It may sound like a disease that will send a hypochondriac scrambling for their medical dictionary, but diverticulosis is a relatively common condition–up to 45% of people in the Western world have it. It is caused when the inner wall of your large intestine or colon pushes through weakened points in the outer lining, creating small, usually benign, pouches called diverticula. It typically becomes a more common condition as you get older, with 50% of people over age 60 having diverticulosis.
Causes
What causes the formation of diverticula is not a simple question to answer. One theory was that a lack of fiber in your diet might cause constipation and create a strain on the walls of your colon. However, recent research has seemingly disproved this theory. Some studies have suggested that, conversely, people who eat foods higher in fiber may increase their chances of developing diverticulosis.
The role of genetics in the development of diverticulosis has also been examined. However, as of yet, there is insufficient data to confirm if it plays a part.
Other factors may include the regular use of certain medicines such as steroids and/or non-steroidal anti-inflammatory drugs (NSAIDs), like aspirin and ibuprofen. Additionally, obesity, lack of exercise, and smoking have all been cited as possibly increasing the risk of diverticulosis.
Complications
Most people with diverticulosis will not know they have it until a complication arises to draw attention to the condition or it is found incidentally during a colonoscopy.
Diverticulitis
The main complication associated with diverticulosis is the risk of diverticulitis. Diverticulitis is caused by the sacs becoming infected or inflamed. In 2009, almost 300,000 patients were hospitalized in the U.S. for diverticulitis.
Diverticulitis symptoms can be varied and depend on whether you suffer any complications with the condition. One of the most common symptoms of diverticulitis is abdominal pain or tenderness, usually on the left side. You may also experience other symptoms such as constipation, diarrhea, fevers, chills, nausea, and vomiting.
The causes of diverticulitis are not yet known. However, research is ongoing into specific factors that may play a role in developing the condition. One theory is that bacteria or stool gets retained in one of these pouches, possibly leading to the colon wall becoming infected and inflamed.
There are several complications attached to diverticulitis, including perforation of the colon or an abscess in the wall of the colon. Symptoms such as abdominal pain or tenderness generally occur in almost all cases and can be more severe when complications occur. Other complications may include bowel obstruction or fistula.
Your doctor will not usually recommend surgery for uncomplicated diverticulitis cases and recommend rest and antibiotics as treatments. Only if it develops into a case of complicated diverticulitis will surgery be recommended.
Diverticular Bleeding
One way to discover you have diverticulosis is when a blood vessel within the wall of one of the pouches bursts. This is known as diverticular bleeding, and it is usually only found when you notice blood in your stool. That said, the condition is quite rare.
Your doctor will typically leave minor cases of diverticular bleeding to heal themselves over time. But if you have severe or persistent bleeding, you may require hospitalization and a colonoscopy or additional testing to find the source. Patients can require embolization, surgery and/or colonic resection if the bleeding is uncontrolled and severe.
Management and Treatments
While diverticulosis is generally a benign condition, ideally everyone wants to avoid complications. While a high-fiber diet has now been shown not to prevent diverticulosis, it may help avoid issues if the pouches have already developed. Problems such as gas and pain in your abdomen can be prevented by slowly adding higher-fiber foods to your diet or by taking fiber supplements.
Another management option being studied is supplementing with probiotics.. This can be done either with a dietary supplement that contains probiotics or by eating probiotic yogurts. That said, the assessment of the benefits of probiotics in the prevention or management of diverticulosis is still up for debate.
In general, anything that may cause extra strain on your colon should be avoided, such as holding a bowel movement. Furthermore, drinking water or other liquids might help to prevent constipation, which can put extra strain on your colon. You can also help ease any potential stress by exercising regularly, especially anything that helps to tone the muscles around your colon.
References
- Diverticulosis
- Diverticular disease and diverticulitis
- Diverticulosis and Diverticulitis
- Diverticulosis and Diverticulitis – Mayo Clinic
- A high-fiber diet does not protect against asymptomatic diverticulosis
- A High-Fiber Diet Does Not Protect Against Asymptomatic Diverticulosis
- Symptoms & Causes of Diverticular Disease
- Treatment for Diverticular Disease