Diverticular Disease and Diverticulitis

Diverticular disease is a condition characterized by the formation of small, bulging pouches (diverticula) in the wall of the colon (large intestine). These diverticula can occur anywhere in the colon, but are most commonly found in the sigmoid colon, which is the lower part of the colon.

Causes and Risk Factors

The exact cause of diverticular disease is not known, but several factors are thought to contribute to its development. These include:

• A low-fiber diet, which can lead to constipation and increased pressure on the colon wall
• Age, as the risk of developing diverticular disease increases with age
• Obesity, which may increase pressure on the colon wall
• Lack of physical activity, which can contribute to constipation and increased pressure on the colon wall
• Certain medical conditions, such as irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD)

Symptoms of Diverticular Disease

Many people with diverticular disease do not experience any symptoms. However, some may experience:

• Mild abdominal pain or discomfort, usually in the lower left side of the abdomen
• Changes in bowel habits, such as constipation or diarrhea
• Bloody stools or rectal bleeding

Diverticulitis

Diverticulitis is a complication of diverticular disease that occurs when one or more of the diverticula become inflamed. This inflammation can be caused by bacteria, food particles, or other foreign substances that enter the diverticulum and cause an infection.

Symptoms of Diverticulitis

The symptoms of diverticulitis are similar to those of diverticular disease, but may be more severe. They include:

• Severe abdominal pain or tenderness, usually in the lower left side of the abdomen
• Fever and chills
• Nausea and vomiting
• Changes in bowel habits, such as constipation or diarrhea
• Bloody stools or rectal bleeding

Diagnosis

Diverticular disease and diverticulitis are typically diagnosed using a combination of the following tests:

• Colonoscopy, which allows a doctor to visualize the inside of the colon and identify any diverticula or inflammation
• Computed tomography (CT) scan, which can help identify any complications of diverticular disease, such as abscesses or perforations
• Blood tests, which can help diagnose infection or inflammation
• Stool tests, which can help diagnose gastrointestinal bleeding or infection

Treatment

The treatment of diverticular disease and diverticulitis depends on the severity of the condition. Mild cases may be treated with:

• A high-fiber diet to help prevent constipation and reduce pressure on the colon wall
• Antibiotics to treat any underlying infection
• Pain medication to manage abdominal pain and discomfort

More severe cases of diverticulitis may require:

• Hospitalization to receive intravenous antibiotics and fluids
• Bowel rest, which involves avoiding solid foods and drinks for a period of time to allow the colon to heal
• Surgery, which may be necessary to remove any affected portion of the colon or to treat complications such as abscesses or perforations

Complications

Diverticular disease and diverticulitis can lead to several complications, including:

• Abscesses, which are collections of pus that can form in the diverticulum
• Perforations, which occur when the diverticulum ruptures and allows bacteria and other substances to leak into the abdominal cavity
• Bleeding, which can occur when a blood vessel in the diverticulum ruptures
• Intestinal obstruction, which occurs when the diverticulum becomes blocked and prevents normal bowel movements

Prevention

To reduce the risk of developing diverticular disease and diverticulitis, it is recommended to:

• Eat a high-fiber diet that includes plenty of fruits, vegetables, and whole grains
• Stay hydrated by drinking plenty of water
• Exercise regularly to help prevent constipation and reduce pressure on the colon wall
• Maintain a healthy weight to reduce pressure on the colon wall