Diverticular Disease

Diverticular disease is a condition characterized by the formation of small, bulging pouches (diverticula) in the digestive tract, most commonly in the colon (large intestine). There are two main types of diverticular disease: diverticulosis and diverticulitis.

Diverticulosis

Diverticulosis is a condition where small, bulging pouches (diverticula) develop in the wall of the colon. These pouches are usually harmless and do not cause symptoms. Diverticulosis is very common, especially after the age of 40, and affects up to 50% of people over the age of 60.

The exact cause of diverticulosis is unknown, but it is thought to be related to a combination of factors, including:

• A low-fiber diet
• Age-related changes in the colon
• Genetics
• Obesity

Diverticulitis

Diverticulitis is a condition where the diverticula become inflamed or infected. This can cause symptoms such as:

• Abdominal pain, usually on the lower left side
• Fever
• Nausea and vomiting
• Changes in bowel habits, such as constipation or diarrhea
• Blood in the stool

Diverticulitis can be caused by a variety of factors, including:

• Bacteria entering the diverticula and causing infection
• Blockage of the diverticula, which can lead to inflammation
• Trauma to the colon, such as from a blow to the abdomen

Symptoms and Diagnosis

The symptoms of diverticular disease can vary depending on the severity of the condition. Some people may not experience any symptoms at all, while others may have severe abdominal pain and other complications.

Diagnosis of diverticular disease is typically made using a combination of:

• Medical history and physical examination
• Imaging tests, such as CT scans or barium enemas
• Endoscopy, which involves inserting a flexible tube with a camera into the colon to visualize the diverticula
• Colonoscopy, which involves inserting a flexible tube with a camera into the colon to visualize the entire colon and remove any polyps or other abnormalities

Treatment and Management

Treatment for diverticular disease depends on the severity of the condition. Mild cases may be managed with:

• A high-fiber diet to help prevent constipation and reduce pressure on the colon
• Antibiotics to treat any underlying infection
• Pain management medications, such as acetaminophen or ibuprofen

More severe cases may require:

• Hospitalization for intravenous antibiotics and pain management
• Surgery to remove the affected portion of the colon (colectomy)
• Other interventions, such as drainage of any abscesses or fistulas that may have formed

Complications

Diverticular disease can lead to several complications, including:

• Abscesses, which are collections of pus that can form in the diverticula
• Fistulas, which are abnormal connections between the colon and other organs or the skin
• Perforation, which is a hole in the wall of the colon that can allow bacteria to leak into the abdominal cavity
• Bleeding, which can occur if the diverticula become inflamed or ulcerated

Prevention

While it is not possible to completely prevent diverticular disease, there are several steps that can be taken to reduce the risk of developing the condition:

• Eating a high-fiber diet, which can help to prevent constipation and reduce pressure on the colon
• Staying hydrated by drinking plenty of water
• Exercising regularly, which can help to improve bowel function and reduce stress
• Maintaining a healthy weight, which can reduce the risk of developing diverticular disease