Diseases and Disorders

What is Diverticulosis and What Causes it?

Diverticulosis is a condition where small pouches form in the colon. It’s more common in older people but anyone can develop it. Learn about diverticulosis and what causes it. 

What is Diverticulosis?

The colon (large intestine) is a long tube-like structure that stores and then removes waste material. With increasing age in a person, pressure within the colon causes bulging pockets of tissue (sacs) that push out from the colon walls. A small bulging sac pushing outward from the colon wall is called a diverticulum. Over one bulging sac is referred to as diverticula. Diverticula can occur throughout the colon but are most common near the end of the left colon, called the sigmoid colon. The condition of having these diverticula in the colon is called diverticulosis, also known as diverticular disease. This condition is uncommon before the age of 40 years, but its incidence increases after this age.

Causes of Diverticulosis

Although not proven, a low-fibre diet is believed to be the major cause of diverticular disease. Lack of fibre in the diet causes constipation, which makes the muscles strain to move stool that is too hard. A diet without sufficient fibre also makes the stools small, requiring the bowel to squeeze harder to remove the smaller stool. This is the primary cause of increased pressure in the colon. This excess pressure might cause weak spots in the colon to bulge out and become diverticula.

Diverticular disease is common in developed or industrialised countries, particularly the United States, England and Australia, where low-fibre diets are common. The disease is rare in countries of Asia and Africa, where people eat high-fibre vegetable diets. Fibre is the part of fruits, vegetables and grains that the body cannot digest. Some fibre dissolves easily in water (soluble fibre). It takes on a soft, jelly-like texture in the intestines. Some fibre passes almost unchanged through the intestines (insoluble fibre). Both kinds of fibre cause stools to keep more water and become easier to pass (either soluble or insoluble fibre will do this).

Thus, we can broadly outline the factors that can cause diverticular disease: A diet low in fibre content or high in fat Increasing age Constipation Connective tissue disorders, which can weaken the colon wall.

What are the symptoms of diverticulosis?

Whereas most patients with diverticular disease have no or few symptoms, some patients develop bleeding, infection (diverticulitis), changes in bowel movements (diarrhea or constipation), bloating, cramps (often in the left lower abdomen) after meals or otherwise and even colon obstruction. Sometimes, symptoms include nonspecific chronic discomfort in the lower left abdomen, with occasional acute episodes of sharper pain. The discomfort is sometimes described as a general feeling of pressure in the region, or pulling sensation. A tickling sensation may be felt as the small pockets fill and infill, a feeling like gas may move in areas outside the colon. At the first occurrence of bleeding, a doctor should be contacted.

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How diverticulosis diagnosed?

Since most people do not have symptoms, diverticulosis is often found through tests ordered for another ailment. Colonoscopy is the most used test for diagnosis. Other tests include abdominal x-ray, barium enema, CT scan, or MRI.

What is the treatment available for diverticulosis?

Most often, diverticulosis requires no treatment. An increase in hydration by increasing fibre content in the diet or removing factors resulting in constipation helps decrease the incidence of new diverticula or possibly keep them from bursting or inflating. However, if there is an infection (diverticulitis), surgery is required to decrease relapse or other complications.

Diverticulosis Vs Diverticulitis

If a diverticulum becomes inflamed or the area around the diverticulum is swollen, it is called diverticulitis. If the inflammation or infection becomes severe enough, the diverticulum can rupture, spreading bacteria from the colon to the surrounding tissues, causing an infection called peritonitis, or forming a pocket of infection called an abscess.

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