Diverticular Disease

Diverticula are small, bulging pouches most commonly found in the large intestine (usually in the left or sigmoid colon); however, they can form anywhere in your digestive system. They usually develop when naturally weak places in your colon give way under pressure.

The presence of diverticula is called diverticulosis, and is common after age 40. In fact, 50% of people aged 60 and most people by age 80 are affected. Diverticulosis itself is not problematic, unless diverticulitis occurs. Diverticulitis is the inflammation or infection of one or more diverticula in your digestive tract.

Symptoms of diverticulitis include severe abdominal pain, fever, nausea and change in bowel habits.

Rest, dietary changes, antibiotics, or anti-spasmodic drugs may treat mild cases of diverticulitis, however, severe cases may require surgery. Diverticulitis is diagnosed with a barium x-ray.

Diverticular disease may cause bleeding and usually stops on its own. Surgical intervention is required for diverticulitis that does not respond to medical treatment. Surgery usually involves drainage of any collections of pus and surgical removal of the segment of the colon containing the diverticula (usually the sigmoid colon).

Several theories exist as to why diverticulitis occurs. One is that the increased pressure in the colon can lead to breakdown of the wall of the diverticula leading to infection. Another is that the narrow openings of diverticula become infected with trapped fecal matter. It is also thought that maybe an obstruction in the narrow opening of a diverticulum may reduce blood supply to the area, leading to inflammation.

It was formerly thought that nuts, seeds, popcorn and corn played a role in causing diverticulitis by getting trapped in the diverticula. However, recent research has found this to not necessarily be true.

Risk factors for diverticulitis include increased age, obesity, lack of dietary fiber, and lack of exercise.

Complications of diverticulitis may include:

• Peritonitis, an inflammation of the lining of your abdominal cavity (peritoneum). This can happen if a pouch ruptures. Peritonitis is a medical emergency and requires immediate care.
• Rectal bleeding;
• Intestinal blockage due to scarring;
• Fistula—an abnormal passageway between different parts of your intestine, your intestine and your bladder or vagina, or your intestine and abdominal wall;
• Interference with routine cancer screening (colonoscopy).

A healthy lifestyle—including exercise and a high fiber diet can minimize the development of diverticulitis as well as manage diverticulosis before inflammation occurs.