Diverticulosis / Diverticulitis

Diverticulosis means that there are pockets or projections extending out from the colon. These occur very gradually over a long period of time. They occur along the natural weak points in the bowel wall.

The pockets develop because of the pressure exerted within by the contracting colon. The sigmoid colon has the highest pressure in the colon, which makes it prone to develop diverticulosis. Because of these balloon-like projections, the sigmoid often becomes thickened and narrowed. When this happens, significant changes in the bowel function can occur, such as discomfort, diarrhea, and/or constipation.

Since it takes so long to develop, diverticulosis usually appears later in life. However, it is not uncommon to see this occur in people who are in their 30s. Eventually the colon, especially the sigmoid colon, becomes studded with these pockets. The disorder is mostly one of Western society. It is uncommon in rural Africa and India. The diet in these areas consists of unprocessed foods and grains with very high fiber content and hence, increased fiber ingestion may have great benefit.

Symptoms

As diverticuli form, few symptoms are noticeable, except perhaps for intermittent spastic discomfort in the left lower abdomen. Usually, there are no symptoms at all. When diverticulosis is far advanced, the lower colon may become very fixed, distorted, and even narrowed. When this occurs, there may be thin or pellet-shaped stools, constipation, and an occasional rush of diarrhea. The problem then becomes a mechanical or structural one, and treatment is more difficult.

Complications

It is, perhaps, remarkable that so few people have complications of diverticulosis when compared with the number of people who have the condition. Still, complications do occur and they can be serious. Diverticulitis, diverticular bleeding and perforation are the common complications. These conditions can require hospitalization, antibiotics and even diverticulosis surgery.

Diverticulosis may be preventable. As noted, fiber, bran and roughage should be an important part of the diet. Certain types of fiber, such as wheat bran retain large quantities of water. This, in turn, provides a bulkier stool. This type of large, soft stool may help decrease the pressure in the bowel over time. Bulking agents are available in drug stores and can be effective. The generic names for some of these products are psyllium and methycellulose.

Treatment

Treatment cannot reverse diverticulosis but is helpful. Bran and fiber can be found in very palatable forms in many cereals, breads and other foods. Generally, a daily intake of 20 to 30 grams is recommended, beginning at a young age as part of diverticulosis treatment. It is known that emotional stress can increase spasms of the colon and, perhaps, result in the formation of diverticuli. Stress should be controlled and treated if necessary. Also, medications can be used to decrease spasm in the colon.

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