Diverticular Disease
Diverticular disease consists of two conditions that affect the colon – diverticulosis and diverticulitis. Diverticulosis occurs when pouches, called diverticula, form in the colon. These pouches bulge out like weak spots in a tire. Diverticulitis occurs if the pouches become inflamed.
It is estimated that one-half of the population of the United States between the ages of 60 and 80 has diverticular disease. Doctors are not sure what causes diverticular disease, but many think that a diet low in fiber is the main cause. Diets low in fiber may cause constipation, which occurs when stools are hard and difficult to pass. Constipation causes your muscles to strain when you pass stool. Straining may cause diverticula to form in the colon and when stool or bacteria get caught in the pouches, diverticulitis can occur.
Most people with the disease do not have serious problems, but diverticulitis can attack suddenly and cause the following:
• An infection in the colon, which could rupture, causing stool to empty from
the colon into the abdomen
• Bleeding
• Blockage
• Fistulas
• Rips in the diverticula (pouches)
Common Symptoms
The symptoms for diverticulosis and diverticulitis are different:
Diverticulosis
Many people don’t have any symptoms, but some people have cramping, bloating, and constipation.
Others experience bleeding, inflammation, and fistulas. Rectal bleeding is usually painless, but it can be angerous. If you have rectal bleeding, see a doctor without delay.
Diverticulitis
People with diverticulitis can have a variety of symptoms. Examples are pain in the lower part of the abdomen, fever, nausea, vomiting, or a change in your bowel habits.
Diagnosis
Diverticulosis is generally discovered through one of the following examinations:
• Barium enema. This x-ray test involves injection of liquid material into the colon through a tube
inserted in the rectum. The x-ray image shows the anatomy of the colon, and can identify if
diverticula, large polyps or growths are present.
• Colonoscopy. This test uses a thin, flexible tube with a light and camera to view the inside of
the colon. Diverticula as well as polyps and other growths can be seen with this instrument.
• CT scan. This x-ray test takes multiple cross section pictures of the body. It is not generally
performed to make a diagnosis of diverticulosis, but this type of exam may identify diverticula.
Treatment Options
Treatment for diverticular disease depends on how serious the problem is and whether you are suffering from diverticulosis or diverticulitis. Most people recover by simply changing their diets. Treatments for diverticulosis include eating high-fiber foods to help relieve the symptoms. Sometimes mild pain medications can help.
For diverticulitis a doctor may prescribe antibiotics and recommend a liquid diet. Most people recover with this treatment. Some people may need surgery and other treatments, as follows:
• Surgery. Serious problems from diverticulitis are treated with surgery. Surgeons can clean the
abdomen after infections and remove bleeding pouches and fistulas.
• Colon resection. If you get diverticulitis many times, your doctor might suggest taking out the
part of the colon with diverticulitis. The healthy sections can be joined together. With the
diverticula gone, you may avoid other infections.
Most doctors agree that the key to preventing diverticular disease is your maintenance of a high-fiber diet. Talk to your doctor about using fiber products like Benefiber, Citrucel, or Metamucil – daily use can help you get the fiber you need if you do not get it through your diet. Eating foods high in fiber is simple and can help reduce diverticular disease symptoms and problems. Try eating more of the following:
• Fruit. Raw apples, peaches, pears, and tangerines
• Vegetables. Fresh broccoli, squash, carrots, and brussels sprouts
• Starchy vegetables. Potatoes, baked beans, kidney beans, and lima beans
• Grains. Whole-wheat bread, brown rice, bran flake cereal, and oatmeal
Questions To Ask Your Healthcare Provider
• What treat option is best for me?
• What are the potential side effects?
• What are my risks?
• What dietary or lifestyle changes do you recommend?