Diverticulosis

What is diverticulosis?

Diverticulosis is the presence of weak areas or tiny pouches in the wall of the intestine. The pouches are usually in the part of the intestine called the colon. The pouches, called diverticula, look like small thumbs or tiny balloons poking out of the side of the colon.

Diverticulosis is a common condition. About half of the people over age 60 in the US have it.

How does it occur?

It appears that the main cause of diverticula is too little fiber in the diet. Fiber is the part of fruits, vegetables, and grains that the body cannot digest. Fiber helps make stools soft and easy to pass. It helps prevent constipation. When you have constipation, you strain to pass the stool that is too hard. The high pressure from the straining causes the weak spots in the colon to bulge out and become diverticula.

What are the symptoms?

Usually diverticulosis does not cause any symptoms. When symptoms occur, abdominal pain is the most common one. The pain is usually in the lower left abdomen. You may feel the pain most of the time, or it may come and go. You may also have more gas or constipation.

Diverticulosis can also cause painless bleeding from the rectum. Bleeding is less common than other symptoms.

When inflammation or infection occurs in or around the pouches, it is called diverticulitis. If you have fever as well as abdominal pain, you may have developed diverticulitis. You should see your healthcare provider if this happens.

How is it diagnosed?

Your healthcare provider will ask about your medical history and examine you. You may have some tests.

Diverticula are best seen with a special intestinal X-ray called a barium enema. In fact, diverticulosis may be discovered when you have this test for some other medical problem. Barium is put into your rectum and colon. The barium then shows the outline of the large intestine on the X-ray. The outline of diverticula can also be seen on the X-ray.

Sigmoidoscopy is another procedure that can find diverticula. The doctor inserts a scope into your rectum. The scope is a thin, flexible, lighted tube. The doctor can then look inside your large intestine. Depending on your symptoms, colonoscopy may be done instead to look for diverticula. The colonoscope is a longer tube. It allows your doctor to see more of the intestine than can be seen with the sigmoidoscope.

How is it treated?

Most importantly, you need to have more fiber in your diet. You can do this by eating more whole-grain products, such as whole-wheat and bran breads, cereals, and muffins. Also eat more fruits and vegetables. In addition, high-fiber dietary supplements may be helpful.

There is no evidence that any foods cause diverticulosis, but you may want to avoid eating foods that irritate the diverticula, such as popcorn kernels, sunflower seeds, sesame seeds, and nuts. If these foods do not seem to cause you abdominal pain, you may eat them.

If you have diverticulosis, you should always watch for symptoms of diverticulitis. See your healthcare provider right away if you have fever and abdominal pain.

How long will the effects last?

The pouches in the wall of the colon are permanent. Symptoms caused by these pouches may come and go. When you do have symptoms, they may last a few days or longer. Often symptoms can be prevented by having a healthy diet, plenty of water, and enough physical activity.

How can I help prevent diverticulosis?

The best way to try to avoid diverticulosis is to do the things that help you have bowel movements that are soft and easy to pass:

• Eat a healthy diet with lots of fiber.
• Drink plenty of water.
• Get enough regular exercise.