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Diverticulosis, Diverticulitis

Definitions

Diverticulosis is the presence of diverticula in the colon. Diverticula are small pouches that bulge out from weak areas in the wall of the large intestine (colon). Each pouch is called a diverticulum. The development of diverticula in the colon is called diverticulosis.

Diverticulitis is an inflammation or infection of a diverticulum that can become serious.

Causes

Diverticulosis: It is thought to occur from increased pressure generated in the colon. The increased pressure is generally thought to be a result of harder stools from a lack of adequate fiber in the diet. Many people with diverticulosis, however, have never complained of constipation and report normal or even loose stools.

Diverticulitis: The cause of diverticulitis is not known with certainty, but is generally believed to be a result of stool or bacteria becoming trapped within a diverticulum.

Symptoms

Diverticulosis: For the large majority of patients, diverticulosis is painless and never causes symptoms. If diverticulosis is found, a doctor will recommend an increase in dietary fiber and/or a fiber supplement. The goal in patients with no symptoms is to 1) prevent the development of more diverticula that might increase the risk of a complication or 2) prevent diverticulitis. Other complications of diverticulosis can occur. They include bleeding, abscess, perforation and fistula. Bleeding results when a vessel on the edge of a diverticulum ruptures, producing a moderate to large amount of red bloody stool. It is frequently painless. If this is suspected, you should see your doctor. Intestinal obstruction can also be caused by diverticular disease. This is a blockage of the large intestine as a result of narrowing from scar tissue, inflammation or a combination of both.

Diverticulitis results in swelling of the diverticulum and inflammation (diverticulitis). Abdominal pain (especially on the left side) is the most common symptom. Other symptoms may include cramps, constipation, fever, chills, nausea and vomiting.
iv. Diagnosis: Diagnose for diverticular disease, the doctor asks about medical history, does a physical exam, and may perform one or more diagnostic tests. Because most people do not have symptoms, diverticulosis is often found through tests ordered for another ailment. For example, diverticulosis is often found during a colonoscopy done to screen for cancer or polyps or to evaluate complaints of pain or rectal bleeding.

Complications/Treatment

Diverticulosis: The current daily recommendation of dietary fiber is 20 – 35 grams. This can be achieved by eating high fiber foods such as fruits, vegetables and whole grain products. If this cannot be achieved by diet, supplementing the diet with fiber supplements is recommended.

Diverticulitis: Most patients will respond to antibiotics, pain relievers and bowel rest. Other diseases can cause similar symptoms, so it is best to see your doctor for evaluation and treatment. Sometimes an inflamed diverticulum will burrow through the wall of a nearby organ such as the urinary bladder or the vagina. This abnormal connection is called a fistula and requires surgical repair in most cases.  Surgery may be necessary if a person has repeated episodes of diverticulitis. The diseased portion of the colon is removed electively to help prevent future attacks and complications of diverticulitis. Treatment for diverticulitis focuses on clearing up the inflammation and infection, resting the colon, and preventing or minimizing complications.

Diet

Diverticulosis: For most people with diverticulosis, eating a high-fiber diet is the only treatment needed.

Diverticulitis: Depending on the severity of symptoms, the doctor may recommend bed rest, oral antibiotics, a pain reliever, and a liquid diet. If symptoms ease after a few days, the doctor will recommend gradually increasing the amount of high-fiber foods in the diet.

Summary

Diverticula are small pouches that bulge out from weak areas in the wall of the large intestine (colon). Each pouch is called a diverticulum. This condition can exist with no symptoms.  These pouches can become infected and can turn into a serious health condition.  When the Diverticula become infected they are then called diverticulitis.

Organizations

  1. American Society for Gastrointestinal Endoscopy - www.asge.org
  2. American Gastroenterological Association- www.gastro.com
  3. American College of Gastroenterology - www.acg.gi.org

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