Diverticular disease refers to the presence of small bulges or sacks (diverticula) that stick out in the lining of the gastrointestinal tract. They are most common on the left side of the large intestine, the area known as the descending or sigmoid colon.When these bulges become inflamed or infected it is referred to as diverticulitis. This often occurs as a result from stool collecting in a diverticulum.
What are the causes of diverticular disease?
The exact cause of diverticula formation is unknown. Risk factors include:
- Low fiber diets and constipation. Fiber softens your stools, so less pressure is needed by the large intestine to push them out of the body. The pressure of moving hard, small pieces of stools through the large intestine creates weak spots in the outside layer of the muscle. This allows the inner layer (mucosa) to squeeze through these weak spots, creating diverticula.
- Hereditary or genetic predisposition (having a close relative with diverticular disease, especially if they developed it before the age of 50.
- Being overweight or obese
- Change in the strength of the wall of the colon with ageing
- Connective tissue disorders that may cause weakness in the colon e.g. Ehlers Danlos syndrome
Signs and symptoms of diverticular disease
Most people have no symptoms while some people may complain of cramping, bloating, flatulence and irregular stool patterns. They may also experience pain and discomfort in the lower left side of the abdomen. The pain often worsens with meals or shortly after having a meal.
Diverticulitis shares most of the above symptoms
Other symptoms of diverticulitis can include:
- Fever of 38`C or more
- Nausea and vomiting
- General feeling of being unwell
- The pain associated with diverticulitis however is more constant and severe.
Complications of diverticulitis
- Abscess forming
- Narrowing of the colon (stricture) due to scar tissue.
- Acute painless, bright red rectal bleeding.
If asymptomatic, diverticulosis is usually diagnosed as an incidental finding on other investigation.
While a good history is often sufficient to form a diagnose, it is important to be confirmed by a colonoscopy.
Treatment for diverticular disease depends on how serious the problem is and whether you are suffering from diverticulosis or diverticulitis.
Your health care provider may prescribe antibiotics for infection and paracetamol for pain relief.
Surgery is only indicated in severe complications.
Make sure to read Part II of this article, where we will advise you on diet guidelines for diverticulitis.