| Diverticular
Disease What is diverticular disease?
In the colon, some people have small pouches that bulge
outward through weak spots. Diverticular disease is an inflammation or infection in the
pouches, known as diverticula, which are located in the colon.
- a single pouch is called a diverticulum.
- two or more pouches are called diverticula.
- having diverticula is a condition called diverticulosis.
- having infected or inflamed diverticula is a condition is called diverticulitis.
The conditions of diverticulosis or diverticulitis are referred to as diverticular
disease.
Diverticulitis occurs in 10 to 25 percent of people with diverticulosis.
Approximately half of all Americans age 60 to 80, and almost everyone over age 80, have
diverticulosis at some time.
The disease is common in developed or industrialized countries --
particularly the United States, England, and Australia -- where low-fiber diets are
common. It is rare in countries of Asia and Africa, where people eat high-fiber, vegetable
diets.
What causes diverticular disease?
It is believed that a low-fiber diet is the main cause of
diverticular disease. Fiber is the part of fruits, vegetables, and grains that the body
cannot digest.
- Soluble fiber dissolves easily in water and takes on a
soft, jelly-like texture in the intestines.
- Insoluble fiber passes almost unchanged through the
intestines.
Both kinds of fiber help make stools soft and easy to pass, which helps
to prevent constipation.
Constipation is the main cause of increased pressure in the colon,
making the muscles strain to move stool that is too hard. The excess pressure caused by
the straining makes the weak spots in the colon bulge out, forming diverticula.
Physicians do not know what causes the infection that causes
diverticulitis, but believe it may begin when stool or bacteria are caught in the
diverticula.
What are the symptoms of diverticular disease?
The following are the most common symptoms for diverticular disease, however,
each individual may experience symptoms differently. Symptoms may include:
- Diverticulosis symptoms:
Diverticulosis may not cause any discomfort or symptoms, but could include mild cramps,
bloating, and constipation. These symptoms may be caused by irritable bowel syndrome
(IBS), stomach ulcers, or other problems, and do not always indicate diverticulosis.
- Diverticulitis symptoms:
The most common symptom is abdominal pain and the most common sign is tenderness around
the left side of the lower abdomen. When infection is the cause, fever, nausea, vomiting,
chills, cramping, and constipation may also occur.
The symptoms of diverticular disease may resemble other conditions or medical problems.
Consult your physician for a diagnosis.
How is diverticular disease diagnosed?
In addition a complete medical history and physical examination, your
doctor may perform a digital rectal exam (DRE) to feel for tenderness, blockage, or blood.
A stool sample and x-rays may also be part of the diagnostic process.
Treatment for diverticular disease:
Specific treatment will be determined by your physician(s) based on:
- your age, overall health, and medical history
- extent of the disease
- your tolerance for specific medications, procedures, or therapies
- expectations for the course of the disease
- your opinion or preference
Treatment may include increasing dietary fiber intake by eating foods
such as:
- whole grain breads, cereals, and other products
- fruit, such as berries, apples, and peaches
- vegetables, such as broccoli, cabbage, spinach, carrots, asparagus, and
squash
- beans
In the past, avoiding foods with small seeds, such as tomatoes or
strawberries, was suggested because it was believed that particles could lodge in the
diverticula and cause inflammation. Consult your physician regarding which foods you
should avoid.
Pain medication may also be prescribed.
Treatment for diverticulitis may also include:
- medications for infection and inflammation
- medications to control muscle spasms
- resting the colon, with liquid diet and bed rest
- preventing or minimizing complications, such as:
- infection
- perforations or tears
- blockages
- bleeding
Hospitalization may be required for acute attacks with severe pain or
infection. Surgery may be necessary in some cases.
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