Diverticular disease consists of diverticulosis and
diverticulitis. Diverticulosis is the formation of numerous tiny
pockets, or diverticula, in the lining of the bowel. Diverticula,
which can range from pea-size to much larger, are formed by
increased pressure on weakened spots of the intestinal walls by
gas, waste, or liquid. Diverticula can form while straining during
a bowel movement, such as with constipation. They are most common
in the lower portion of the large intestine (called the sigmoid
colon).
Complications can occur in about 20 percent of people with
diverticulosis. One of these complications is rectal bleeding,
called diverticular bleeding, and the other is diverticulitis.
Diverticular bleeding occurs with chronic injury to the small
blood vessels that are adjacent to the diverticula. Diverticulitis
occurs when there is inflammation and infection in one or more
diverticula. This usually happens when outpouchings become blocked
with waste, allowing bacteria to build up, causing infection.
Diverticulosis is very common and occurs in 10 percent of people
over age 40 and in 50 percent of people over age 60. The occurrence
of diverticulosis increases with age and affects almost everyone
over age 80.
What are the symptoms of diverticulosis?
Usually
diverticulosis does not cause any troublesome symptoms. Some people
may feel tenderness over the affected area or abdominal cramps.
How is diverticulosis diagnosed?
Because most
people with diverticulosis do not have any symptoms, it is usually
found through tests ordered for an unrelated reason.
How is diverticulosis treated?
People who have
diverticulosis without symptoms or complications do not need
treatment, yet it is important to adopt a high-fiber diet.
Laxatives should not be used to treat diverticulosis, and enemas
should also be avoided or used infrequently.
How can diverticulosis be prevented?
Good bowel
hygiene is most important to prevent diverticular disease or reduce
the complications from it. This means having regular bowel
movements and avoiding constipation and straining. Eating
appropriate amounts of the right types of fiber are important to
maintain good bowel hygiene. Drinking plenty of water and
exercising regularly are also important.
The American Dietetic Association recommends 20 to 35 grams of
fiber a day. Every person, regardless of the presence of
diverticula, should try to consume this much fiber every day. Fiber
is the indigestible part of plant foods. High-fiber foods include
whole grain breads, cereals and crackers; berries; fruit;
vegetables, such as broccoli, cabbage, spinach, carrots, asparagus,
squash, and beans; brown rice; bran products; and cooked dried peas
and beans, among other foods.