Diverticulosis is a common digestive condition that affects the colon. It involves the formation of small pouches or sacs called diverticula that bulge outward through weak spots in the colon wall. While often asymptomatic at first, diverticulosis can lead to uncomfortable symptoms and serious complications if left untreated. Read on to learn more about the causes, symptoms, diagnosis, and treatment of diverticulosis.
What is Diverticulosis?
Diverticulosis refers to the presence of diverticula in the colon. Diverticula are small, bulging pouches that can form in the lining of the digestive tract.
Key points about diverticulosis:
- It occurs when weaknesses develop in the colon wall, causing it to bulge outward and form sac-like pouches called diverticula.
- Diverticula most commonly occur in the sigmoid colon (part of the large intestine) but can form anywhere in the colon.
- Diverticulosis is very common, impacting more than half of all people over age 60. However, many people with diverticulosis don't have symptoms.
- Symptoms, if present, can include abdominal pain, bloating, constipation, and diarrhoea. These symptoms may come and go.
- Complications like diverticulitis (infection/inflammation of diverticula), bleeding, or blockages can occur in some cases.
- Risk factors include older age, lack of exercise, obesity, smoking, and a low-fiber diet. Genetics may also play a role.
- Diagnosis involves a colonoscopy or CT scan to visualize the diverticula.
- Treatment focuses on increasing fibre intake, exercise, managing complications if they arise, and in some cases, surgery.
In summary, diverticulosis itself is a common, often asymptomatic condition characterized by small pouches in the colon wall. Managing risk factors and complications is important to prevent flare-ups of diverticular disease.
What Causes Diverticulosis?
Diverticulosis occurs when pressure inside the colon from constipation or straining leads to protrusions forming in weak areas of the muscular colon wall. Risk factors include:
- Age: The risk increases dramatically after age 40. Over half of people have diverticulosis by age 60.
- A diet low in fibre: Fibre helps add bulk to stools and prevent straining. A low-fiber diet increases pressure in the colon.
- Inactivity and lack of exercise.
- Obesity.
- Smoking.
- Genetics may also play a role in developing diverticulosis.
Over time, bulging pockets called diverticula can gradually form in the colon wall as it weakens and loses elasticity. The diverticula initially causes no problems, a condition called asymptomatic diverticulosis.
What are the Symptoms of Diverticulosis?
Many people with diverticulosis experience no symptoms for years. When symptoms do occur, they may include:
- Mild abdominal cramps or tenderness.
- Bloating and gas.
- Constipation or diarrhoea.
- Nausea.
- Feeling the need to pass stool even after going to the bathroom.
- Passing mucus in the stool.
Symptoms are often temporary and can come and go. However, if the diverticula become inflamed or infected, known as diverticulitis, severe abdominal pain and complications can occur.
How to Test for Diverticulosis?
If symptoms are present, diverticulosis can be diagnosed through:
- Medical history: The doctor will ask about risk factors, symptoms, and family history.
- Physical exam: An abdominal exam helps rule out other conditions.
- Colonoscopy: The most accurate test, it allows direct visualization of the diverticula.
- Barium enema: An X-ray of the colon using a contrast dye which shows the pouches.
- CT scan: A computed tomography scan can also identify diverticula.
- Blood tests: Check levels of infection or inflammation.
Early diagnosis allows treatment to prevent complications of diverticular disease. Colonoscopy screening test is recommended starting at age 50.
Blood Test for Diverticulosis
There are a few key lab tests and procedures that may be used to diagnose diverticulosis:
- Complete blood count (CBC): Checks for signs of infection or inflammation based on white blood cell count.
- C-reactive protein (CRP): A marker of inflammation that may be elevated with diverticulitis.
- Stool test: Checks for blood in the stool, which may indicate diverticulosis complications.
- Colonoscopy: The most accurate test to visualize the diverticula pouches in the colon lining. Done with sedation.
- Barium enema: An x-ray with contrast dye which outlines the diverticula in the colon.
- CT scan: Computed tomography with contrast can also identify diverticula. Helpful in diagnosing diverticulitis.
- Blood culture: This may be done if infection is suspected to identify the bacteria involved.
The diagnostic tests for diverticulosis aim to confirm the presence of diverticula, rule out complications like infection or bleeding, and evaluate the extent of the disease in the colon. Colonoscopy is considered the gold standard, but CT scans and barium enemas can also diagnose diverticulosis.
Treatment is usually focused on managing symptoms and preventing complications through increased fibre intake, exercise, hydration, and possibly antibiotics or surgery if diverticulitis develops. Regular colonoscopy screening may be recommended to monitor the condition over time.
What is the Treatment for Diverticulosis?
- Increased fibre intake: Consuming 25–35 grams of fibre daily softens stools and prevents constipation and straining to reduce pressure in the colon.
- Hydration: Drinking plenty of fluids, especially water, keeps stools soft.
- Exercise: Regular physical activity improves colon function and motility.
- Medications: Sometimes antispasmodics, pain relievers, and probiotics.
- Surgery: For severe recurrent cases not controlled by other treatments. Involves removing the affected part of the colon.
Treatment focuses mainly on preventing complications through a high-fiber diet, exercise, hydration, and other lifestyle measures. Most people with mild to moderate diverticulosis can manage symptoms successfully without surgery.
Can Diverticulosis Be Prevented?
While you can't always prevent the formation of diverticula, you can reduce your risk and prevent complications by:
- Eating a high-fiber diet with plenty of fruits, vegetables, beans and whole grains.
- Exercising regularly to improve colon function.
- Staying well hydrated.
- Maintaining a healthy weight.
- Not smoking.
- Avoiding medications that can cause constipation.
- Managing medical conditions, like diabetes, increases risk.
Making healthy lifestyle choices provides the best defence against developing diverticulosis and its complications.
What foods should I eat or avoid with diverticulosis?
Eat a high-fibre diet with whole grains, fruits, vegetables, beans, nuts, and seeds. Avoid processed foods low in fibre. Some find limiting dairy, red meat, fat, and sugar beneficial.
How do you know if diverticulosis has become diverticulitis?
Diverticulitis causes severe, constant abdominal pain, fever, nausea/vomiting, and a change in bowel habits. Seek medical care immediately if diverticulosis symptoms suddenly worsen.
Can diverticulosis turn into cancer?
There is no direct link between diverticulosis and colon cancer. However, some studies show people with diverticulosis may have a slightly increased risk for colon cancer compared to those without it.
Do I need surgery for diverticulosis?
Most diverticulosis cases don’t require surgery. Making lifestyle and dietary changes is the first line of treatment. Surgery may be considered for severe, recurrent cases not responsive to other treatments.
Partner with healthcare nt sickcare for Diverticulosis Care
At healthcare nt sickcare, we have experience accurately diagnosing diverticulosis and providing ongoing monitoring and care. We help patients understand their condition and make lifestyle changes to prevent diverticulitis flare-ups. If you have symptoms or risk factors for diverticulosis, schedule a colonoscopy screening today. Our team is here to support your digestive health every step of the way.
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