Diverticulosis is a condition which develops in a large percentage of the population as we age. Well over 50% of us will have the condition once we reach the age of 50-60; with the incidence approaching 80% by age 80.
Diverticulosis is not a disease, but a condition. It is the result of weakness which develops within the connective tissue of the wall of the colon. It is a normal process of aging much like developing wrinkles or gray hair. It becomes a problem or ‘disease’ when it causes inflammation called diverticulitis; or bleeding.
Diverticula are small out-pouchings of the colon wall which develop where the small blood vessels penetrate the bowel wall carrying blood to the inside layers of the colon.
Though the vast majority of people have diverticulosis, a relatively small percentage of people develop symptoms. Approximately 10% of those with diverticula will develop diverticulitis. Of those with diverticulitis 85% will recover without further episodes of inflammation. The vast majority of patients can be treated as an outpatient with antibiotics, with full recovery expected. Hospitalization is required in only 10-15% of patients. Overall, less than 1% of patients ultimately require surgery.
It is thought that diverticulitis is caused by increased pressures within the colon; resulting in decreased blood flow, inflammation and perforation of the diverticula. For this reason we recommend diets high in fiber for all patients; but especially those with a history of diverticulitis. This however, will not completely eliminate the risk of diverticulitis!
Contrary to popular belief, peanuts, seeds, nuts, and popcorn have not been found to increase the risk of diverticulitis. We therefore do not put restrictions on diet; while encouraging a diet high in fiber.
Diverticulitis usually presents as left lower abdominal pain. This can be relatively mild and may resolve on it’s own in mild cases. In more severe cases the pain increases in intensity, with fever, chills and other generalized symptoms of infection. These cases should be evaluated urgently, with CT scanning af the abdomen to assist in making the diagnosis. Treatment is then initiated depending on severity of symptoms and the findings on CT scan. Following recovery, all patients should undergo colonoscopy to rule out other causes of the symptoms, such as cancer and other types of inflammation.
Bleeding is a much less common complication of diverticulosis. Though the bleeding can be significant, it stops spontaneously in 90% of patients. Any bleeding requires a thorough evaluation. This will be discussed in upcoming articles.
For questions or to make an appointment call us at (812)-301-8110 Tri-State Colorectal.