Key Definitions – Diverticular Disease
A person with diverticular disease may have diverticulosis, diverticulitis, or diverticular bleeding.
Diverticula / Diverticulum
Small pockets that form in the wall of the bowel. Diverticula is plural (more than one) and Diverticulum is singular (one pocket).
The formation of diverticula in the lining of the bowel. Diverticula can be small (pea-sized) or larger. The formation occurs because of increased pressure from fluid, waste, or gas on weak spots of the bowel wall.
Diverticulosis is common but rarely causes symptoms or problems during a patient’s lifetime. It’s found most often during a test for other reasons like a colonoscopy or sigmoidoscopy.
When one or more diverticula become infected or inflamed. This occurs most often when waste blocks the small pockets which allow bacteria to multiply and develop into an infection.
When a small artery in a diverticulum breaks into the colon. Diverticular bleeding is usually painless and causes bleeding from the rectum. Patients may see maroon or bright red blood during bowel movements.
Typically, Diverticulosis has no symptoms. It’s possible some may feel tenderness in the area or experience abdominal cramping.
Symptoms of diverticulitis include:
- Painful cramping which may persist for days. Often pain is felt in the left lower abdomen.
- Tenderness in the lower abdomen
- Nausea / Vomiting
- Fever / Chills
You should see a doctor if you have persistent, painful abdominal pain. Schedule an appointment.
Complications from diverticulitis are often the result of a tear or perforation in the wall of the intestine. This allows waste from the intestine to leak into the abdominal cavity. This can cause:
- Abscess — a collection of pus in the sack
- Fistula — an abnormal passageway between two areas not normally connected, such as the bowel and bladder
- Obstruction — a blockage in the colon
- Peritonitis — infection as a result of a tear or perforation in the wall of the intestine. This allows waste from the intestine to leak into the abdominal cavity. Peritonitis is a serious condition requiring immediate care.
- Sepsis — a bodywide infection that can lead to failure of multiple organs
Diverticulitis Risk Factors
There are several risk factors that can affect the likelihood of developing diverticulosis:
- Age: People over 40 are more likely to develop diverticulosis.
- Obesity: People who are significantly overweight are at increased risk of developing diverticulosis.
- Smoking: Smoking cigarettes increases your risk of diverticulosis compared to non-smokers.
- Lack of exercise: Exercise has shown to lower risk of diverticulosis.
Since most don’t experience symptoms, Diverticulosis is often found during medical procedures done for other reasons. Examples include routine colon cancer screenings such as a colonoscopy or examination for rectal bleeding or abdominal pain.
Diverticulitis is normally found during an acute attack. Because there are many causes of abdominal pain, your doctor will rule out other conditions first.
Your doctor may recommend the following tests:
- Blood Tests
- Pregnancy Test
- Liver enzyme test
- Stool test
- CT Scan
Those with diverticulosis who don’t have symptoms don’t need treatment. Doctors typically recommend adopting a high-fiber diet. Eating more fiber could possibly prevent additional diverticula from forming.
It was previously thought that eating seeds, nuts, and corn could lead to diverticulitis. However, there is no scientific evidence of this. Doctors no longer recommend that patients avoid eating seeds, nuts, or corn.
Treatment of diverticulitis will depend on the severity of your symptoms.
For mild diverticulitis symptoms, home treatment may be all that is required. Home treatment may include:
- Antibiotics – Antibiotics may be used to treat the infection. In some mild cases, antibiotics may not be necessary.
- Clear Liquid Diet – To give your bowels a break, your doctor may recommend a clear liquid diet. This will allow your bowel to heal. As symptoms improve you can begin to gradually add solid foods.
- If you develop a fever higher than 100.1ºF, abdominal pain, or are unable to tolerate liquids you should see a doctor. Schedule an appointment.
For severe symptoms of diverticulitis, hospital care may be necessary. This may include:
- Intravenous antibiotics and fluids. Patients do not eat or drink during this treatment, removing as much pressure on the bowels as possible.
- Abscess draining – If an abscess or colon blockage occurs, the doctor may need to drain the site. This is usually done with a small drainage tube placed through the abdomen, rectum, or vagina.
Surgery for Diverticulitis may not be necessary if you improve with medical treatment. If you develop an abdominal infection (Peritonitis) it will usually require surgery.
Types of Diverticulitis Surgery
In this procedure, the surgeon removes the diseased portion of the intestine and reconnects the healthy areas. In more mild cases, this surgery can be performed using less invasive laparoscopic techniques. This type of resection is often used in non-emergency cases.
Resection & Colostomy
If the intestinal inflammation is too great, it may not be possible to reconnect the healthy portions of your colon to the rectum after removing the diseased portion. In this case, the surgeon will create a colostomy. A colostomy creates an opening (stoma) in your skin that connects to the colon. Waste flows through the opening and collects in a bag.
After a few months, inflammation should be reduced enough to surgically reconnect the colon and allow waste to flow normally through the rectum. The stoma is closed and colostomy bag removed.
Improving the health of your bowel is the best preventative measure for diverticulosis. That includes:
- Consuming 20 to 35 grams of fiber each day
- Avoiding constipation and straining during bowel movements
- Drinking eight 8-ounce glasses of water a day
- Exercising most days
Are Diverticulitis, Diverticulosis, and Diverticular disease the same thing?
No. Diverticulousis is the formation of diverticula, Diverticulitis is when diverticula become infected or inflamed, and Diverdictular disease is the blanket term to describe both conditions.