Diverticular Disease: Diverticulosis and Diverticulitis

Diverticular Disease includes both diverticulosis and diverticulitis, and is especially common in the United States, where the diet is typically low in fiber, and constipation is a problem.  Diverticula are small sacs in the walls of the lower end of the colon, although they may sometimes develop in other parts of the digestive tract, such as the stomach, small intestine, and esophagus.

Diverticulosis refers to the presence of diverticula in the digestive tract.  It is very common and about half of those older than age 60 experience it.

Diverticulitis is the inflammation, or infection, of one or more diverticula. 

Symptoms

Many people with Diverticulosis have no symptoms.  Approximately one in five people with this condition have abdominal pain, bloating, gas, constipation, or diarrhea.  However, few people with Diverticulosis ever develop Diverticulitis.  Left untreated, Diverticulosis can lead to serious complications, such as an absess.

With Diverticulitis, the inflammation leads to muscle spasms, severe abdominal pain, nausea, and fever.  Cramps and tenderness may occur on the left side of the abdomen.  The passing of gas or a bowel movement may relieve cramps temporarily.  Stools usually become small, round, and hard.  If diverticula bleed, red blood appears in the stools.  Possible complications of Diverticulitis include the development of a stricture, narrowing of the intestine, or a fistula, which is an abnormal channel that forms between parts of the intestine; an abscess, a pus-filled sac around the diverticulum; and Peritonitis, a life-threatening inflammation of the membrane lining the abdominal cavity that occurs after an abscess bursts.

Diagnosis and Treatment

Dr. Klin will complete a physical examination and tests, such as blood tests, a stool analysis, and perhaps he will need to prescribe a Gastrointestinal Series (GI), which is an X-ray procedure also referred to as a barium enema.)  A Colonoscopy may also be needed to fully diagnose the condition.  Because the symptoms of diverticular disease are similar to those of Irritable Bowel Syndrome, it is important to differentiate between them in making the diagnosis.

In many cases, Diverticulosis responds well to the adoption of a high-fiber diet.  In Diverticulitis, Dr. Klin may prescribe antibiotics, as well as an antispasmodic drug, to control abdominal pain.

Unfortunately, an attack of Diverticulitis may require hospitalization.  If the abdomen is distended and there is no passage of stool or gas, the contents of the stomach and intestine may need to be emptied by using suction.  All fluids must be given intravenously for several days to allow inflammation to subside.

In severe cases of Diverticulitis, a Colectomy (the surgical removal of all or part of the colon), may be necessary.

People with diverticular disease are advised not to eat poppy or sesame seeds, or fruit with tiny seeds.

Source: AMA Complete Encyclopedia, Copyright 2003, American Medical Association
Return to list.