their twenties. A diverticula is a small pouch of the colon lining through a weakness in the muscle wall. A small percentage of those with diverticulosis will go on to have symptoms of Diverticulitis, which is an infection of the colon. Fewer patients still will require surgery for this condition.

What are the symptoms?

The following are the most common symptoms of diverticular disease. Each individual may experience symptoms differently. Symptoms may include:

  • Diverticulosis
    Diverticulosis may not cause any discomfort or symptoms, but could include mild cramps, bloating, and constipation. These symptoms may be caused by irritable bowel syndrome (IBS), stomach ulcers, or other problems and do not always indicate diverticulosis.

  • Diverticulitis
    The most common symptom is abdominal pain and the most common sign is tenderness around the left side of the lower abdomen. When infection is the cause, fever, nausea, vomiting, chills, cramping, and constipation may occur. When these complications occur the diverticulum may perforate, resulting in an abscess or life-threatening infection in the abdomen.

What is the cause of diverticular disease?

It is believed that a low-fiber diet is the main cause of diverticular disease. Fiber is the part of fruits, vegetables, and grains that the body cannot digest.

  • Soluble fiber dissolves easily in water and takes on a soft, jelly-like texture in the intestines.
  • Insoluble fiber passes almost unchanged through the intestines.

Both kinds of fiber help make stools soft and easy to pass, which helps to prevent constipation. Constipation is the main cause of increase pressure in the colon, making the muscles strain to move stool that is too hard. The excess pressure caused by straining makes the weak spots in the colon bulge out, forming diverticula.

How is diverticular disease treated?

Treatment may include increasing dietary fiber intake by eating foods such as:

  • Whole grain breads, cereals, and other products
  • Fruits, such as berries, apples, and peaches
  • Vegetables, such as broccoli, cabbage, spinach, carrots, asparagus, and squash
  • Beans (legumes)

Diverticulitis requires more intense management. Mild cases may be managed without hospitalization, but this is a decision made by your physician.

Treatment for diverticulitis may also include:

  • Medications (control pain)
  • Antibiotics (for infection and inflammation)
  • Resting the colon, with liquid diet or not eating at all

Hospitalization may be required for acute attacks with severe pain or infection. Surgery is reserved for recurrent episodes, complications or severe attacks when there is little or no response to medication. In surgery, usually part of the colon – commonly the left or sigmoid colon – is removed and the colon is hooked up or “anastomosed” again to the rectum. Complete recovery can be expected. Normal bowel function usually resumes in about one week.

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