General Illness Information
Common Name: None Specified
Description: Divertculosis is the presence of small, sac-like swellings or pouches (diverticula) in the walls of the large intestine. Diverticula may appear anywhere in the large intestine but they are most common in the sigmoid colon, the last part of the large intestine before the rectum. A diverticula bulges at a point of weakness, usually where an artery penetrates the muscle layer of the large intestine. Diverticula may vary in diameter from one tenth of an inch to more than an inch. Giant diverticula are rare outpouchings that range from 1 to 6 inches in diameter. A person may only have a single giant diverticulum.
These pouches may be present without any symptoms, and are not contagious or cancerous.
Colonic diverticular disease is prevalent in over one-third of patients over 60 years of age.
Diverticulits is the inflammation of the pouches.
Causes: Unknown. Recent evidence suggests an association with low fiber diet. Patients with connective disorders are also predisposed to development of diverticulosis (e.g. in in Marfan’s Syndrome and scleroderma).
Prevention: Diverticulosis cannot be prevented at present, but risk can be reduced by eating a diet high in fiber throughout life and by avoiding constipation and straining during bowel movement.
Signs & Symptoms
Diverticulosis symptoms- More than two-thirds of the patients with diverticulosis have uncomplicated disease and no specific symptoms. The majority of these will never aware of the diverticula.
- Mild cramping or tenderness in the left side of the abdomen that is relieved by passing gas or moving bowels;
- Occasional bright red blood in the stool. Non-infected diverticula sometimes bleed;
- Constipation (sometimes).
Diverticulitis symptoms – Intermittent cramping, abdominal pain that becomes constant. Pain may be disabling from the onset, or may not become disabling for several days.
- Tenderness over the affected area of the colon.
- Improper diet that lacks fiber;
- Family history of diverticulosis;
- Age over 50;
- Use of laxatives on a regular basis.
Diagnosis & Treatment
Diagnostic tests may include X-rays of the lower intestinal tract (barium enema), sigmoidoscopy (examination of the sigmoid using a flexible viewing tube) and colonoscopy (examination of the large intestine using a flexible viewing tube).
- Try to have a bowel movement at about the same time each day. Allow at least 10 minutes, and don’t strain;
- Check your stool daily for bleeding. If the stool is black, report to your doctor;
- Treatment is usually unnecessary if there are no symptoms. For mild symptoms, a change in diet by increasing the fiber in the diet and the use of stool softeners may be sufficient. For more severe symptoms, you may require bed rest, medications and surgery;
- To relieve mild pain and spasms, apply a heating pad to the abdomen;
- Surgery to remove part of the colon if diverticula become infected or bleed significantly;
- Hospitalization in cases with complications.
- Bulk-producing laxatives, if you are unable to eat a high-fiber diet. Don’t take laxatives unless prescribed;
- Stool softeners may be recommended;
- Antibiotics, if the diverticula are infected.
If you have fever or severe pain, stay in bed. Resume normal activity as soon as symptoms improve.
Eat a well-balanced diet that is high in fiber, low in salt and low in fat.
Possible Complications :
- If diverticula become infected, they may bleed profusely or perforate (erode through the intestinal wall) and cause peritonitis. Both are medical and surgical emergencies;
- Inflammation occurring in diverticulitis can lead to abnormal connections (fistulas) between the large intestine and other organs. Most fistulas form between the sigmoid colon and the bladder. Other fistulas may develop between the large intestine and the small intestine, uterus vagina, and abdominal wall.
Good with early detection and treatment of complications. Diverticulitis recurs in one-third of patients treated with medical management. Recurrent attacks warrant elective surgical resection, which carries a lower morbidity and mortality risk than emergency surgery.