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 United States population 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, 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
• Rips in the diverticula (pouches)
The symptoms for diverticulosis and diverticulitis are different:
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 dangerous. If you have rectal bleeding, see a doctor without delay.
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.
Diverticulosis is generally diagnosed 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 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 for diverticular disease depends on how serious the problem is and whether you are suffering from diverticulosis or diverticulitis. Most people are treated by simply changing their diets to include eating high-fiber foods. Sometimes mild pain medications are necessary.
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 complications 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?
This information is intended for patient education and information only. It does not constitute advice, nor should it be taken to suggest or replace professional medical care from your physician. Your treatment options may vary, depending upon your medical history and current condition. Only your physician and you can determine your best treatment option.
For more information:
American Society of Colon and Rectal Surgeons
85 W. Algonquin Road, Suite 550
Arlington Heights, IL 60005
American College of Gastroenterologists
P.O. Box 342260
Bethesda, MD 20827-2260
College of American Pathologists
325 Waukegan Road
Northfield, IL 60093-2750
Please visit www.cap.org, from the cap home page, please click on “Health and Wellness Resources for the Public”. The following options will appear on the Resources for the Public page:
1. Medical Test Information: Understanding cancer diagnoses: MyBiopsy.org – Your Source for Information About Cancer Diagnosis.
2. Your Health: Your health test reminder – Patients can put in personal data and will get reminder emails for important tests, screening colonoscopies, etc. Information on disease diagnosis and prevention – A page developed by pathologists, doctors who specialize in prevention, early detection, and diagnosis of disease.