Diverticulosis is a common condition that refers to the presence of small pouches or pockets in the colon called diverticula. Approximately 10% of adults over 40, 50% of adults over 60 and almost everyone over the age of 80 have diverticulosis.
Most people with diverticulosis have no symptoms and the diagnosis is usually incidental after tests such as colonoscopy, barium enema or CT scan of the abdomen. Symptoms from diverticulosis are primarily due to bleeding or infection/inflammation of one of the pouches or diverticula. These complications of diverticulosis occur in approximately 20% (one out of every 5 individuals) of those with diverticulosis.
- Infection and inflammation of one of the pouches or diverticula is called diverticulitis.
- Symptoms include abdominal pain, usually on the left side, fever, chills, nausea, and constipation.
- Diagnosis usually but not always requires labs and CT scan of the abdomen.
- Treatment generally includes antibiotics, pain relievers and often a liquid diet.
- Hospitalization is not always necessary for management of diverticulitis.
- A colonoscopy is usually necessary after recovery from a bout of diverticulitis as other conditions such as a colon cancer can mimic the symptoms of diverticulitis.
- Diverticulitis can be further complicated by:
- Abscess formation.
- Bowel perforation.
- Serious infection of the linings of the abdomen called peritonitis.
Diverticular bleeding is usually seen as painless heavy rectal bleeding. It appears to be due to chronic injury to the small blood vessels adjacent to the diverticula. Hospitalization is usually necessary for monitoring the bleeding. A colonoscopy is usually performed to identify the source of bleeding.
Segmental Colitis associated with Diverticulosis (SCAD)
A specific type of colitis is occasionally seen in association with diverticulosis. The inflammation of the lining is usually restricted to a segment of the colon with severe diverticulosis which is usually in the area of the colon called sigmoid colon. This may cause diarrhea, blood in the stools and urgent need to evacuate your bowels. Mild cases respond to medication. Severe cases may need surgery.
Prevention of Complication of diverticulosis
The following are recommendations to avoid complications of diverticulosis:
- Follow a high fiber diet and avoid a diet high in fat and red meat.
- Exercise regularly and maintain a healthy body weight.
- Avoid nonsteroidal anti-inflammatory drugs (NSAIDs), like aspirin, ibuprofen (Advil®, Motrin®) and naproxen (Aleve®); steroids; or opioids.
- Avoid smoking.
- Drink plenty of fluids unless your need to restrict fluids due to other conditions.
Diverticulosis is a condition that occurs when small, bulging pouches (diverticula) form in the wall of the colon. Diverticula are common, especially in people over the age of 50, and most people with diverticula do not experience any symptoms.
The exact cause of diverticulosis is not fully understood, but it is thought to be related to a diet low in fiber and high in processed foods.
Diverticulosis is a common condition, affecting an estimated 50% of people over the age of 60 and almost everyone over the age of 80. Diverticulitis, which is a complication of diverticulosis, occurs in about 10-25% of people with diverticulosis. About 5 to 15 percent will develop diverticular bleeding.
Diverticulosis is more common in older adults, with the incidence increasing with age. It is also more common in industrialized countries and in people who consume a low-fiber diet. Diverticulitis is a complication of diverticulosis, so it also tends to occur more often in older adults and in people who consume a low-fiber diet. However, diverticulitis can also occur in younger people and in those who consume a high-fiber diet. Other risk factors for diverticulitis include smoking, obesity, and certain medications such as non-steroidal anti-inflammatory drugs (NSAIDs).
Most people with diverticulosis do not experience any symptoms. However, some people may experience abdominal pain or discomfort, bloating, or changes in bowel habits.
Diverticulosis is often discovered during a diagnostic test such as a colonoscopy or CT scan or when complications such as diverticulitis or diverticular bleeding occur.
In most cases, diverticulosis does not require treatment. However, if a person is experiencing symptoms, treatment may involve dietary changes (such as increasing fiber intake) and the use of medications to manage symptoms.
- Diverticulitis: inflammation or infection of the diverticula. It can cause abdominal pain, fever, constipation or diarrhea and in severe cases can lead to other complications such as:
- Abscess or pus pocket formation.
- Bowel perforation: A hole in the wall of the colon that can lead to peritonitis, sepsis and even death if not treated quickly.
- Fistula formation: abnormal connection between the colon and other organs or skin.
- Peritonitis: inflammation of the peritoneum (the lining of the abdominal cavity) as a result of perforation of a diverticulum.
- Diverticular bleeding: bleeding from one or more of the diverticula in the colon, which can cause rectal bleeding.
- Strictures: narrowing of the colon caused by inflammation or scarring.
- Intestinal obstruction: blockage of the intestine caused by a diverticulum or inflammation.
- Colitis or colon lining inflammation causing diarrhea, abdominal pain and bloody stools.
In most cases, diverticulosis is not a serious condition and does not cause any serious complications. However, if a person with diverticulosis develops diverticulitis (an inflammation or infection of the diverticula) or bleeding from diverticulosis, the condition can be serious and may require hospitalization.
There is no sure way to prevent diverticulosis, but there are steps you can take to reduce your risk of developing the condition. These include:
- Eating a diet that is high in fiber: Increasing your intake of fruits, vegetables, and whole grains can help reduce the risk of diverticulosis.
- Staying hydrated: Drinking plenty of fluids can help prevent constipation and reduce the risk of diverticulosis.
- Exercising regularly: Regular physical activity can help improve bowel function and reduce the risk of diverticulosis.
Diverticulosis does not increase the risk of colon cancer.
In most cases, surgery is not necessary for diverticulosis. The condition can be managed with dietary changes and medications to control symptoms. However, if a person with diverticulosis develops complications such as a blockage or perforation of the colon, surgery may be necessary.
There is a common belief that seeds and nuts should be avoided if you have diverticulosis, as it is thought that these foods can get stuck in the diverticula and cause inflammation. However, there is no evidence to support this recommendation, and seeds and nuts can be a part of a healthy diet for people with diverticulosis.
There is no evidence to suggest that popcorn should be avoided if you have diverticulosis.
There is no evidence to suggest that red meat should be avoided if you have diverticulosis. However, a diet that is high in red and processed meats has been linked to an increased risk of diverticulosis and other digestive conditions. It is generally recommended to eat a balanced diet with an adequate amount of fiber.
There is no evidence to say that spicy foods are unsafe to eat for people with diverticulosis. Some people with diverticulosis may find that spicy foods trigger symptoms such as abdominal pain or discomfort, while others may be able to tolerate spicy foods without any problems. There is no medical reason to avoid spicy foods in people with diverticulosis.
According to some researchers, an imbalance of beneficial bacteria in the gut may contribute to the development of diverticulitis. However, currently, there is insufficient scientific evidence to confirm that probiotics can prevent diverticulitis.