Diverticular Disease

What is diverticular disease?

Diverticular disease is a group of conditions in which tiny pouches form in the colon. The pouches are called diverticula. 

These pouches bulge out through weak spots in your colon. The pouches can become inflamed (red, swollen) or infected. When the pouches are infected, the condition is called diverticulitis.

Diverticular disease includes:

  • Diverticulosis. This is when you have tiny pouches called diverticula in your colon.
  • Diverticulitis. This is when the pouches in your colon get infected.
  • Diverticular bleeding. This happens when a small blood vessel in a pouch breaks open and bleeds.

Over half of people in the United States over age 60 will have diverticulosis. Some people with diverticulosis also get diverticulitis.

Diverticular disease is often seen in developed countries. It is very common in the U.S., England, and Australia. People in these countries eat less fiber.

Diverticular disease is rare in countries such as Asia and Africa. People in these countries eat more fiber and more vegetables.

What causes diverticular disease?

Experts are not sure what causes diverticular disease. They think it might happen when you don’t eat enough fiber. Fiber is the part of fruits, vegetables, and grains that the body can’t digest.

Fiber helps make your stools soft and easy to pass. Eating more fiber helps stop constipation.

Constipation is the main cause of greater pressure in your colon. When you are constipated, your muscles strain to move stool that is too hard. The extra pressure from this straining makes the weak spots in your colon bulge out. These pouches that bulge out are the diverticula.

Experts do not know what causes the infection that leads to diverticulitis. They think the infection may start when stool or bacteria are caught in the diverticula.

Who is at risk for diverticular disease?

Experts don’t know for sure if your diet affects your risk of getting diverticular disease. But you are more at risk for the disease if you:  

  • Are over 50 years old
  • Are male
  • Have diverticulosis
  • Are obese
  • Don’t get enough exercise
  • Use nonsteroidal anti-inflammatory drugs (NSAIDS)
  • Smoke

What are the symptoms of diverticular disease?

Each
person’s symptoms may vary. Symptoms may include:

  • Diverticulosis.You can have diverticulosis and not have any pain or symptoms. But symptoms may
    include mild cramps, swelling or bloating, and constipation. These symptoms can also
    be caused by irritable bowel syndrome, stomach ulcers, or other health problems.
    These symptoms don’t always mean that you have diverticulosis.
  • Diverticulitis.The most common symptom of diverticulitis is belly or abdominal pain. The most
    common sign that you have it is feeling sore or sensitive on the left side of your
    lower belly. If infection is the cause, then you may have fever, nausea, vomiting,
    chills, cramping, and constipation.
  • Diverticular colitis. This is when the
    colon gets inflamed (colitis) as a result of the diverticular disease. This is less
    common than diverticulitis.
  • Diverticular bleeding. The
    most common symptom of diverticular bleeding is painless bleeding from the rectum.
    You likely will see bright red or maroon-colored blood in your stool.

The
symptoms of diverticular disease may look like other health problems. Always see your
healthcare provider to be sure.

How is diverticular disease diagnosed?

Your healthcare provider will look at your past health and do a physical exam. He or she may also use some of the following tests:

  • X-rays. A small amount of radiation is used
    to make images of body tissues onto film.
  • Digital rectal exam. This test checks if
    you have problems in the anus or rectal area. Your healthcare provider will gently
    put a gloved, lubricated finger into your rectum. Using his or her finger, your
    healthcare provider will check the muscle that closes off the anus.
  • A stool sample. This test checks for any
    abnormal bacteria or parasites in your digestive tract. To do this, a small stool
    sample is taken and sent to a lab.
  • CT scan. This test shows detailed images of
    any part of the body, such as the bones, muscles, fat, and organs. This is used to
    check for complications of diverticular disease like diverticulitis.
  • Barium enema.This is also called a lower GI (gastrointestinal) series. This is an X-ray exam
    of your rectum, the large intestine, and the lower part of your small intestine. You
    will be given a metallic fluid called barium. Barium coats the organs, so that they
    can be seen on an X-ray. The barium is put into a tube and inserted into your rectum
    as an enema. An X-ray of your belly will show if you have any narrowed areas
    (strictures), blockages, or other problems.
  • Virtual colonoscopy. This is a CT scan
    that checks your colon using air and contrast.
  • Flexible sigmoidoscopy. This test checks
    the inside of part of your large intestine. It helps to tell what is causing
    constipation. A short, flexible, lighted tube (sigmoidoscope) is put into your
    intestine through the rectum. This tube blows air into your intestine to make it
    swell. This makes it easier to see inside. A tissue sample (biopsy) can be taken if
    needed.
  • Colonoscopy. This test looks at the full
    length of your large intestine. It can help check for any abnormal growths, tissue
    that is red or swollen, sores (ulcers), or bleeding. A long, flexible, lighted tube
    (colonoscope) is put into your rectum up into the colon. This tube lets your
    healthcare provider see the lining of your colon and take out a tissue sample
    (biopsy) to test it. He or she can also treat some problems that may be found.