Diverticular Disease



Introduction

Diverticular disease is a very common condition affecting the large bowel (also known as the colon). Diverticulae are small pockets that appear in the lining of the colon; having these small pockets is known as having diverticular disease. They develop with age, so most people over 75 years of age have them and around one third of people over the age of 60. They are not so common in patients under the age of 50 years.

Why does diverticular disease develop?

The modern western diet is low in fibre and is thought that this leads to stools becoming firm and harder. Consequently the colon has to contract or push harder to pass stools. This leads to growth (hypertrophy) of the muscles of the colon. The increased force to push stools along the colon leads to the development of these pockets (diverticulae) to develop over time. So the diverticulae are made by the thin lining of the colon being pushed through the muscular layer of the colon, creating small pockets.

Problems caused by diverticular disease

In most people diverticular disease does not cause any problems. The finding of diverticular disease is usually incidental when having investigations for other symptoms. Some people with diverticular disease can have a change in bowel habit, leading to intermittent constipation or diarrhoea.

Diverticulitis

Occasionally patients can develop diverticulitis. Diverticulitis is when inflammation and infection can develop usually within one diverticulum (a single pocket). This usually causes the symptoms of abdominal pain, fever, diarrhoea and sometimes bleeding. The pain usually occurs on the left side of the abdomen since most diverticular disease is present in the left colon. Diverticulitis can be treated with antibiotics which usually settle down the episode; however, occasionally people need to be admitted to hospital for antibiotics and other treatments. If the diverticulitis is severe occasionally an abscess can develop and very occasionally a hole can form in the colon (called a perforation). This sometimes settles down with medications, however, occasionally an operation may be required to remove the involved segment of colon.

What should you do if you have diverticular disease?

  1. Increase your fibre intake. Best sources for soluble dietary fibre is peeled fruit, porridge
  2. Medications: fybogel if you have constipation
  3. Aim to drink at least 2 litres or 4 pints of water a day.
  4. There is no increased risk of colon cancer for patients with diverticular disease.