Diverticular Disease

Diverticulosis occurs when small pouches, known as diverticula, form in the walls of the large intestine or colon. Diverticulitis occurs when those pouches, or diverticula, become infected or inflamed. Between 10 and 25 percent of people with diverticulosis develop diverticulitis.

Diverticular disease is believed to be caused by increased pressure in the colon. The colon weakens with age and with increased pressure small pouches, called diverticula, can bulge out at the weakest places in the intestinal wall. One of the causes of this pressure can be related to constipation. Normally, your colon muscles move in waves, expanding and contracting as they move waste through your system. But when waste material is hard and dry, the muscles have to squeeze harder, and with more force. In addition to not getting enough fiber and fluids, other causes of constipation include: lack of exercise; ignoring the urge to have a bowel movement; stress and anxiety; medications side effects; and changes in life and routine; such as pregnancy and travel.

Most people with diverticulosis do not have symptoms, and they are typically found during routine examinations such as X-ray, sigmoidoscopy or colonoscopy. When symptoms are present, they may include constipation, abdominal pain or cramping, diarrhea and abdominal bloating. Since other conditions have similar symptoms, see your doctor if these symptoms occur. In rare cases the diverticula may bleed, which you will notice in your stool or in the toilet. If bleeding occurs, see your doctor to assess and manage the bleeding. The most common symptoms of diverticulitis are abdominal pain or cramping, which usually occurs on the left side. Other symptoms include nausea, vomiting, fever and constipation.

In cases of diverticulosis, a physician may recommend that you increase the fiber in your diet. Some sources of fiber, specifically nuts and corn, may aggravate diverticulosis. Consult your physician as to what sources of fiber are best for you. In cases of diverticulitis, antibiotics may be prescribed to heal the infected diverticula. While the colon is healing, the doctor may recommend a low fiber diet for a period of time. If attacks are severe or recurrent, surgery may be required.

There are several ways to help prevent and manage diverticular disease. Follow a high fiber diet and drink plenty of fluids; this has been shown to decrease the pressure in your colon, help soften stools and promote regular bowel habits.

More information on a high fiber diet can be located in the Patient Information tab under the heading GI Diets. Don’t ignore the urge to have a bowel movement. Delaying now can mean straining later, which increase the pressure in your colon.