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Diverticular Disease

Research suggests that the major cause of diverticular disease is a low-fiber diet. Fiber softens stool so it can pass easily through the colon. Individuals who consume lower amounts of fiber have harder stool. The colon has to generate greater pressures to propel the stool forward. In areas of the colon where the wall is thinner, this pressure build-up causes the lining of the colon to “pop-out” and form pouches called diverticula.

WHAT IS DIVERTICULOSIS?

Diverticulosis is a condition in which the patient develops small pouches in the wall of the colon. Each pouch is called a diverticulum (plural: diverticula). Diverticula do not go away once they develop.

Diverticulosis is more common in people over 60. However, increasing numbers of younger people are developing this condition, probably because they follow a low-fiber diet. Most people do not have any symptoms resulting directly from the diverticula. The only symptoms are constipation and lower abdominal pain, i.e. symptoms explained on the basis of strong colonic contractions in attempt to pass hard stool.    However, up to 20% of people, may develop inflammation (diverticulitis) or bleeding from diverticula.

WHAT CAN YOU DO ABOUT DIVERTICULOSIS?

  • Treat the underlying problem, a low-fiber diet leading to constipation. The American Dietetic Association recommends 20 to 35 grams of fiber a day;
  • Fruits and vegetables are an excellent source of fiber;
  • There is no scientific basis to recommending the avoidance of seeds, corn, and nuts for fear of precipitating diverticulitis.

WHAT IS DIVERTICULITIS?

When a diverticulum or several diverticula become inflamed, the condition is called diverticulitis. If the inflammation penetrates the wall of the diverticulum, an abscess (collection of pus) may develop.

Diverticulitis causes many symptoms, including fever, sudden lower abdominal pain, nausea and changes in bowel movements (constipation or diarrhea).

DIAGNOSING DIVERTULITIS

The gastroenterologist will perform a thorough physical examination before conducting test and imaging studies. Diagnostic tests may include the following:

  • Blood tests, to look for evidence of a high white blood count;
  • CT scan, look for inflammation surrounding the diverticula in the colon.

TREATMENT OPTIONS FOR DIVERTULITIS

  • Antibiotics (oral or intravenous, depending on the severity of diverticulitis) to treat the inflammation and localized infection near the diverticula
  • Surgery, if a patient has recurrent attacks of diverticulitis or major complications (such as abscesses). The surgeon removes the diseased part of the colon

 

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