Diverticulosis & Diverticulitis

The colon is a long tubular structure that transports digested food material from the small intestine to the rectum and onwards to be excreted through the anus. In some people, due to excessive pressure from inside, the food material bulges out of the wall causing a pouch. This is known as diverticulum (plural – diverticulae). The condition is known as diverticulosis. In some conditions they become infected and it is known as diverticulitis.

Causes & Symptoms

Diverticulosis is common in developed or industrialised countries, particularly the United States, England and Australia where low fibre diets are common. The condition is uncommon in Asia and Africa, where people eat high fibre vegetable diets. Some fibres

Some fibres dissolve easily in water (soluble fibre) taking on a soft jelly-like texture in the intestines while some pass almost unchanged through the intestines (insoluble fibre). Both kinds of fibre help make stools soft and easy to pass. Lack of fibre or a diet low in fibre leads to hard stools that cannot move through the intestines causing constipation. Due to constipation and increased pressure in the colon which leads to release of the pressure out of the weak spots in the colon bulging out to become diverticulae.

Diverticulitis occurs when diverticulae become infected or inflamed. Doctors are not certain what causes the infection. It may begin when stool or bacteria are caught in the diverticulae. An attack of diverticulitis can develop suddenly and without warning.

Diverticulosis

Most people with diverticulosis do not have any discomfort or symptoms. However, symptoms may include mild cramps, bloating and constipation when they do occur. Other diseases such as irritable bowel syndrome (IBS) cause similar problems, so these symptoms do not always mean a person has diverticulosis.

Diverticulitis

The most common symptoms of diverticulitis is abdominal pain. The most common sign is tenderness around the left side of the lower abdomen. If infection is the cause fever, nausea, vomiting, chills, cramping and constipation may occur as well. The severity of symptoms depends on the extent of the infection and complications.

Diagnosis

Diverticulosis is often diagnosed through tests like colonoscopy, barium x-ray, CT scan done for another condition or while routine screening.

Treatment

Increasing the amount of fibre in the diet may reduce symptoms of diverticulosis and prevent complications such as diverticulitis. Fibre keeps stool soft and helps the bowel contents move through easily lowering pressure inside the colon. The doctor may also recommend taking a fibre product in the form of powders or pills.

Treatment for diverticulitis focuses on clearing up the infection and inflammation, resting the colon and preventing or minimizing complications. An attack of diverticulitis without complications may respond to antibiotics within a few days if treated early. At the Centre for Digestive Diseases treatment of patients with recurrent diverticulitis on 5-ASA compounds for a long-term has shown good success. In some cases, however, surgery may be necessary.