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OVERVIEW

What is diverticular disease?

Diverticular disease is a group of conditions that affect your large intestine (colon) It involves small pouches or sacs called diverticula. These pouches can form  in your intestine wall.. The most common conditions of diverticular disease are:

• This is the base condition where the pouches form. It becomes more common as you age. Most people with diverticulosis don’t know they have it.
• This occurs when the pouches become inflamed or infected. It can cause pain and other symptoms. Serious cases could require staying in the hospital.
• Diverticular bleeding. Diverticular bleeding occurs when a blood vessel in a pouch bursts. It’s not as common as diverticulitis.

SYMPTOMS

Diverticulosis normally doesn’t have symptoms. It could cause mild cramps, bloating, constipation, and diarrhea. Many other conditions cause these symptoms, too.

The most common symptom of diverticulitis is severe abdominal pain. It is usually felt in the lower left side of your abdomen. It often comes on suddenly. It can also start out mild and increase over several days. Other symptoms could include fever, nausea, constipation, or diarrhea.

You may have diverticular bleeding if you see a large amount of blood in your stool or in the toilet.

CAUSES & RISK FACTORS

What causes diverticular disease?

Healthcare providers haven’t determined exactly what causes diverticular disease. They think it may be caused by not eating enough fibre. When you don’t eat enough fibre, your stools may not be soft. You can get constipated. Constipation and hard stools increase the pressure in the bowel walls. This pressure may cause the diverticular pouches to form.

Other factors that could contribute to diverticular disease include:

• genetics
• lack of exercise
• obesity
• smoking
• decrease in healthy gut bacteria
• increase in disease-causing bacteria in your colon
• certain medicines, including steroids and nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen

Diverticular disease becomes more common as you age. Your risk starts increasing after age 40. Most people have it by the time they’re 80 years old.

DIAGNOSIS & TESTS

How is diverticular disease diagnosed?

Your healthcare provider may check your abdomen for tenderness and ask you about your bowel habits, diet and medications. Your healthcare provider may also want to do some tests to screen for diverticular disease.  These tests can include:

• CT Scan. This test is a type of X-ray that allows your healthcare provider to see if you have pouches in your colon that are inflamed or infected.
• Barium enema (also called lower GI series). This test injects liquid barium into your rectum and colon. Then X-rays are taken. The barium makes your colon more visible on the X-rays.
• Flexible sigmoidoscopy. In this test, your healthcare provider puts a thin, flexible, hollow tube with a light on the end into your rectum. The tube is connected to a tiny video camera, which allows your healthcare provider to see the rectum and the last part of your colon.
• Before you have this test, you are given a medicine to make you relaxed and sleepy. A thin, flexible tube connected to a video camera is put into your rectum, which allows your healthcare provider to see your whole colon. A colonoscopy may be uncomfortable, but it is usually not painful.

Sometimes, diverticular disease is found when you are being tested for something else. This could include a screening for colorectal cancer or when tests are performed to diagnose other digestive problems.

PREVENTION

Can diverticular disease be prevented or avoided?

diet. You can increase the amount of fibre you eat by including more fruits, vegetables and whole-grain foods in your diet. Also be sure to drink plenty of fluids and exercise regularly.

TREATMENT

Diverticulosis treatment focuses on preventing the pouches from getting inflamed or infected. Your healthcare provider may recommend:

• a high-fibre diet
• fiber supplements
• medicines
• probiotics

For mild cases of diverticulitis, your healthcare provider may recommend rest and a liquid diet until symptoms ease. They may also prescribe medicine to treat the infection.

For severe cases of diverticulitis or diverticular bleeding, you may need to stay in the hospital. There you can get intravenous medicine and the rest you need. Some people need surgery to remove the pouches and diseased parts of their colon.

Living with diverticular disease

If you have diverticulosis, you may sometimes get flare-ups of diverticulitis. To prevent these, your healthcare provider may suggest you eat more fibre, drink plenty of fluids, and exercise regularly. This should help prevent the pouches from becoming infected or inflamed.

If you think certain foods are making your symptoms worse, stop eating them and talk to your healthcare provider.

Untreated diverticulitis can lead to dangerous complications. These include intestinal blockages and openings in the bowel wall.