The colon or large intestine is a part of digestive system, which stores and eliminates waste material left after the digestion of food in the small intestine. Diverticulosis is referred to as formation of small pouches or diverticula on the lining of intestine due to increased pressure of hard stools passing through the weakened intestine. The condition is associated with aging. People after the age of 40 are more likely to develop diverticulosis. Diverticulosis usually doesn’t cause any symptoms, hence remains unnoticeable. When diverticula get infected and inflamed, it can give rise to the symptoms like abdominal pain, nausea, vomiting, constipation, diarrhea, changes in bowel habits and fever. Diverticulosis and its complications including diverticulitis can be collectively referred to as diverticular disease.
Causes of Diverticular Disease
Pressure within the colon gives rise to bulging tissue sacs that protrude from the colonic walls. These sacs are identified as diverticula and the condition is known as diverticulosis. Diverticula can be formed throughout the colon; however, the most common site is the sigmoid colon, the end of the left colon. When the diverticulum ruptures and gets infected, the condition is known as diverticulitis.
The exact causes of diverticular disease are unknown. Consumption of low-fiber diet is supposed to be the major contributing factor. People who eat more processed foods like white rice or white bread are at higher risk of developing diverticular disease. Some other factors that can increase the risk of diverticulosis are aging, obesity, lack of exercise and smoking. Reduced strength and elasticity of bowel wall due to aging increases the risk of diverticular disease.
Symptoms of Diverticulosis and Diverticulitis
Diverticulosis is usually asymptomatic; means the sufferer don’t notice any symptoms. Many people are not aware of having diverticulosis. They come to know about it during routine screening examinations for other intestinal problems. When multiple diverticula are present, the normal functioning of the bowel can be affected. This may give rise to the symptoms like abdominal pain and bloating, constipation, diarrhea and flatulence. In some cases, there may be blood in faeces, if diverticulum gets inflamed or if it is present near the blood vessel. The sufferer may experience anemia, if repeated bleeding occurs.
On the other hand, diverticulitis can be diagnosed during an acute attack. The symptoms are quite severe and can start suddenly. Some of the common signs and symptoms of diverticulitis are abdominal pain and tenderness, constipation, diarrhea, nausea and vomiting, bloating, changes in bowel habits and fever.
Some of the possible complications of diverticular disease include formation of fistula, abscess in the large intestine, perforation (hole or tear in the colon), peritonitis and hemorrhage.
Diagnosis of Diverticulosis and Diverticulitis
If suspected, diverticulosis and diverticulitis can be diagnosed on the basis of a variety of tests. The colon can be visualized by barium X-rays. Diverticula can be seen as barium-filled pouches that protrude from the colon wall. Sigmoidoscopes or colonoscopes are used to make direct visualization of inside of the colon and openings of diverticula. This test is helpful for the confirmation of diagnosis and to rule out possibility of other diseases that can resemble diverticular disease. If the patient is suspected for diverticulitis, then ultra-sound and computerized tomography (CT) scan of the abdomen and pelvis can be performed to detect inflammation of tissues surrounding the ruptured diverticulum.
Treatment for Diverticulosis and Diverticulitis
Most people with diverticulosis have no noticeable symptoms and they don’t need any medical treatment. The normal fiber diet is recommended to prevent constipation and to prevent formation of more diverticula. Patients with mild symptoms like abdominal pain may benefit from anti-spasmodic drugs like dicyclomine, chlordiazepoxide, phenolbarbital and hyoscyamine.
In cases of diverticulitis, when the symptoms are quite painful and severe, antibiotics are required. Oral antibiotics like ciprofloxacin, cephalexin, metronidazole and doxycycline are prescribed. For acute attacks of diverticulitis, liquid or low-fiber diet is advised to take along with antibiotics. Patients with severe diverticulitis with extreme pain and high fever are advised to be hospitalized for intravenous antibiotics. Surgery is required for those with persistent bowel obstruction or abscess.
Diverticular disease is a very painful condition that can affect the quality of life. You can prevent it by means of balanced lifestyle, consumption of high-fiber foods, regular exercising and staying away from unhealthy habits.