Diverticulosis

Diverticulosis is a condition where small pouches or pockets (diverticulae) develop in the lining of the digestive tract- Typically it occurs most frequently in the colon more on the left side but can involve the entire colon or parts of the small intestine.

It is a very common occurrence as people age with an estimated 65 % of all patients having some degree of diverticulosis by age 80, though it can be seen in people as young as 40.

It is felt that diverticulosis is caused by lack of fiber in diet (diverticulosis is uncommon in regions of the world with a high fiber /grain diet) which leads to increase pressure in the digestive tract and constipation. These leads to a strain at points of weakness in the intestinal wall where the pouches develop.

Most patients with diverticulosis do not develop symptoms.

There are three types of complications from Diverticulosis

  1. Diverticulitis- this occurs when the pouches or pockets become inflamed or infected. Some bacteria from inside the intestine seeps out and causes an infection around the area of the defect. This typically presents as localized abdominal pain, tender abdomen to touch, and fever- A patient may also complain of nausea and vomiting, and constipation. Only about 15-20% of patients with diverticulosis develop diverticulitis.
  2. Diverticular Bleeding- Probably the most common cause of major rectal bleeding in patients over the age of 40.  It presents as recurrent episodes (within an hour or so) of bright red blood or maroon blood from the rectum typically without pain or bowel movement. This is typically caused by a rupture of a blood vessel that is located at the site of one of the pouches.
  3. Obstruction/Fistula formation-this is a blockage of the intestine or a connection between the bowel and neighboring structures such as the bladder or uterus- surgery is usually needed

Once you have diverticulosis there is nothing you can do to reverse it. We do recommend a high fiber and fluid diet but again the literature is mixed on the benefits. There are a lot of “urban myth’s” that have recently been dispelled or called into question

-avoidance of seeds, pits, popcorn, sesame, and poppy seeds can prevent attacks-There has been recent conclusive studies to show that avoiding certain foods doesn’t make any difference in terms or getting attacks

-Antibiotics are always needed- recent studies have suggested that not all cases of uncomplicated diverticulitis need antibiotics- We may be using too many antibiotics as a rule and in the appropriate patient liquid diet, analgesics with Tylenol may work just as well

We encourage you to discuss your condition and concerns with your physician

The preceding information is provided by DDC of NJ and is not a definitive basis for diagnosis and treatment in any individual case.