Diverticular disease, also known as diverticulosis,
is the presence of small sac-like out-pouchings
of the lining of the colon that balloon through the
outer colon wall. These pockets are called diverticula.
Diverticulosis can be present without noticeable symptoms, but might be associated
with constipation or diarrhea.
This condition is very common as we age, but
still affects young people.
More than 65% of those 85 years of age and
older have diverticular disease.
A person might have one diverticulum or hundreds
of diverticula, which are typically less than
1 centimetre in diameter, but tend to increase
in number and size over time.
In about 10-25% of people, the diverticula can
become inflamed and/or infected,
known as diverticulitis.
This leads to distinct symptoms, including
diarrhea, cramping, bowel irritability, intense
pain, bleeding, bloating, and fever.
The pain and tenderness is often felt in the
left lower portion of the abdomen.
Rarely, serious complications can occur, sometimes
requiring urgent surgery.
Researchers aren’t sure what causes diverticular
disease, but it does seem to be more common
in those who don’t consume enough fibre.
One theory is that pressure, such as straining
during constipation, builds up inside the
colon, causing the intestinal wall to balloon
out between muscle bundles, which run both
lengthwise and circularly throughout the colon.
To diagnose diverticular disease, a physician
will likely consider your symptoms and might
use a colonoscopy to observe the shape and
function of the colon.
During periods of flare-up, the bowel might
be too tender to perform these investigations,
and the risk of bowel perforation might be
too high, so a physician might choose a CT
scan or a procedure known as virtual colonoscopy.
Blood tests can also help analyze levels of
inflammation in the body.
The best way to avoid diverticular disease,
and to manage it, is to consume a well-balanced diet,
ensuring high-fibre content and adequate
fluid intake.
Fibre and fluid help soften stool, allowing
it to move more quickly and easily, thereby
avoiding excessive pressure against the colon
wall.
However, treatment is quite different if you
are experiencing diverticulitis.
A physician will likely recommend an immediate
transition to a restricted-fibre or liquid-only
diet and physical rest, pain medications,
and possibly antispasmodics.
Although often used, there is growing evidence
that antibiotics might not be needed in uncomplicated
diverticulitis.
In severe cases, you might need to be hospitalized
for intravenous feeding so that the bowel
may rest for a few days.
If episodes become frequent, then surgical
removal of the affected area might be necessary.
Once a diverticulum forms, it does not go
away on its own.
Therefore, it is best to try to prevent the
disease from developing or progressing further
by following a well-balanced, high-fibre diet,
drinking adequate fluids, and staying physically
active.
Many people are able to live symptom-free
with diverticular disease by making these
lifestyle changes.
Medical and surgical treatments are available
for those whose disease is persistent.
Go to www.badgut.org for more information.
I’m Dr. James Gray on behalf of the Gastrointestinal
Society.
Thanks for watching.
