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
Diverticulosis is very common in Western populations 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 it 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.